International Journal of Particle Therapy最新文献

{"title":"The Role of Particle Therapy in Adenoid Cystic Carcinoma and Mucosal Melanoma of the Head and Neck.","authors":"Daniel K Ebner,&nbsp;Timothy D Malouff,&nbsp;Steven J Frank,&nbsp;Masashi Koto","doi":"10.14338/IJPT-D-20-00076","DOIUrl":"https://doi.org/10.14338/IJPT-D-20-00076","url":null,"abstract":"<p><p>Particle irradiation is suitable for resistant histologies owing to a combination of improved dose delivery with potential radiobiologic advantages in high linear energy transfer radiation. Within the head and neck, adenoid cystic carcinoma and mucosal melanoma are two such histologies, being radioresistant and lying closely proximal to critical structures. Here, we review the use of particle irradiation for adenoid cystic carcinoma and mucosal melanoma of the head and neck.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":" ","pages":"273-284"},"PeriodicalIF":1.7,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270088/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39203026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Passively Scattered Proton Therapy for Nonmelanoma Skin Cancer with Clinical Perineural Invasion.","authors":"Curtis M Bryant,&nbsp;Roi Dagan,&nbsp;Adam L Holtzman,&nbsp;Rui Fernandes,&nbsp;Anthony Bunnell,&nbsp;William M Mendenhall","doi":"10.14338/IJPT-20-00062.1","DOIUrl":"https://doi.org/10.14338/IJPT-20-00062.1","url":null,"abstract":"<p><strong>Purpose: </strong>To report our experience with the delivery of passively scattered proton therapy in the management of nonmelanoma skin cancers with clinical perineural invasion.</p><p><strong>Materials and methods: </strong>We reviewed the medical records of patients who received definitive or postoperative proton therapy for nonmelanoma skin cancer with clinical perineural invasion at our institution and updated patient follow-up when possible. All patients were treated with curative intent with or without the delivery of concurrent systemic therapy. We report disease control rates and the rates of late toxicity among this cohort.</p><p><strong>Results: </strong>Twenty-six patients treated between 2008 and 2017 were included in the analysis. Following proton therapy, the 3-year overall, cause-specific, and disease-free survival rates were 59%, 73%, and 60%, respectively. The 3-year local control, local regional control, and distant metastasis-free survival rates were 80%, 65%, and 96%, respectively. On univariate analysis, surgical resection before radiation therapy significantly improved local regional control rates at 3 years (55% versus 86%; <i>P</i> = .04). Grade 3+ late toxicities occurred in 13 patients (50%) and the most common toxicities included grade 3+ keratitis of the ipsilateral eye, which occurred in 4 patients (15%) and grade 3+ brain necrosis in 4 patients (15%).</p><p><strong>Conclusion: </strong>Proton therapy is effective in the management of nonmelanoma skin cancer with clinical perineural invasion. Although disease control and complication rates compare favorably to those previously published for photon-based radiation therapy, the risk for late toxicity is significant and patients should be appropriately counseled.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":" ","pages":"285-293"},"PeriodicalIF":1.7,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270093/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39203473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proton Radiotherapy to Reduce Late Complications in Childhood Head and Neck Cancers.","authors":"Michael T Spiotto,&nbsp;Susan L McGovern,&nbsp;G Brandon Gunn,&nbsp;David Grosshans,&nbsp;Mary Frances McAleer,&nbsp;Steven J Frank,&nbsp;Arnold C Paulino","doi":"10.14338/IJPT-20-00069.1","DOIUrl":"https://doi.org/10.14338/IJPT-20-00069.1","url":null,"abstract":"<p><p>In most childhood head and neck cancers, radiotherapy is an essential component of treatment; however, it can be associated with problematic long-term complications. Proton beam therapy is accepted as a preferred radiation modality in pediatric cancers to minimize the late radiation side effects. Given that childhood cancers are a rare and heterogeneous disease, the support for proton therapy comes from risk modeling and a limited number of cohort series. Here, we discuss the role of proton radiotherapy in pediatric head and neck cancers with a focus on reducing radiation toxicities. First, we compare the efficacy and expected toxicities in proton and photon radiotherapy for childhood cancers. Second, we review the benefit of proton radiotherapy in reducing acute and late radiation toxicities, including risks for secondary cancers, craniofacial development, vision, and cognition. Finally, we review the cost effectiveness for proton radiotherapy in pediatric head and neck cancers. This review highlights the benefits of particle radiotherapy for pediatric head and neck cancers to improve the quality of life in cancer survivors, to reduce radiation morbidities, and to maximize efficient health care use.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":" ","pages":"155-167"},"PeriodicalIF":1.7,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270100/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39204502","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spot Scanning Proton Therapy for Sinonasal Malignant Tumors.","authors":"Koichiro Nakajima,&nbsp;Hiromitsu Iwata,&nbsp;Yukiko Hattori,&nbsp;Kento Nomura,&nbsp;Shingo Hashimoto,&nbsp;Toshiyuki Toshito,&nbsp;Kensuke Hayashi,&nbsp;Yo Kuroda,&nbsp;Hideo Fukano,&nbsp;Hiroyuki Ogino,&nbsp;Yuta Shibamoto","doi":"10.14338/IJPT-D-20-00043.1","DOIUrl":"https://doi.org/10.14338/IJPT-D-20-00043.1","url":null,"abstract":"<p><strong>Purpose: </strong>Treatment of sinonasal malignant tumors is challenging, and evidence to establish a standard treatment is limited. Our objective was to evaluate the efficacy and safety of spot scanning proton therapy (SSPT) for sinonasal malignant tumors.</p><p><strong>Patients and methods: </strong>We retrospectively analyzed patients with sinonasal malignant tumors (T1-4bN0-2M0) who underwent SSPT between May 2014 and September 2019. The prescription dose was typically either 60 GyRBE in 15 fractions or 60.8 GyRBE in 16 fractions for mucosal melanoma and 70.2 GyRBE in 26 fractions for other histologic subtypes. Endpoints included local control (LC), progression-free survival, overall survival (OS), and incidence of toxicity. Prognostic factors were analyzed using the Kaplan-Meier method and log-rank test.</p><p><strong>Results: </strong>Of 62 enrolled patients, the common histologic subtypes were mucosal melanoma (35%), squamous cell carcinoma (27%), adenoid cystic carcinoma (16%), and olfactory neuroblastoma (10%). Locally advanced stages were common (T3 in 42% and T4 in 53%). Treatment-naïve tumors and postsurgical recurrent tumors accounted for 73% and 27%, respectively. No patient had previous radiotherapy. The median follow-up was 17 months (range, 6-66) for all patients and 21.5 months (range, 6-66) for survivors. The 2-year LC, progression-free survival, and OS rates of all patients were 92%, 50%, and 76%, respectively. Univariate analysis revealed histology as a prognostic factor for OS, being higher in adenoid cystic carcinoma and olfactory neuroblastoma than in other tumors. Sixteen grade ≥3 late toxicities were observed in 12 patients (19%), including 11 events resulting in visual impairment; the most common was cataract. There was 1 grade 4 toxicity, and there were no grade 5 toxicities.</p><p><strong>Conclusion: </strong>SSPT was well tolerated and yielded good LC for sinonasal malignant tumors. Although we consider SSPT to be a leading treatment modality, further studies are required to establish its status as a standard treatment.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":" ","pages":"189-199"},"PeriodicalIF":1.7,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270097/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39204505","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PTCOG Head and Neck Subcommittee Consensus Guidelines on Particle Therapy for the Management of Head and Neck Tumors.","authors":"Alexander Lin,&nbsp;John H C Chang,&nbsp;Ryan S Grover,&nbsp;Frank J P Hoebers,&nbsp;Upendra Parvathaneni,&nbsp;Samir H Patel,&nbsp;Juliette Thariat,&nbsp;David J Thomson,&nbsp;Johannes A Langendijk,&nbsp;Steven J Frank","doi":"10.14338/IJPT-20-00071.1","DOIUrl":"https://doi.org/10.14338/IJPT-20-00071.1","url":null,"abstract":"<p><strong>Purpose: </strong>Radiation therapy is a standard modality in the treatment for cancers of the head and neck, but is associated with significant short- and long-term side effects. Proton therapy, with its unique physical characteristics, can deliver less dose to normal tissues, resulting in fewer side effects. Proton therapy is currently being used for the treatment of head and neck cancer, with increasing clinical evidence supporting its use. However, barriers to wider adoption include access, cost, and the need for higher-level evidence.</p><p><strong>Methods: </strong>The clinical evidence for the use of proton therapy in the treatment of head and neck cancer are reviewed here, including indications, advantages, and challenges.</p><p><strong>Results: </strong>The Particle Therapy Cooperative Group Head and Neck Subcommittee task group provides consensus guidelines for the use of proton therapy for head and neck cancer.</p><p><strong>Conclusion: </strong>This report can be used as a guide for clinical use, to understand clinical trials, and to inform future research efforts.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":" ","pages":"84-94"},"PeriodicalIF":1.7,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270078/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39204498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual-Energy Computed Tomography Proton-Dose Calculation with Scripting and Modified Hounsfield Units.","authors":"Anthony Kassaee,&nbsp;Chingyun Cheng,&nbsp;Lingshu Yin,&nbsp;Wei Zou,&nbsp;Taoran Li,&nbsp;Alexander Lin,&nbsp;Samuel Swisher-McClure,&nbsp;John N Lukens,&nbsp;Robert A Lustig,&nbsp;Shannon O'Reilly,&nbsp;Lei Dong,&nbsp;Roni Hytonen Ms,&nbsp;Boon-Keng Kevin Teo","doi":"10.14338/IJPT-20-00075.1","DOIUrl":"https://doi.org/10.14338/IJPT-20-00075.1","url":null,"abstract":"<p><strong>Purpose: </strong>To describe an implementation of dual-energy computed tomography (DECT) for calculation of proton stopping-power ratios (SPRs) in a commercial treatment-planning system. The process for validation and the workflow for safe deployment of DECT is described, using single-energy computed tomography (SECT) as a safety check for DECT dose calculation.</p><p><strong>Materials and methods: </strong>The DECT images were acquired at 80 kVp and 140 kVp and were processed with computed tomography scanner software to derive the electron density and effective atomic number images. Reference SPRs of tissue-equivalent plugs from Gammex (Middleton, Wisconsin) and CIRS (Computerized Imaging Reference Systems, Norfolk, Virginia) electron density phantoms were used for validation and comparison of SECT versus DECT calculated through the Eclipse treatment planning system (Varian Medical Systems, Palo Alto, California) application programming interface scripting tool. An in-house software was also used to create DECT SPR computed tomography images for comparison with the script output. In the workflow, using the Eclipse system application programming interface script, clinical plans were optimized with the SECT image set and then forward-calculated with the DECT SPR for the final dose distribution. In a second workflow, the plans were optimized using DECT SPR with reduced range-uncertainty margins.</p><p><strong>Results: </strong>For the Gammex phantom, the root mean square error in SPR was 1.08% for DECT versus 2.29% for SECT for 10 tissue-surrogates, excluding the lung. For the CIRS Phantom, the corresponding results were 0.74% and 2.27%. When evaluating the head and neck plan, DECT optimization with 2% range-uncertainty margins achieved a small reduction in organ-at-risk doses compared with that of SECT plans with 3.5% range-uncertainty margins. For the liver case, DECT was used to identify and correct the lipiodol SPR in the SECT plan.</p><p><strong>Conclusion: </strong>It is feasible to use DECT for proton-dose calculation in a commercial treatment planning system in a safe manner. The range margins can be reduced to 2% in some sites, including the head and neck.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":" ","pages":"62-72"},"PeriodicalIF":1.7,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270086/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39203655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Facilitating MR-Guided Adaptive Proton Therapy in Children Using Deep Learning-Based Synthetic CT.","authors":"Chuang Wang,&nbsp;Jinsoo Uh,&nbsp;Thomas E Merchant,&nbsp;Chia-Ho Hua,&nbsp;Sahaja Acharya","doi":"10.14338/IJPT-20-00099.1","DOIUrl":"https://doi.org/10.14338/IJPT-20-00099.1","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether self-attention cycle-generative adversarial networks (cycle-GANs), a novel deep-learning method, can generate accurate synthetic computed tomography (sCT) to facilitate adaptive proton therapy in children with brain tumors.</p><p><strong>Materials and methods: </strong>Both CT and T1-weighted magnetic resonance imaging (MRI) of 125 children (ages 1-20 years) with brain tumors were included in the training dataset. A model introducing a self-attention mechanism into the conventional cycle-GAN was created to enhance tissue interfaces and reduce noise. The test dataset consisted of 7 patients (ages 2-14 years) who underwent adaptive planning because of changes in anatomy discovered on MRI during proton therapy. The MRI during proton therapy-based sCT was compared with replanning CT (ground truth).</p><p><strong>Results: </strong>The Hounsfield unit-mean absolute error was significantly reduced with self-attention cycle-GAN, as compared with conventional cycle-GAN (65.3 ± 13.9 versus 88.9 ± 19.3, <i>P</i> < .01). The average 3-dimensional gamma passing rates (2%/2 mm criteria) for the original plan on the anatomy of the day and for the adapted plan were high (97.6% ± 1.2% and 98.9 ± 0.9%, respectively) when using sCT generated by self-attention cycle-GAN. The mean absolute differences in clinical target volume (CTV) receiving 95% of the prescription dose and 80% distal falloff along the beam axis were 1.1% ± 0.8% and 1.1 ± 0.9 mm, respectively. Areas of greatest dose difference were distal to the CTV and corresponded to shifts in distal falloff. Plan adaptation was appropriately triggered in all test patients when using sCT.</p><p><strong>Conclusion: </strong>The novel cycle-GAN model with self-attention outperforms conventional cycle-GAN for children with brain tumors. Encouraging dosimetric results suggest that sCT generation can be used to identify patients who would benefit from adaptive replanning.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":"8 3","pages":"11-20"},"PeriodicalIF":1.7,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8768893/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39592760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Initial Experience with Proton Beam Therapy for Differentiated Thyroid Cancer.","authors":"Nathan Y Yu,&nbsp;Aditya Khurana,&nbsp;Daniel J Ma,&nbsp;Michelle A Neben-Wittich,&nbsp;Michael A Golafshar,&nbsp;Lisa A McGee,&nbsp;Jean-Claude M Rwigema,&nbsp;Robert L Foote,&nbsp;Samir H Patel","doi":"10.14338/IJPT-D-20-00053","DOIUrl":"https://doi.org/10.14338/IJPT-D-20-00053","url":null,"abstract":"<p><strong>Purpose: </strong>External beam radiotherapy is used in a subset of high-risk patients with differentiated thyroid cancer (DTC). Recurrent, radioactive iodine (RAI)-refractory DTC carries a poor prognosis. We report our initial experience of intensity-modulated proton therapy (IMPT) for recurrent, RAI-refractory DTC.</p><p><strong>Patients and methods: </strong>Fourteen patients with recurrent, RAI-refractory DTC were consecutively treated with IMPT from November 2016 to March 2020 at our multisite institution. Patient, tumor, and treatment characteristics were recorded. Overall survival and local-regional recurrence-free survival were recorded and estimated using the Kaplan-Meier method. Acute and late treatment-related toxicities were recorded based on the Common Terminology Criteria for Adverse Events version 5.0. Patients completed the European Organization for Research and Treatment of Cancer Quality of Life Head and Neck Module at baseline and after IMPT. Eleven patients were included in the final analysis.</p><p><strong>Results: </strong>Median follow-up was 8 months (range, 3-40) for all patients. Median age at treatment with IMPT was 64 years (range, 40-77), and the majority were men (64%). Recurrent histologies included papillary (55%), Hurthle cell (36%), and poorly differentiated (9%) carcinoma; 1 patient had tall cell variant. Concurrent chemotherapy was not administered for any patient in this cohort. At 8 months, all patients were alive without local-regional failure. Acute grade 3 toxicities were limited to 1 patient with dysphagia, requiring feeding tube placement. Two patients experienced late grade 3 esophageal stenosis requiring dilation. There were no grade 4 or 5 toxicities. There were no differences in pretreatment versus posttreatment patient-reported outcomes in terms of dysphagia or hoarseness.</p><p><strong>Conclusion: </strong>In our early experience, IMPT provided promising local-regional control for recurrent, RAI-refractory DTC. Further study is warranted to evaluate the long-term efficacy and safety of IMPT in this patient population.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":" ","pages":"311-318"},"PeriodicalIF":1.7,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270099/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39202957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Work Outcomes after Intensity-Modulated Proton Therapy (IMPT) versus Intensity-Modulated Photon Therapy (IMRT) for Oropharyngeal Cancer.","authors":"Grace L Smith,&nbsp;Shuangshuang Fu,&nbsp;Matthew S Ning,&nbsp;Diem-Khanh Nguyen,&nbsp;Paul M Busse,&nbsp;Robert L Foote,&nbsp;Adam S Garden,&nbsp;Gary B Gunn,&nbsp;Clifton D Fuller,&nbsp;William H Morrison,&nbsp;Gregory M Chronowski,&nbsp;Shalin J Shah,&nbsp;Lauren L Mayo,&nbsp;Jack Phan,&nbsp;Jay P Reddy,&nbsp;James W Snider,&nbsp;Samir H Patel,&nbsp;Sanford R Katz,&nbsp;Alexander Lin,&nbsp;Nasiruddin Mohammed,&nbsp;Roi Dagan,&nbsp;Nancy Y Lee,&nbsp;David I Rosenthal,&nbsp;Steven J Frank","doi":"10.14338/IJPT-20-00067.1","DOIUrl":"https://doi.org/10.14338/IJPT-20-00067.1","url":null,"abstract":"<p><strong>Purpose: </strong>We compared work outcomes in patients with oropharyngeal cancer (OPC), randomized to intensity-modulated proton (IMPT) versus intensity-modulated photon therapy (IMRT) for chemoradiation therapy (CRT).</p><p><strong>Patients and methods: </strong>In 147 patients with stage II-IVB squamous cell OPC participating in patient-reported outcomes assessments, a prespecified secondary aim of a randomized phase II/III trial of IMPT (n = 69) versus IMRT (n = 78), we compared absenteeism, presenteeism (i.e., the extent to which an employee is not fully functional at work), and work productivity losses. We used the work productivity and activity impairment questionnaire at baseline (pre-CRT), at the end of CRT, and at 6 months, 1 year, and 2 years. A one-sided Cochran-Armitage test was used to analyze within-arm temporal trends, and a χ² test was used to compare between-arm differences. Among working patients, at each follow-up point, a 1-sided Wilcoxon rank-sum test was used to compare work-productivity scores.</p><p><strong>Results: </strong>Patient characteristics in IMPT versus IMRT arms were similar. In the IMPT arm, within-arm analysis demonstrated that an increasing proportion of patients resumed working after IMPT, from 60% (40 of 67) pre-CRT and 71% (30 of 42) at 1 year to 78% (18 of 23) at 2 years (<i>P</i> = 0.025). In the IMRT arm, the proportion remained stable, with 57% (43 of 76) pre-CRT, 54% (21 of 39) at 1 year, and 52% (13 of 25) working at 2 years (<i>P</i> = 0.47). By 2 years after CRT, the between-arm difference between patients who had IMPT and those who had IMRT trended toward significance (<i>P</i> = 0.06). Regardless of treatment arm, among working patients, the most severe work impairments occurred from treatment initiation to the end of CRT, with significant recovery from absenteeism, presenteeism, and productivity impairments by the 2-year follow-up (<i>P</i> < 0.001 for all). Higher magnitudes of recovery from absenteeism (at 1 year, <i>P</i> = 0.05; and at 2 years, <i>P</i> = 0.04) and composite work impairment scores (at 1 year, <i>P</i> = 0.04; and at 2 years, <i>P</i> = 0.04) were seen in patients treated with IMPT versus those treated with IMRT.</p><p><strong>Conclusion: </strong>In patients with OPC receiving curative CRT, patients randomized to IMPT demonstrated increasing work and productivity recovery trends. Studies are needed to identify mechanisms underlying head and neck CRT treatment causing work disability and impairment.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":" ","pages":"319-327"},"PeriodicalIF":1.7,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270077/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39202958","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"National Protocol for Model-Based Selection for Proton Therapy in Head and Neck Cancer.","authors":"Johannes A Langendijk,&nbsp;Frank J P Hoebers,&nbsp;Martin A de Jong,&nbsp;Patricia Doornaert,&nbsp;Chris H J Terhaard,&nbsp;Roel J H M Steenbakkers,&nbsp;Olga Hamming-Vrieze,&nbsp;Jeroen B van de Kamer,&nbsp;Wilko F A R Verbakel,&nbsp;Fatma Keskin-Cambay,&nbsp;Johannes B Reitsma,&nbsp;Arjen van der Schaaf,&nbsp;Liesbeth J Boersma,&nbsp;Ewoud Schuit","doi":"10.14338/IJPT-20-00089.1","DOIUrl":"https://doi.org/10.14338/IJPT-20-00089.1","url":null,"abstract":"<p><p>In the Netherlands, the model-based approach is used to identify patients with head and neck cancer who may benefit most from proton therapy in terms of prevention of late radiation-induced side effects in comparison with photon therapy. To this purpose, a National Indication Protocol Proton therapy for Head and Neck Cancer patients (NIPP-HNC) was developed, which has been approved by the health care authorities. When patients qualify according to the guidelines of the NIPP-HNC, proton therapy is fully reimbursed. This article describes the procedures that were followed to develop this NIPP-HNC and provides all necessary information to introduce model-based selection for patients with head and neck cancer into routine clinical practice.</p>","PeriodicalId":36923,"journal":{"name":"International Journal of Particle Therapy","volume":" ","pages":"354-365"},"PeriodicalIF":1.7,"publicationDate":"2021-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8270079/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39202961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}