Proton therapy for nasopharyngeal carcinoma.

The treatment of nasopharyngeal carcinoma (NPC) has traditionally included a multimodality approach including radiotherapy (RT) and systemic chemotherapy. RT has long been favored as the mainstay of local treatment for disease in this challenging anatomic location owing to the morbidity of extensive surgical resection in the nasopharynx. However, NPC presents a unique treatment challenge for radiation oncologists because such tumors typically involve complex anatomic structures near several critical organ structures such as the brainstem, spinal cord, temporal lobes, salivary glands, cochleae, oral cavity, mandible and optic structures. Thus, radiation is not without toxicity, and critical organs in these areas clearly benefit from the use of conformal and precise treatment delivery. The unique physical properties of proton radiotherapy (PRT) make it especially well-suited for treating tumors in this anatomically complex area and offer promising potential for acute and chronic toxicity reduction while maintaining excellent disease control.