Proton Therapy for Major Salivary Gland Cancer: Clinical Outcomes

Alexander N. Hanania, MD, MPH; Xiaodong Zhang, PhD; G. Brandon Gunn, MD; David I. Rosenthal, MD; Adam S. Garden, MD; C. David Fuller, MD, PhD; Jack Phan, MD, PhD; Jay P. Reddy, MD; Amy Moreno, MD; Gregory Chronowski, MD; Shalin Shah, MD; Noveen Ausat, BA; Ehab Hanna, MD; Renata Ferrarotto, MD; Steven J. Frank, MD

doi:10.14338/IJPT-20-00044.1

International Journal of Particle Therapy (Jun 2021)

Proton Therapy for Major Salivary Gland Cancer: Clinical Outcomes

Alexander N. Hanania, MD, MPH,
Xiaodong Zhang, PhD,
G. Brandon Gunn, MD,
David I. Rosenthal, MD,
Adam S. Garden, MD,
C. David Fuller, MD, PhD,
Jack Phan, MD, PhD,
Jay P. Reddy, MD,
Amy Moreno, MD,
Gregory Chronowski, MD,
Shalin Shah, MD,
Noveen Ausat, BA,
Ehab Hanna, MD,
Renata Ferrarotto, MD,
Steven J. Frank, MD

Affiliations

Alexander N. Hanania, MD, MPH: 1 Department of Radiation Oncology, Baylor College of Medicine, Houston, TX, USA
Xiaodong Zhang, PhD: 3 Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
G. Brandon Gunn, MD: 2 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
David I. Rosenthal, MD: 2 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Adam S. Garden, MD: 2 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
C. David Fuller, MD, PhD: 2 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Jack Phan, MD, PhD: 2 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Jay P. Reddy, MD: 2 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Amy Moreno, MD: 2 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Gregory Chronowski, MD: 2 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Shalin Shah, MD: 2 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Noveen Ausat, BA: 2 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Ehab Hanna, MD: 4 Department of Head and Neck Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Renata Ferrarotto, MD: 5 Department of Head and Neck Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
Steven J. Frank, MD: 2 Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

DOI: https://doi.org/10.14338/IJPT-20-00044.1
Journal volume & issue: Vol. 8, no. 1
pp. 261 – 272

Abstract

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Purpose: To report clinical outcomes in terms of disease control and toxicity in patients with major salivary gland cancers (SGCs) treated with proton beam therapy. Materials and Methods: Clinical and dosimetric characteristics of patients with SGCs treated from August 2011 to February 2020 on an observational, prospective, single-institution protocol were abstracted. Local control and overall survival were calculated by the Kaplan-Meier method. During radiation, weekly assessments of toxicity were obtained, and for patients with ≥ 90 days of follow-up, late toxicity was assessed. Results: Seventy-two patients were identified. Median age was 54 years (range, 23-87 years). Sixty-three patients (88%) received postoperative therapy, and nine patients (12%) were treated definitively. Twenty-six patients (36%) received concurrent chemotherapy. Nine patients (12%) had received prior radiation. All (99%) but one patient received unilateral treatment with a median dose of 64 GyRBE (relative biological effectiveness) (interquartile range [IQR], 60-66), and 53 patients (74%) received intensity-modulated proton therapy with either single-field or multifield optimization. The median follow-up time was 30 months. Two-year local control and overall survival rates were 96% (95% confidence interval [CI] 85%-99%) and 89% (95% CI 76%-95%], respectively. Radiation dermatitis was the predominant grade-3 toxicity (seen in 21% [n = 15] of the patients), and grade ≥ 2 mucositis was rare (14%; n = 10 patients). No late-grade ≥ 3 toxicities were reported. Conclusion: Proton beam therapy for treatment of major SGCs manifests in low rates of acute mucosal toxicity. In addition, the current data suggest a high rate of local control and minimal late toxicity.

Published in International Journal of Particle Therapy

ISSN: 2331-5180 (Online)
Publisher: Elsevier
Country of publisher: Netherlands
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine; Science: Physics: Nuclear and particle physics. Atomic energy. Radioactivity
Website: https://www.sciencedirect.com/journal/international-journal-of-particle-therapy

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