Definitive proton beam therapy for adenoid cystic carcinoma of the nasopharynx involving the base of skull

Gentile, Michelle S.; Yip, D.; Liebsch, Norbert J.; Adams, Judith; Busse, Paul M.; Chan, Annie W.

doi:10.1016/j.oraloncology.2016.11.016

Cited by 35 publications

(60 citation statements)

References 20 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although IMRT can provide conformality in these clinical situations, reports have shown suboptimal outcomes for patients with T4 tumors in nasopharyngeal cancer, likely because of the advanced nature of the disease in close proximity to critical structures, such as the temporal lobes and cranial nerves [6,7]. A retrospective study [8] of 14 patients with unresectable adenoid cystic carcinoma of the nasopharynx treated with proton therapy found 93% had T4 disease. At median follow-up of 69 months, there were 3 local failures (21%) and 3 patients (21%) with grade 3 or higher late toxicity, thus highlighting the acceptable rates in an otherwise difficult disease to control [8] Most patients in the current study had T4 (94 of 303; 31.0%) underscoring the utility of proton therapy in advanced disease.…”

Section: Discussionmentioning

confidence: 99%

“…A retrospective study [8] of 14 patients with unresectable adenoid cystic carcinoma of the nasopharynx treated with proton therapy found 93% had T4 disease. At median follow-up of 69 months, there were 3 local failures (21%) and 3 patients (21%) with grade 3 or higher late toxicity, thus highlighting the acceptable rates in an otherwise difficult disease to control [8] Most patients in the current study had T4 (94 of 303; 31.0%) underscoring the utility of proton therapy in advanced disease. A systematic review and meta-analysis of patients with nasal cavity and paranasal sinus cancer from 41 observational studies compared 1186 photon cases to 286 charged-particle cases [9].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Trends and Disparities of Proton Therapy Use among Patients with Head and Neck Cancer: Analysis from the National Cancer Database (2005-14)

Lee

Kang

et al. 2019

International Journal of Particle Therapy

View full text Add to dashboard Cite

Purpose: The purpose of this study was to analyze national trends and disparities in proton therapy use among patients with head and neck cancer receiving radiotherapy to primary disease sites. Patients and Methods: Using the National Cancer Database, we identified patients diagnosed with any nonmetastatic head and neck primary malignancy between 2005 and 2014 who were treated with radiation therapy or proton therapy directed specifically at the primary disease site. Distributions of patient and clinical factors between the two groups were evaluated. Multivariable logistic regression was used to correlate factors associated with proton therapy use compared with other modalities of radiation therapy. Results: There were 220 491 patients who received any radiation therapy as part of their initial treatment course, only 417 (0.2%) of whom received proton therapy. The use of protons underwent a small increase from 0.13% in 2005-06 to 0.41% by 2013-14 (P < .001). The most common primary sites treated with proton therapy were the nasal cavity/nasopharynx (n = 151, 36.2%) and the oral cavity (n = 98, 23.5%). Most patients had T4 disease (n = 94, 31.0%). On multivariable logistic regression, all primary sites compared with hypopharynx/larynx sites (odds ratio [OR], 2.53-10.53; P < .001), treatment at an academic facility (OR, 2.54; P < .001), ≥ 13-mile distance from the treating facility (OR, 1.94; P < .001), and highest median household income quartile (> $63 000; OR, 2.52; P = .002) were associated with an increased likelihood of receiving proton therapy. Conclusion: Proton use has undergone an incremental increase in the United States but remains an uncommon modality for the treatment of primary head and neck cancer.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Trends and Disparities of Proton Therapy Use among Patients with Head and Neck Cancer: Analysis from the National Cancer Database (2005-14)

Lee

Kang

et al. 2019

International Journal of Particle Therapy

View full text Add to dashboard Cite

show abstract

“…The high conformity of the proton beam allows one to spare critical structures at all dose levels with acceptable homogeneity within the target volume . As a result, proton beam therapy for the nasal cavity and paranasal sinuses has been shown to have very promising outcome with potential lower toxicity than photon therapy . However, the same characteristics that make protons attractive may result in high sensitivity of the proton beam to anatomic changes occurring during treatment.…”

Section: Introductionmentioning

confidence: 99%

Impact of aeration change and beam arrangement on the robustness of proton plans

Shusharina

Fullerton

Adams

et al. 2019

J Applied Clin Med Phys

Self Cite

View full text Add to dashboard Cite

This study determines the impact of change in aeration in sinonasal cavities on the robustness of passive‐scattering proton therapy plans in patients with sinonasal and nasopharyngeal malignancies. Fourteen patients, each with one planning CT and one CT acquired during radiotherapy were studied. Repeat and planning CTs were rigidly aligned and contours were transferred using deformable registration. The amount of air, tumor, and fluid within the cavity containing the tumor were measured on both CTs. The original plans were recalculated on the repeat CT. Dosimetric changes were measured for the targets and critical structures. Median decrease in gross tumor volume (GTV) was 19.8% and correlated with the time of rescan. The median change in air content was 7.1% and correlated with the tumor shrinkage. The median of the mean dose Dmean change was +0.4% for GTV and +0.3% for clinical target volume. Median change in the maximum dose Dmax of the critical structures were as follows: optic chiasm +0.66%, left optic nerve +0.12%, right optic nerve +0.38%, brainstem +0.6%. The dose to the GTV decreased by more than 5% in 1 case, and the dose to critical structure(s) increased by more than 5% in three cases. These four patients had sinonasal cancers and were treated with anterior proton fields that directly transversed through the involved sinus cavities. The change in dose in the replanning was strongly correlated with the change in aeration (P = 0.02). We found that the change in aeration in the vicinity of the target and the arrangement of proton beams affected the robustness of proton plan.

show abstract

“…The refractoriness of non‐squamous cell malignant tumors of the nasopharynx means that there are no proper data for their treatment. Indeed, there are only a few single case reports about the clinical outcome of treatment for non‐squamous cell malignant tumors of the nasopharynx …”

Section: Introductionmentioning

confidence: 99%

A multi‐institutional retrospective study of carbon‐ion radiotherapy for non‐squamous cell malignant tumors of the nasopharynx: Subanalysis of Japan Carbon‐Ion Radiation Oncology Study Group study 1402 HN

et al. 2018

View full text Add to dashboard Cite

BackgroundThis multi‐institutional retrospective study focused on the clinical outcome of carbon‐ion radiotherapy (C‐ion RT) for non‐squamous cell malignant tumors of the nasopharynx.MethodsThe Japan Carbon‐ion Radiation Oncology Study Group collected and analyzed data for 43 patients with non‐squamous cell malignant tumors of the nasopharynx treated with C‐ion RT at four institutions in Japan.ResultsTwenty‐nine patients had adenoid cystic carcinomas, seven had malignant melanomas, three had adenocarcinomas, two had mucoepidermoid carcinomas, and two had other pathologies. Twenty‐six of the 43 patients (61%) had T4 tumors. The most common dose‐fractionation schedule was 64 Gy (relative biological effectiveness) in 16 fractions. The median follow‐up period was 30 months. The 2‐year local control (LC) and overall survival (OS) rates were 88% and 84%, respectively. For late toxicity, one patient developed grade 4 optic nerve disorder and two developed grade 5 pharyngeal hemorrhage. Actual incidence of grade 3 or higher late adverse events was 19%, and included cranial nerve dysfunction, jaw bone necrosis, central nervous system necrosis, and ear inflammation.ConclusionsC‐ion RT provided good LC and OS rates with acceptable toxicity for treatment of non‐squamous cell malignant tumors of the nasopharynx.

show abstract

Definitive proton beam therapy for adenoid cystic carcinoma of the nasopharynx involving the base of skull

Cited by 35 publications

References 20 publications

Trends and Disparities of Proton Therapy Use among Patients with Head and Neck Cancer: Analysis from the National Cancer Database (2005-14)

Trends and Disparities of Proton Therapy Use among Patients with Head and Neck Cancer: Analysis from the National Cancer Database (2005-14)

Impact of aeration change and beam arrangement on the robustness of proton plans

A multi‐institutional retrospective study of carbon‐ion radiotherapy for non‐squamous cell malignant tumors of the nasopharynx: Subanalysis of Japan Carbon‐Ion Radiation Oncology Study Group study 1402 HN

Contact Info

Product

Resources

About