Oncologic Outcomes for Head and Neck Skin Malignancies Treated with Protons.

IF 2.1 Q3 ONCOLOGY

International Journal of Particle Therapy Pub Date : 2021-06-25 eCollection Date: 2021-01-01 DOI:10.14338/IJPT-20-00045.1

Jidapa Bridhikitti, Jason K Viehman, W Scott Harmsen, Adam C Amundson, Satomi Shiraishi, Daniel W Mundy, Jean-Claude M Rwigema, Lisa A McGee, Samir H Patel, David M Routman, Scott C Lester, Michelle A Neben-Wittich, Yolanda I Garces, Daniel J Ma, Robert L Foote

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Abstract

Purpose: Radiation therapy (RT) is the standard treatment for patients with inoperable skin malignancies of the head and neck region (H&N), and as adjuvant treatment post surgery in patients at high risk for local or regional recurrence. This study reports clinical outcomes of intensity-modulated proton therapy (IMPT) for these malignancies.

Materials and methods: We retrospectively reviewed cases involving 47 patients with H&N malignancies of the skin (squamous cell, basal cell, melanoma, Merkel cell, angiosarcoma, other) who underwent IMPT for curative intent between July 2016 and July 2019. Overall survival was estimated via Kaplan-Meier analysis, and oncologic outcomes were reported as cumulative incidence with death as a competing risk.

Results: The 2-year estimated local recurrence rate, regional recurrence rate, local regional recurrence rate, distant metastasis rate, and overall survival were 11.1% (95% confidence interval [CI], 4.1%-30.3%), 4.4% (95% CI, 1.1%-17.4%), 15.5% (95% CI, 7%-34.3%), 23.4% (95% CI, 5.8%-95.5%), and 87.2% (95% CI, 75.7%-100%), respectively. No patient was reported to have a grade 3 or higher adverse event during the last week of treatment or at the 3-month follow-up visit.

Conclusion: IMPT is safe and effective in the treatment of skin malignancies of the H&N.

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质子治疗头颈部皮肤恶性肿瘤的肿瘤预后。

目的:放疗(RT)是头颈部无法手术的皮肤恶性肿瘤(H&N)患者的标准治疗方法，也是局部或区域复发高危患者术后的辅助治疗方法。本研究报告了调强质子治疗(IMPT)治疗这些恶性肿瘤的临床结果。材料和方法:我们回顾性分析了2016年7月至2019年7月期间接受IMPT治疗的47例皮肤H&N恶性肿瘤(鳞状细胞、基底细胞、黑色素瘤、默克尔细胞、血管肉瘤等)。通过Kaplan-Meier分析估计总生存率，肿瘤预后报告为累积发病率，死亡为竞争风险。结果:2年估计局部复发率、区域复发率、局部区域复发率、远处转移率和总生存率分别为11.1%(95%可信区间[CI]， 4.1% ~ 30.3%)、4.4% (95% CI, 1.1% ~ 17.4%)、15.5% (95% CI, 7% ~ 34.3%)、23.4% (95% CI, 5.8% ~ 95.5%)和87.2% (95% CI, 75.7% ~ 100%)。在治疗的最后一周或3个月的随访中，没有患者报告出现3级或更高级别的不良事件。结论:IMPT治疗H&N皮肤恶性肿瘤安全有效。

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