Cancers,
Год журнала:
2024,
Номер
16(24), С. 4150 - 4150
Опубликована: Дек. 12, 2024
Radiotherapy
(RT)
is
an
integral
component
in
the
multidisciplinary
management
of
patients
with
head
and
neck
squamous
cell
carcinoma
(HNSCC).
Significant
advances
have
been
made
toward
optimizing
tumor
control
toxicity
profiles
RT
for
HNSCC
past
two
decades.
The
development
intensity
modulated
radiotherapy
(IMRT)
concurrent
chemotherapy
established
standard
care
most
locally
advanced
around
turn
century.
More
recently,
selective
dose
escalation
to
radioresistant
part
avoidance
critical
substructures
organs
at
risk,
often
guided
by
functional
imaging,
allowed
even
further
improvement
therapeutic
ratio
IMRT.
Other
highly
conformal
modalities,
including
proton
therapy
(IMPT)
stereotactic
body
(SBRT)
are
being
increasingly
utilized,
although
there
gaps
our
understanding
normal
tissue
complication
probabilities
their
relative
biological
effectiveness.
There
renewed
interest
spatially
fractionated
(SFRT),
such
as
GRID
LATTICE
radiotherapy,
both
palliative
definitive
settings.
emergence
immune
checkpoint
inhibitors
(ICIs)
has
revolutionized
treatment
recurrent
metastatic
HNSCC.
Novel
IMPT,
SBRT,
SFRT,
potential
reduce
lymphopenia
suppression,
stimulate
anti-tumor
immunity,
synergize
ICIs.
next
frontier
may
lie
exploration
combined
modality
new
technologies
Journal of Applied Clinical Medical Physics,
Год журнала:
2025,
Номер
unknown
Опубликована: Фев. 17, 2025
Abstract
Purpose
To
compare
plan
quality
among
photon
volumetric
modulated
arc
therapy
(VMAT)
and
intensity‐modulated
proton
(IMPT)
with
robustness
using
three
different
beam
delivery
systems
various
spot
size
(σ)
ranges:
cyclotron‐generated
beams
(CPBs)
(σ:
2.7–7.0
mm),
linear
accelerator
(LPBs)
2.9–5.5
mini
(LPMBs)
0.8–3.9
mm)
for
the
treatment
of
head
neck
(HN)
cancer
bilateral
irradiation.
Methods
Ten
patients
treated
oropharynx
irradiation
were
planned
CPBs,
LPBs,
LPMBs,
VMAT.
The
homogeneity
index
(HI),
mean
body
dose,
defined
doses
selected
critical
organs‐at‐risk
(OARs)
compared.
Set‐up
uncertainties
±3
mm
±
3.5%
range
included
in
robust
evaluation
V
95%Rx
>
95%
(Volume
that
covers
target
volume
at
prescription
(Rx)
dose)
to
high
dose
low
CTV
volumes
(CTV_70
Gy
CTV_56
Gy).
VMAT
plans
compared
terms
OAR
only.
Homogeneity
Indices
IMPT
addition
doses.
Wilcoxon
signed‐rank
test
was
used
evaluate
statistical
differences
between
metrics
all
types.
Results
improved
by
2%
30%
from
CPB
LPB
or
LPMB
plans.
Compared
plans,
except
mandible
53%
also
7.5%
10.8%
LPMB.
In
addition,
44%
CPB,
48%
LPB,
50%
HI
significantly
better
(
p
<
0.05)
considerably
For
both
CTV_70
Gy,
average
across
worst‐case
scenarios
slightly
an
97.6%
1.22%,
followed
97.2%
1.31%
1.35%
respectively.
Robustness
showed
comparable
types,
97.4%
0.87%
1.21%,
97.5%
1.08%
Conclusion
With
decreased
size,
are
excellent
alternatives
can
reduce
normal
tissue.
Cancers,
Год журнала:
2024,
Номер
16(19), С. 3249 - 3249
Опубликована: Сен. 24, 2024
Ultrahigh-dose-rate
therapy,
also
known
as
FLASH
radiotherapy
(RT),
is
an
emerging
technique
that
garnering
significant
interest
in
cancer
treatment
due
to
its
potential
revolutionize
therapy.
This
method
can
achieve
comparable
tumor
control
conventional-dose-rate
RT
while
offering
the
enhanced
protection
of
normal
tissue
through
FLASH-sparing
effect.
innovative
has
demonstrated
promising
results
preclinical
studies
involving
animals
and
cell
lines.
Particularly
noteworthy
application
treating
head
neck
(HN)
cancers,
especially
patients
with
challenging
recurrent
tumors
reirradiation
cases,
where
toxicity
rates
conventional
are
high.
Such
applications
aim
enhance
minimizing
side
effects
preserving
patients’
quality
life.
In
comparison
electron
or
photon
modalities,
proton
therapy
superior
dosimetric
delivery
characteristics
a
safe
effective
for
human
malignancies.
Compared
transmission
FLASH,
single-energy
Bragg
peak
novel
allows
highly
conformal
doses
targets
minimal
radiation
crucial
OARs.
Proton
HN
still
not
been
well
studied.
review
highlights
significance
enhancing
by
examining
advantages
challenges
using
it
reirradiation.
Cancers,
Год журнала:
2024,
Номер
16(11), С. 1947 - 1947
Опубликована: Май 21, 2024
Proton
therapy
has
emerged
as
a
crucial
tool
in
the
treatment
of
head
and
neck
skull-base
cancers,
offering
advantages
over
photon
terms
decreasing
integral
dose
reducing
acute
late
toxicities,
such
dysgeusia,
feeding
tube
dependence,
xerostomia,
secondary
malignancies,
neurocognitive
dysfunction.
Despite
its
benefits
distribution
biological
effectiveness,
application
proton
is
challenged
by
uncertainties
relative
effectiveness
(RBE).
Overcoming
challenges
related
to
RBE
key
fully
realizing
therapy's
potential,
which
extends
beyond
physical
dosimetric
properties
when
compared
with
photon-based
therapies.
In
this
paper,
we
discuss
clinical
significance
within
volumes
adjacent
serial
organs
at
risk
management
tumors.
We
review
modeling
explore
outcomes.
Additionally,
highlight
technological
advancements
innovations
plan
optimization
delivery,
including
linear
energy
transfer/RBE
optimizations
development
spot-scanning
arc
therapy.
These
show
promise
harnessing
full
capabilities
from
an
academic
standpoint,
further
outcome
studies,
however,
are
needed
for
their
integration
into
routine
practice.
Journal of Oral Pathology and Medicine,
Год журнала:
2023,
Номер
52(7), С. 567 - 574
Опубликована: Март 5, 2023
Abstract
Background
Oral
and/or
oropharyngeal
cancers
account
for
approximately
2%
of
all
malignancies,
with
variation
across
age
groups,
genders,
and
geographic
locations.
Treatments
oral
usually
consist
a
combination
surgical
excision
most
commonly
followed
by
radiotherapy
±
chemotherapy
immunotherapy/biotherapy
depending
on
the
nature
malignancy.
The
significant
morbidity
caused
high‐dose
to
head
neck
region
is
widely
observed.
Proton
therapy
promising
treatment
option
that
localises
proton
beam
direct
radiation
at
specific
target,
reduced
irradiation
adjacent
structures.
Method
objective
was
explore
toxicity
associated
adults
cancer.
Eligibility
criteria
included
full‐text
articles,
English
published
between
up
till
7
January
2023.
Databases
PubMed,
Scopus,
Web
Science,
Embase,
Scopus.
Results
systematic
search
identified
345
studies
total
18
were
after
two
independent
reviewers
completed
title,
abstract,
screening.
Included
from
four
countries,
median
participant
range
53.3
66
years.
reported
acute
toxic
effects
dysphagia,
dermatitis,
mucositis,
dysgeusia,
alopecia.
Conclusion
an
evolving
cancer
technique
has
diverse
advantages
over
conventional
chemotherapy.
This
review
provides
evidence
supports
improved
profile
compared
treat
individuals.
