Head, Neck & Oral Cancer
Proton Therapy for Head, Neck & Oral Cancer Treatment
When treating head, neck, and oral cancers, it’s critical to protect the delicate organs that surround the tumor. Depending on the size of the tumor, a combination of treatment methods can be used, including radiation therapy and surgery. With traditional radiation therapy, which uses x-rays, nearby vulnerable structures like the spinal cord and jawbone may be exposed to unnecessary radiation.
The precision of proton therapy allows physicians to deliver the prescribed radiation dose to the targeted area of the head, neck, or mouth, while avoiding unnecessary radiation to healthy tissue. This minimizes damage to vital organs and lowers the risk of side effects during and after treatment.
Head, neck, and oral cancers most often appear in the squamous cells, which line areas like the throat, mouth, and nose. These tumors can sometimes cause face and neck disfiguration, as well as impact a patient’s speech, sight, and sense of smell.
Men are more likely than women to be diagnosed with head, neck, and oral cancer, and people over the age of 40 are at higher risk. Other risk factors include:
- Alcohol abuse
- Tobacco use, including smokeless tobacco
- HPV (human papillomavirus) infection
- Poor nutrition
- Inadequate oral and dental hygiene
- Weakened immune system
Symptoms of head, neck, and oral cancers vary depending on the affected area, but can include:
- Lump or sore in the throat
- Persistent sore throat
- Difficulty swallowing
- Recurring pain in the neck or throat
- Frequent headaches
- Blocked sinuses that do not clear
- Swelling under the chin and around the jawbone
- A white or red patch on gums, tongue, or lining of the mouth
In order to properly diagnosis head, neck, and oral cancer, a physician may recommend:
- Physical examination – Oral and nasal cavities, neck, throat, and tongue are inspected using a small mirror and lights. Neck, lips, gums, and cheeks are inspected for the presence of lumps.
- X-ray imaging
- CT scans
- Magnetic resonance imaging (MRI)
- Biopsy – Tissue is removed from the area in question. A pathologist evaluates the cells and checks for cancer.
When treating head, neck, and oral cancers a combination of proton therapy and surgery may be used for treatment. With cancers in this area of the body, there are often several delicate organs surrounding the tumor. Proton therapy helps physicians attack the cancer cells with radiation, while minimizing damage to these organs.
The physical characteristics of protons allow for better control of the prescribed radiation dose, allowing physicians to precisely target the areas in which protons are emitted into the body and release their energy. This increases the radiation’s effectiveness, while decreasing the risk of damage to the structures surrounding the treatment area.
When treated with proton therapy, patients have a lower risk of developing negative side effects, including dry mouth and bone injury. Research also shows that proton therapy substantially reduces damage to eyes, optic nerves, salivary glands, and other nearby tissue and organs.1-3 Proton therapy also reduces the likelihood of side effects such as blindness, hearing deterioration, and dry mouth.2 Secondary cancers are also less likely to develop in patients who choose proton therapy.1
Proton therapy can be used to treat a variety of head, neck, and oral cancers. Some of the types that benefit most from proton therapy include:
- Nasopharynx (back of the nose where it meets the throat)
- Nasal cavity (nose)
- Paranasal sinuses (sinuses in the face)
- Oropharynx (area of the throat at the back of the mouth), including tonsils and base of tongue
Clinical Benefits of Proton Therapy for Head, Neck & Oral Cancer Treatment
27% reduction in overall risk of needing a feeding tube for oropharyngeal cancer.4
44% relative increase in disease free survival rate for nasal and paranasal sinus cavity cancers at 5 years.5
45% reduction in overall risk of needing a feeding tube for nasopharyngeal cancer.6
Fewer side effects first 3 months after treatment. Quicker return to normal function in patients with oropharyngeal cancer.7
Dramatic reduction of negative impact on taste, nausea, and painful changes to the mouth in salivary gland treatment.8
- Sources and Studies
- Steneker M, Lomax A, Schneider U. Intensity modulated photon and proton therapy for the treatment of head and neck tumors. Radiother Oncol. 2006;80(2):263-267. Read More
- Taheri-Kadkhoda Z, Björk-Eriksson T, Nill S, et al. Intensity-modulated radiotherapy of nasopharyngeal carcinoma: a comparative treatment planning study of photons and protons. Radiat Oncol. 2008;3:4. Read More
- Yeung D, Malyapa RS, Mendenhall WM, et al. Dosimetric comparison of IMRT and proton therapy for head and neck tumors. Int J Radiat Oncol Biol Phys. 2006;66(3):S412. Read More
- Frank SJ, Rosenthal DI, And K, Sturgi EM, Chambers MS, Gunn GB, Hutcheson KA, Zhu XR, Palmer MB, Garden AS. Gastrostomy Tubes Decrease by Over 50% with Intensity Modulated Proton Therapy (IMPT) During the Treatment of Oropharyngeal Cancer Patients: A Case-Control Study. Int J Radiat Oncol Biol Phys. 2013 Oct 1;87(2):S144. Read More
- Sio T, Lin H, Shi Q, Gunn GB, Cleeland CS, Lee JJ, Hernandez M, Blanchard P, Thaker NG, Phan J, Rosenthal DI, Garden AS, Morrison WH, Fuller CD, Mendoza TR, Mohan R, Wang XS, Frank SJ. Intensity-Modulated Proton Therapy (IMPT) versus Intensity-Modulated Photon Radiotherapy )IMRT) for Oropharyngeal Cancer: First Comparative Results of Patient-Reported Outcomes. Int J Radiat Biol Once Phys. 2016 Feb 12;95(4):1107-14. Read More
- Holliday EB, Garden AS, Rosenthal DI, Fuller CD, Morrison WH, Gunn GB, Phan J, Beadle BM, Zhu XR, Zhang X, Hanna E, Glisson BS, Hutcheson KA, El-Naggar AK, Hong JH, Hung TM, Uzel EK, Lewis G, Frank SJ. Proton Therapy Reduces Treatment-Related Toxicities for Patients with Nasopharyngeal Cancer: A Case-Match Control Study of Intensity-Modulated Proton Therapy and Intensity-Modulated Photon Therapy. Int J Particle Ther. 2015;2(1):19-28. Read More
- Romesser PB, Cahlon O, Scher E, Zhou Y, Berry SL, Rybkin A, Sine KM, Tang S, Sherman EJ, Wong R, Lee NY. Proton beam radiation therapy results in significantly reduced toxicity compared with intensity-modulated radiation therapy for head and neck tumors that require ipsilateral radiation. Radiother Oncol. 2016 Feb;118(2):286-92. Read More
- Patel SH, Wang Z, Wong WW, Murad MH, Buckey CR, Mohammed K, Alahdab F, Altayar O, Nabhan M, Schild SE, Foote RL. Charged particle therapy versus photon therapy for paranasal sinus and nasal cavity malignant diseases: a systematic review and meta-analysis. Lancet Oncol. 2014 Aug;15(9):1027-38. Read More
- Chan AW, Pommier P, Deschler DG, et al. Change in patterns of relapse after combined proton and photon irradiation for locally advanced paranasal sinus cancer. Int J Radiat Oncol Biol Phys. 2004;60(1):320. Read More