Acute, late toxicities & early outcomes in children after proton therapy for head & neck malignancy
Pilar, A Saunders, Daniel Pan, Shermaine Gaito, Simona Charlwood, Frances C Lowe, Matthew Smith, Ed McPartlin, Andrew J Thorp, Nicola
Pilar, A
Saunders, Daniel
Pan, Shermaine
Gaito, Simona
Charlwood, Frances C
Lowe, Matthew
Smith, Ed
McPartlin, Andrew J
Thorp, Nicola
Citations
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Abstract
Purpose or Objective
To report acute and early late toxicities and early clinical outcomes following proton beam therapy (PBT) for
paediatric/adolescent head and neck (HN) malignancies treated at our institute.
Materials and Methods
We retrospectively analysed prospectively maintained electronic records for all patients <25 years of age treated with PBT
at our institute for HN malignancies between 2018-2020. All patients were treated with pencil beam scanning PBT with
daily cone-beam CT (CBCT). Toxicity was assessed weekly on treatment and then at regular follow-up and graded according
to CTCAE v5. All patients had post-treatment imaging to assess response at 12 weeks and repeat imaging was performed in
those with suspicion of clinical recurrence.
Results
48 patients <25 years of age were treated with PBT at our institute for HN malignancies during the study period. The median
age at treatment was 14 years (range: 1-25 years). Patient, disease, and treatment characteristics are highlighted in table
1. After a median follow-up of 18 months (Range: 8-34 months), the actuarial 1-year overall survival, local control, and
distant control rates for the entire cohort were 92%, 89%, and 94%, respectively. Five patients experienced an isolated local
failure (3 RMS, 1 ES, and 1 other). Only 1 patient had a nodal recurrence and was surgically salvaged. Isolated distant failure . Conclusion
Our BH technique results in sufficiently stable breath-holds for proton therapy. The BH proton technique resulted in a lower
MHD than the BH photon technique in all patients. In the current cohort, BH proton therapy would have resulted in a
clinically significant reduction of ≥ 2% in the life time risk of ≥ grade 4 acute coronary events in the majority of patients.
Description
Date
2022
Publisher
Collections
Keywords
Type
Meetings and Proceedings
Citation
Pilar A, Saunders D, Pan S, Gaito S, Charlwood F, Lowe M, et al. Acute, late toxicities & early outcomes in children after proton therapy for head & neck malignancy. Radiotherapy and Oncology. 2022 May;170:S143-S4. PubMed PMID: WOS:000806759200142.