Contributed by: Dr Looi Wen Shen, Dr Wong Ru Xin, Dr Shaun Ho
Proton Therapy Radiotherapy Shown To Be Superior To Conventional Radiotherapy In A Trial
In a phase III randomized trial, proton therapy radiotherapy was demonstrated to be superior to conventional radiotherapy such as IMRT and VMAT. Proton therapy reduced tube feeding dependence from 42% to 28%, and more proton therapy patients sustained their nutrition with end of treatment weight loss < 5% from baseline. The authors’ conclusion was that proton therapy has emerged as a standard of care CRT approach for oropharyngeal cancer that reduces malnutrition and tube feeding dependence. Similar findings have also been reported for nasopharyngeal cancer (NPC) in a systematic review.
Given that both early-onset and late-onset toxicity is related to radiotherapy doses, it is concievable that we will see a reduction of late-onset side effects in proton therapy patients. This is important as late-onset side effects have significant impact on patients’ quality of life.
Based on the authors’ conclusions, it is questionable if patients with oropharyngeal and nasopharyngeal cancer should be treated with conventional radiotherapy such as IMRT and VMAT if proton therapy is accessible to the patient.
