BACKGROUND AND PURPOSE: IMPT improves normal tissue sparing compared to VMAT in treating oropharyngeal cancer (OPC). Our aim was to assess if this translates into clinical benefits. MATERIALS AND METHODS: OPC patients treated with definitive or adjuvant IMPT or VMAT from 2013 to 2018 were included. All underwent prospective assessment using patient-reported-outcomes (PROs) (EORTC-QLQ-H&N35) and provider-assessed toxicities (CTCAEv4.03). End-of-treatment and pretreatment scores were compared. PEG-tube use, hospitalization, and narcotic use were retrospectively collected. Statistical analysis used the Wilcoxon Rank-Sum Test with propensity matching for PROs/provider-assessed toxicities, and t-tests for other clinical outcomes. RESULTS: 46 IMPT and 259 VMAT patients were included; median follow-up was 12 months (IMPT) and 30 months (VMAT). Baseline characteristics were balanced except for age (p = 0.04, IMPT were older) and smoking (p < 0.01, 10.9% IMPT >20PYs, 29.3% VMAT). IMPT was associated with lower PEG placement (OR = 0.27; 95% CI: 0.12-0.59; p = 0.001) and less hospitalization ≤60 days post-RT (OR = 0.21; 95% CI:0.07-0.6, p < 0.001), with subgroup analysis revealing strongest benefits in patients treated definitively or with concomitant chemoradiotherapy (CRT). IMPT was associated with a relative risk reduction of 22.3% for end-of-treatment narcotic use. Patients reported reduced cough and dysgeusia with IMPT (p < 0.05); patients treated definitively or with CRT also reported feeling less ill, reduced feeding tube use, and better swallow. Provider-assessed toxicities demonstrated less pain and mucositis with IMPT, but more mucosal infection. CONCLUSION: IMPT is associated with improved PROs, reduced PEG-tube placement, hospitalization, and narcotic requirements. Mucositis, dysphagia, and pain were decreased with IMPT. Benefits were predominantly seen in patients treated definitively or with CRT.
BACKGROUND AND PURPOSE: IMPT improves normal tissue sparing compared to VMAT in treating oropharyngeal cancer (OPC). Our aim was to assess if this translates into clinical benefits. MATERIALS AND METHODS: OPC patients treated with definitive or adjuvant IMPT or VMAT from 2013 to 2018 were included. All underwent prospective assessment using patient-reported-outcomes (PROs) (EORTC-QLQ-H&N35) and provider-assessed toxicities (CTCAEv4.03). End-of-treatment and pretreatment scores were compared. PEG-tube use, hospitalization, and narcotic use were retrospectively collected. Statistical analysis used the Wilcoxon Rank-Sum Test with propensity matching for PROs/provider-assessed toxicities, and t-tests for other clinical outcomes. RESULTS: 46 IMPT and 259 VMAT patients were included; median follow-up was 12 months (IMPT) and 30 months (VMAT). Baseline characteristics were balanced except for age (p = 0.04, IMPT were older) and smoking (p < 0.01, 10.9% IMPT >20PYs, 29.3% VMAT). IMPT was associated with lower PEG placement (OR = 0.27; 95% CI: 0.12-0.59; p = 0.001) and less hospitalization ≤60 days post-RT (OR = 0.21; 95% CI:0.07-0.6, p < 0.001), with subgroup analysis revealing strongest benefits in patients treated definitively or with concomitant chemoradiotherapy (CRT). IMPT was associated with a relative risk reduction of 22.3% for end-of-treatment narcotic use. Patients reported reduced cough and dysgeusia with IMPT (p < 0.05); patients treated definitively or with CRT also reported feeling less ill, reduced feeding tube use, and better swallow. Provider-assessed toxicities demonstrated less pain and mucositis with IMPT, but more mucosal infection. CONCLUSION: IMPT is associated with improved PROs, reduced PEG-tube placement, hospitalization, and narcotic requirements. Mucositis, dysphagia, and pain were decreased with IMPT. Benefits were predominantly seen in patients treated definitively or with CRT.
Authors: Sabah Falek; Rajesh Regmi; Joel Herault; Melanie Dore; Anthony Vela; Pauline Dutheil; Cyril Moignier; Pierre-Yves Marcy; Julien Drouet; Arnaud Beddok; Noah E Letwin; Joel Epstein; Upendra Parvathaneni; Juliette Thariat Journal: Support Care Cancer Date: 2022-05-05 Impact factor: 3.359
Authors: Nicolette Taku; Li Wang; Adam S Garden; David I Rosenthal; G Brandon Gunn; William H Morrison; C David Fuller; Jack Phan; Jay P Reddy; Amy C Moreno; Michael T Spiotto; Gregory Chronowski; Shalin J Shah; Lauren L Mayo; Neil D Gross; Renata Ferrarotto; X Ronald Zhu; Xiaodong Zhang; Steven J Frank Journal: Curr Treat Options Oncol Date: 2021-06-04
Authors: Yihang Xu; Jonathan Cyriac; Mariluz De Ornelas; Elizabeth Bossart; Kyle Padgett; Michael Butkus; Tejan Diwanji; Stuart Samuels; Michael A Samuels; Nesrin Dogan Journal: Front Oncol Date: 2021-10-19 Impact factor: 6.244
Authors: James E Han; Alicia Lozano; Shaakir Hasan; J Isabelle Choi; Arpit M Chhabra; Henry Tsai; Nasiruddin Mohammed; Samir Patel; Sanford Katz; John H Chang; Charles B Simone; Robert H Press Journal: Int J Part Ther Date: 2022-07-06
Authors: Grace L Smith; Shuangshuang Fu; Matthew S Ning; Diem-Khanh Nguyen; Paul M Busse; Robert L Foote; Adam S Garden; Gary B Gunn; Clifton D Fuller; William H Morrison; Gregory M Chronowski; Shalin J Shah; Lauren L Mayo; Jack Phan; Jay P Reddy; James W Snider; Samir H Patel; Sanford R Katz; Alexander Lin; Nasiruddin Mohammed; Roi Dagan; Nancy Y Lee; David I Rosenthal; Steven J Frank Journal: Int J Part Ther Date: 2021-06-25
Authors: Xingzhe Li; Sarin Kitpanit; Anna Lee; Dennis Mah; Kevin Sine; Eric J Sherman; Lara A Dunn; Loren S Michel; James Fetten; Kaveh Zakeri; Yao Yu; Linda Chen; Jung Julie Kang; Daphna Y Gelblum; Sean M McBride; Chiaojung J Tsai; Nadeem Riaz; Nancy Y Lee Journal: JAMA Netw Open Date: 2021-06-01
Authors: Danmeng Huang; Steven J Frank; Vivek Verma; Nikhil G Thaker; Eric D Brooks; Matthew B Palmer; Ross F Harrison; Ashish A Deshmukh; Matthew S Ning Journal: Int J Part Ther Date: 2021-06-25
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