What is Proton Therapy

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Head & Neck Cancer Treatments

Hank shares his experience with proton therapy.

Protons can be controlled with greater precision than X-rays. This means that more energy goes into destroying the tumor and less radiation is delivered to surrounding healthy tissue. For this reason, proton therapy is particularly good for treating tumors near healthy organs, including head and neck tumors.

More than 60,000 Americans are diagnosed annually with head and neck cancer. When treating head and neck tumors it’s critical to protect the delicate organs that surround the tumor. Proton therapy can potentially reduce damage to eyes, optic nerves, salivary glands, and other organs near head and neck tumors, thereby reducing the likelihood of side effects such as blindness, hearing deterioration, and dry mouth. Secondary malignancies are also less likely with proton therapy.

Tobacco (including smokeless tobacco) and alcohol use are the most important risk factors for head and neck cancers. People who use both tobacco and alcohol are at greater risk for developing these cancers than people who use either tobacco or alcohol alone. Over the past decade, an increasing number of young, non- smokers have developed mouth and throat cancer associated with the human papilloma virus, or HPV.

The left-hand image above shows a proton beam treatment plan for head-and-neck cancer. The right-hand image shows typical treatment with X-rays.

Base-of-Skull Tumors

Base-of-skull tumors include chordomas and chondrosarcomas. Tumors in the base-of-skull region are difficult to treat because they are often close to critical structures such as the brainstem, brain, cranial nerves, and optic nerves. The location of these tumors often makes surgical removal difficult and limits the dose of radiation that can be delivered with standard X-ray radiation treatments. Proton therapy can be particularly appropriate for these tumors because it minimizes radiation exposure to surrounding healthy tissue. Since these tumors are found at a shallow depth, proton therapy is often able to deliver a high dose of radiation precisely to the tumor without affecting tissues of the brain and spinal cord. The more radiation delivered to the tumor the greater the chance of completely destroying it.

The greater precision of proton therapy (left, above) spares healthy organs, allowing a higher dose of radiation to be delivered to base-of-skull tumors. The higher the dose, the better tumor can be controlled.

 

Head & Neck Tract Tumors Most Appropriate for Proton Therapy

  • Base of Skull tumors (including, but not limited to, anterior, middle, and posterior cranial fossa, sphenoid and temporal bone-related tumors)
  • Sino – Nasal cancers (paranasal sinuses and nasal cavity)
  • Cancers located near the orbits/eyes
  • Nasopharynx cancers
  • Small/early oropharyngeal cancers (tonsils, tongue base)
  • Select salivary gland tumors (parotid, sub-mandibular and minor salivary glands of the upper aero-digestive tract) 
  • Complex skin cancers involving cranial nerves and/or lymph nodes of the neck (with a lateralized primary
  • Select patients who have received previous radiation
  • Unknown primary cancers (after a thorough surgical work up)

Three-Field Head & Neck Treatment Technique

Our medical physics and dosimetry teams worked with our radiation oncologists to develop a 3-field treatment technique using pencil beam scanning. This new technique enables us to treat complicated head and neck cancers with multiple dose levels and bi-lateral neck involvement. 

Additional Resources

To read a head-and-neck cancer survivor story, please click here

Head and Neck Cancers; Prostate Cancer

“High tech medicine can be adapted to the individual patient's needs. I enjoy using the latest technological innovations in radiation oncology to design and carry out the optimal treatment for each patient.”

Head and Neck Cancers; Prostate Cancer

“I enjoy establishing strong relationships with my patients, providing individualized and compassionate care, and educating patients about their disease process and treatment.”

Head and Neck Cancers; Melanoma

“My philosophy is to treat my patients as I would like to be treated.”

Related Studies

Charged particle therapy versus photon therapy for paranasal sinus and nasal cavity malignant diseases: a systematic review and meta-analysis Patel, SH, Wang Z, Wong WW, Murad MH, Buckey CR, Mohammed K, Altayar O, Nabhan M, Schild SE, Foote RL Read Study
Application of the pencil-beam redefinition algorithm in heterogeneous media for proton beam therapy. Egashira Y, Nishio T, Hotta K, Kohno R, Uesaka M. Read Study
Cost-effectiveness analysis of cochlear dose reduction by proton beam therapy for medulloblastoma in childhood Hirano E, Fuji H, Onoe T, Kumar V, Shirato H, Kawabuchi K. Read Study
Biological considerations when comparing proton therapy with photon therapy Paganetti H, van Luijk P. Read Study