LITERATURE REVIEW - Cancers of the head and neck represent a heterogeneous group of malignancies with a variety of etiologies, pathologies, and natural histories. Anatomic sites include the paranasal sinuses, salivary glands, oral cavity, pharynx, and larynx. However, they are united by a common anatomy that is particularly challenging to treat because of the close proximity of tumors to multiple critical organ structures.

Although surgery has been the mainstay of treatment for many head and neck malignancies, radiation therapy is often used as an adjunct to surgery or definitively to treat tumors for which surgical resection would produce particularly severe morbidity.

Initial observations show that proton therapy is particularly useful for treating tumors in challenging locations close to non-target critical structures (e.g. head and neck cancers near the spinal cord, at the base of skull, and in the paranasal sinus region) due to its ability to spare surrounding normal tissues from unintended irradiation.

Current evidence from the use of proton therapy for tumors at selected head and neck subsites suggest that proton therapy is not only feasible and safe for the treatment of head and neck cancer but indeed may be superior in terms of reducing toxicity while maintaining or improving local control. Continuing advances in the delivery of protons such as IMPT may further reduce toxicity and further enhance the conformality of target coverage.

Holliday E.B., Frank S.J., « Proton radiation therapy for head and neck cancer: a review of the clinical experience to date », Pubmed 24837890, International Journal of Radiation Oncology, Biology, Physics, 2014 June 1, 89(2):292-302.


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