Proton beam therapy may be best option in some head and neck cancers

Volume 3, Issue 4, 2014


Study shows that intensity-modulated radiation therapy is less effective for survival, tumor control.

Photograph of Robert L. Foote, M.D.

Robert L. Foote, M.D.

A new study by radiation oncologists at the Mayo Clinic Cancer Center has found that proton beam therapy significantly improved disease-free survival and tumor control when compared with intensity-modulated radiation therapy (IMRT).

The results of the study were published in the August 2014 edition of The Lancet Oncology.

"We undertook a systematic review and meta-analysis to compare the clinical outcomes of patients treated with proton therapy with patients receiving photon IMRT," said senior author Robert L. Foote, M.D., a radiation oncologist at the Mayo Clinic Cancer Center. "Our findings suggest that the theoretical advantages of proton beam therapy may in fact be real."

Researchers reviewed studies of nasal cavity and paranasal sinus tumors through extensive database searches. They included studies of patients who had no previous treatment — neither primary radiation therapy nor adjuvant radiation therapy — and patients who had recurrent disease.

Researchers collected data on overall survival, disease-free survival and tumor control at five years and at the patient's longest follow-up. They used random-effect models to pool outcomes across studies and compared event rates of combined outcomes for proton therapy and IMRT using an interaction test.

Researchers found disease-free survival to be significantly higher at five years for patients who received proton therapy than for patients who received IMRT (72 percent vs. 50 percent). Although tumor control did not differ between treatment groups at five years, tumor control was higher for patients who received proton therapy than for those who received IMRT at the longest follow-up (81 percent vs. 64 percent).

Watch a video of Dr. Foote discussing this study.