Proton Therapy Lowers Cancer Treatment Side Effects

A new study concludes that proton beam therapy (PBT) is as effective as photon radiation in pediatric patients with head and neck cancer, but with less impact on their quality of life.

Researchers at the University of Pennsylvania (Penn; Philadelphia, USA), the Children's Hospital of Philadelphia (CHOP, PA, USA), and other institutions conducted a study involving 69 consecutive pediatric patients treated with PBT for head and neck malignancies between 2010 and 2016. Among the children, 50% had rhabdomyosarcoma, 7% were treated for Ewing sarcoma, and the remaining pediatric patients were treated for a variety of other cancers affecting the head and neck regions.

Clinical and dosimetric data were abstracted from the medical record in order to identify acute toxicities and early outcomes, which were compared to historic photon radiation results. The researchers found that one year after treatment, 93% of patients were still alive, and 92% did not experience recurrence at their primary disease site. No patients suffered toxicities above grade 3 (out of 5), with the most severe toxicities being mucositis (4%), loss of appetite (22%) and difficulty swallowing (7%), significantly lower toxicity rates associated with photon radiation. The study was published on October 23, 2017, in Pediatric Blood and Cancer.

“Protons may be an important tool in improving quality of life both during treatment and for years after for these young patients,” said senior author Christine Hill-Kayser, MD, chief of the pediatric radiation oncology service at Penn and an attending physician at CHOP. “These concerns are especially important to address in pediatric patients, since they’re still developing and may need to deal with any adverse effects for the rest of their lives.”

PBT is a precise form of radiotherapy that uses charged particles instead of x-rays to deliver a dose of radiotherapy for patients. It can be a more effective form of treatment than conventional radiotherapy because it directs the radiotherapy more precisely with minimal damage to surrounding tissue. Evidence is growing that protons can be effective in treating a number of cancers, in particular in children and young people with brain tumors, for whom PBT appears to produce fewer side effects such as secondary cancers, growth deformity, hearing loss, and learning difficulties.

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University of Pennsylvania
Children's Hospital of Philadelphia