Michael Chuong1, John Bryant2, William Hartsell3, Gary Larson4, Shahed Badiyan5, George E Laramore6, Sanford Katz7, Henry Tsai8, Carlos Vargas9. 1. Department of Radiation Oncology, Miami Cancer Institute, Miami, FL, USA. 2. Florida International University Herbert Wertheim College of Medicine, Miami, FL, USA. 3. Proton Therapy Center, Northwestern University - Chicago, Chicago, IL, USA. 4. ProCure Proton Therapy Center Oklahoma, Oklahoma City, OK, USA. 5. Department of Radiation Oncology, Washington University, St. Louis, MO, USA. 6. Department of Radiation Oncology, University of Washington Medical Center, Seattle, WA, USA. 7. Department of Radiation Oncology, Willis-Knighton Medical Center, Shreveport, LA, USA. 8. ProCure Proton Therapy Center Somerset, Somerset, NJ, USA. 9. Mayo Clinic Arizona, Scottsdale, AZ, USA.
Abstract
Introduction: Proton beam therapy (PBT) reduces normal organ dose compared to intensity-modulated radiation therapy (IMRT) for patients with major salivary gland tumors. It is not known whether this dosimetric advantage is clinically meaningful for reducing acute toxicity. Methods: We evaluated treatment parameters and acute toxicity outcomes of patients with major salivary gland cancers enrolled on the Proton Collaborative Group REG001-09 trial (NCT01255748). Results: One-hundred and five patients with a median age of 61 years were included. The majority had parotid (N = 90) versus submandibular gland (N = 15) tumors. The patients were treated across seven institutions in the United States between 2010 and 2017, most commonly in the postoperative setting (70.5%) although a minority were treated definitively (29.5%). Median PBT dose was 66.5 GyE in 33 fractions; only one patient was prescribed less than 50 GyE. Chemotherapy was given concurrently to 20%. Median follow-up was 14.3 months. Acute grade 2 or higher toxicity included nausea (1.5%), dysgeusia (4.8%), xerostomia (7.6%), mucositis (10.5%) and dysphagia (10.5%).Conclusions: PBT should be strongly considered when ipsilateral radiation therapy is indicated for major salivary gland cancer based on a considerably lower incidence of acute grade 2 or higher toxicity in this analysis compared to historical IMRT outcomes.
Introduction: Proton beam therapy (PBT) reduces normal organ dose compared to intensity-modulated radiation therapy (IMRT) for patients with major salivary gland tumors. It is not known whether this dosimetric advantage is clinically meaningful for reducing acute toxicity. Methods: We evaluated treatment parameters and acute toxicity outcomes of patients with major salivary gland cancers enrolled on the Proton Collaborative Group REG001-09 trial (NCT01255748). Results: One-hundred and five patients with a median age of 61 years were included. The majority had parotid (N = 90) versus submandibular gland (N = 15) tumors. The patients were treated across seven institutions in the United States between 2010 and 2017, most commonly in the postoperative setting (70.5%) although a minority were treated definitively (29.5%). Median PBT dose was 66.5 GyE in 33 fractions; only one patient was prescribed less than 50 GyE. Chemotherapy was given concurrently to 20%. Median follow-up was 14.3 months. Acute grade 2 or higher toxicity included nausea (1.5%), dysgeusia (4.8%), xerostomia (7.6%), mucositis (10.5%) and dysphagia (10.5%).Conclusions: PBT should be strongly considered when ipsilateral radiation therapy is indicated for major salivary gland cancer based on a considerably lower incidence of acute grade 2 or higher toxicity in this analysis compared to historical IMRT outcomes.
Authors: Robert H Press; Richard L Bakst; Sonam Sharma; Rafi Kabarriti; Madhur K Garg; Brian Yeh; Daphna Y Gelbum; Shaakir Hasan; J Isabelle Choi; Chris A Barker; Arpit M Chhabra; Charles B Simone; Nancy Y Lee Journal: Int J Part Ther Date: 2021-06-25
Authors: Alexander N Hanania; Xiaodong Zhang; G Brandon Gunn; David I Rosenthal; Adam S Garden; C David Fuller; Jack Phan; Jay P Reddy; Amy Moreno; Gregory Chronowski; Shalin Shah; Noveen Ausat; Ehab Hanna; Renata Ferrarotto; Steven J Frank Journal: Int J Part Ther Date: 2021-06-25