PURPOSE: To assess accelerated fractionation using photon and proton radiation to improve local control and reduce complications in treating locally advanced oropharyngeal cancer. METHODS AND MATERIALS: Twenty-nine patients with localized Stage II-IV oropharyngeal cancer received accelerated photon and proton radiation, 75.9 GyE in 45 fractions/5.5 weeks, to the primary disease, involved lymph nodes, and potential areas of subclinical spread. Follow-up ranged from 2 to 96 months. RESULTS: Five-year actuarial control for local disease was 88%, and for neck node disease, 96%; yielding a 84% locoregional control rate at 5 years. Four patients developed distant metastases. The 5-year actuarial locoregional control rate was 84%. The actuarial 2-year disease-free survival rate was 81%; at 5 years, it was 65%. All patients completed the prescribed treatment; though aggressive nutritional and anesthetic support was necessary. Late Grade 3 toxicity was seen in 3 patients. CONCLUSIONS: Protons used as a concomitant boost with photons effectively delivered an accelerated time-dose schedule to the cancer with a more tolerable schedule to surrounding normal tissues. Preliminary results reveal increased locoregional control without increased toxicity. Future studies must evaluate the optimum time-dose schedule.
PURPOSE: To assess accelerated fractionation using photon and proton radiation to improve local control and reduce complications in treating locally advanced oropharyngeal cancer. METHODS AND MATERIALS: Twenty-nine patients with localized Stage II-IV oropharyngeal cancer received accelerated photon and proton radiation, 75.9 GyE in 45 fractions/5.5 weeks, to the primary disease, involved lymph nodes, and potential areas of subclinical spread. Follow-up ranged from 2 to 96 months. RESULTS: Five-year actuarial control for local disease was 88%, and for neck node disease, 96%; yielding a 84% locoregional control rate at 5 years. Four patients developed distant metastases. The 5-year actuarial locoregional control rate was 84%. The actuarial 2-year disease-free survival rate was 81%; at 5 years, it was 65%. All patients completed the prescribed treatment; though aggressive nutritional and anesthetic support was necessary. Late Grade 3 toxicity was seen in 3 patients. CONCLUSIONS: Protons used as a concomitant boost with photons effectively delivered an accelerated time-dose schedule to the cancer with a more tolerable schedule to surrounding normal tissues. Preliminary results reveal increased locoregional control without increased toxicity. Future studies must evaluate the optimum time-dose schedule.
Authors: David G Pfister; Sharon Spencer; David M Brizel; Barbara Burtness; Paul M Busse; Jimmy J Caudell; Anthony J Cmelak; A Dimitrios Colevas; Frank Dunphy; David W Eisele; Robert L Foote; Jill Gilbert; Maura L Gillison; Robert I Haddad; Bruce H Haughey; Wesley L Hicks; Ying J Hitchcock; Antonio Jimeno; Merrill S Kies; William M Lydiatt; Ellie Maghami; Thomas McCaffrey; Loren K Mell; Bharat B Mittal; Harlan A Pinto; John A Ridge; Cristina P Rodriguez; Sandeep Samant; Jatin P Shah; Randal S Weber; Gregory T Wolf; Frank Worden; Sue S Yom; Nicole McMillian; Miranda Hughes Journal: J Natl Compr Canc Netw Date: 2015-07 Impact factor: 11.908
Authors: Charles B Simone; David Ly; Tu D Dan; John Ondos; Holly Ning; Arnaud Belard; John O'Connell; Robert W Miller; Nicole L Simone Journal: Radiother Oncol Date: 2011-06-12 Impact factor: 6.280
Authors: G Brandon Gunn; Pierre Blanchard; Adam S Garden; X Ronald Zhu; C David Fuller; Abdallah S Mohamed; William H Morrison; Jack Phan; Beth M Beadle; Heath D Skinner; Erich M Sturgis; Merrill S Kies; Kate A Hutcheson; David I Rosenthal; Radhe Mohan; Michael T Gillin; Steven J Frank Journal: Int J Radiat Oncol Biol Phys Date: 2016-02-12 Impact factor: 7.038