Carcinoma of the tonsillar region: Potential for use of proton beam therapy

Slater, James M.; Slater, Jerry D.; Archambeau, John O.

doi:10.1016/0360-3016(92)90048-m

Cited by 30 publications

(12 citation statements)

References 36 publications

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“…It not only rinses the oral cavity, but supports the colonization with anticariogenic bacteria [1,2,17], reduces oral acidity [2,27], and keeps cariogenic bacteria in check [1,7,20,27]. We confirmed the observation of other authors [19,39] concerning an exponential decrease of saliva production immediately after the beginning of radiotherapy also for patients with unilateral treatment of the parotid glands. This correlates with the patients' complaint of a dry mouth soon after the start of radiotherapy.…”

Section: Saliva Flowsupporting

confidence: 80%

Saliva Flow, pH, Buffer Capacity, and Colonization by <i>Streptococcus mutans</i> during and after Radical Radiotherapy of Head and Neck Tumours

Beer

Zehnder

Lussi

et al. 2002

Otorhinolaryngol Nova

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Background: How does oral health (saliva pH, buffer capacity, and colonization with Streptococcus mutans) change because of reduced salivary flow during and after radical radiotherapy of head and neck carcinoma dependent on ipsilateral or bilateral parotid irradiation? Patients and Methods: 20 consecutive patients who were radically irradiated because of head and neck carcinomas were studied. They were evaluated before radiotherapy, weekly during therapy, and 6 weeks after the end of treatment. Flow rate, pH and buffer capacity of saliva, and colonization with S. mutans were tested. Results: Stimulated saliva secretion rate dropped in the first radiotherapy week in both groups (p < 0.006). This effect was more pronounced in patients with bilateral parotid gland radiation (BPR) in comparison with unilateral parotid gland radiation (UPR). Depending on dose saliva production declined exponentially up to the end of treatment. No rebound was found up to 6 weeks after the end of therapy, a trend towards a further saliva production was observed. Stimulated saliva was significantly diminished when compared to production before the start of treatment (p < 0.003 for UPR and p < 0.001 for BPR). Buffer capacity was reduced parallel to the saliva deficit. The pH of saliva decreased from a mean of 7.3 before treatment to 6.3 at the end of radiotherapy and did not recover for patients with BPR. For patients with UPR, the pH decreased from a mean of 7.8 to 7.4 and remained constant. Colonization with S. mutans increased during treatment and stayed high after the end of radiotherapy. Conclusion: Saliva production is exponentially reduced during radiotherapy, starting in the first week of treatment. Recovery is not observed up to 6 weeks after therapy. Buffer capacity and pH decline during radiotherapy in relation to saliva loss. Colonization by S. mutans increases markedly during radiotherapy and remained high afterwards.

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Section: Saliva Flowsupporting

confidence: 80%

Saliva Flow, pH, Buffer Capacity, and Colonization by <i>Streptococcus mutans</i> during and after Radical Radiotherapy of Head and Neck Tumours

Beer

Zehnder

Lussi

et al. 2002

Otorhinolaryngol Nova

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“…In general, the dose to OARs could be substantially lower, in particular to the parotid glands [15][16][17][18][19]21], the larynx [19,21], and the spinal cord [16,19,20]. In one study, no difference was noted among three-, five-and nine-field scanning IMPT [18].…”

Section: Oropharyngeal Hypopharyngeal and Laryngeal Cancermentioning

confidence: 99%

“…We identified seven studies reporting on ISPC studies among patients with oropharyngeal, hypopharyngeal, and laryngeal carcinoma, including a total of 22 patients [15][16][17][18][19][20][21] (Table 3). In one study, only 3D-CRT using parallelopposed fields was compared with 3D-CPT [15].…”

Section: Oropharyngeal Hypopharyngeal and Laryngeal Cancermentioning

confidence: 99%

“…In one study, only 3D-CRT using parallelopposed fields was compared with 3D-CPT [15]. However, in the majority of studies, IMRT or HT was compared with scanned and/or scattered 3D-CPT [16,17] or with IMPT [18 -21].…”

Section: Oropharyngeal Hypopharyngeal and Laryngeal Cancermentioning

confidence: 99%

“…In general, dose conformity and dose coverage to the PTV were better when protons were used (Table 4). In one study [15], the use of scattered protons allowed dose escalation with approximately 10 Gy, without exceeding the tolerance dose to critical structures, which could not be achieved with photon techniques.…”

Section: Oropharyngeal Hypopharyngeal and Laryngeal Cancermentioning

confidence: 99%

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The Potential Benefit of Radiotherapy with Protons in Head and Neck Cancer with Respect to Normal Tissue Sparing: A Systematic Review of Literature

et al. 2011

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Purpose. Clinical studies concerning head and neck cancer patients treated with protons reporting on radiation-induced side effects are scarce. Therefore, we reviewed the literature regarding the potential benefits of protons compared with the currently used photons in terms of lower doses to normal tissue and the potential for fewer subsequent radiation-induced side effects, with the main focus on in silico planning comparative (ISPC) studies.Materials and Methods. A literature search was performed by two independent researchers on ISPC studies that included proton-based and photon-based irradiation techniques.Results. Initially, 877 papers were retrieved and 14 relevant and eligible ISPC studies were identified and included in this review. Four studies included paranasal sinus cancer cases, three included nasopharyngeal cancer cases, and seven included oropharyngeal, hypopharyngeal, and/or laryngeal cancer cases. Seven studies compared the most sophisticated photon and proton techniques: intensity-modulated photon therapy versus intensity-modulated proton therapy (IMPT). Four studies compared different proton techniques. All studies showed that protons had a lower normal tissue dose, while keeping similar or better target coverage. Two studies found that these lower doses theoretically translated into a significantly lower incidence of salivary dysfunction.Conclusion. The results of ISPC studies indicate that protons have the potential for a significantly lower normal tissue dose, while keeping similar or better target coverage. Scanned IMPT probably offers the most advantage and will allow for a substantially lower probability of radiation-induced side effects. The results of these ISPC studies should be confirmed in properly designed clinical trials. The Oncologist 2011;16:366 -377

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Proton Therapy

Paganetti

Bortfeld

Medical Radiology

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Carcinoma of the tonsillar region: Potential for use of proton beam therapy

Cited by 30 publications

References 36 publications

Saliva Flow, pH, Buffer Capacity, and Colonization by <i>Streptococcus mutans</i> during and after Radical Radiotherapy of Head and Neck Tumours

Saliva Flow, pH, Buffer Capacity, and Colonization by <i>Streptococcus mutans</i> during and after Radical Radiotherapy of Head and Neck Tumours

The Potential Benefit of Radiotherapy with Protons in Head and Neck Cancer with Respect to Normal Tissue Sparing: A Systematic Review of Literature

Proton Therapy

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