Head, Neck & Orofacial Tumours

ENT tumours are a common diagnosis treated at proton centres around the world. The reason is the complexity of the target volumes, which often does not allow the administration of curative doses while respecting the tolerated doses to critical organs.

In addition to increasing curability, the aim is to reduce late side effects and maintain the quality of life of the patients.

Indications for Proton Radiotherapy

  • Tumours of paranasal sinuses (primary or postoperative radiotherapy)
  • Tumours of salivary glands (primary or postoperative radiotherapy)
  • Nasopharyngeal cancer (primary radio-chemotherapy)
  • Base of skull tumours (chordoma, chondrosarcoma)
  • Tonsil tumours (mainly postoperative., HPV16+, youth)

Contraindications

  • Metastasis (the cancer has spread from its primary location to other organs)
  • Metal/ceramic parts in the radiation field
  • Presence of a pacemaker

Advantages of Proton Therapy

The main advantage of proton therapy derived from the Bragg peak is that it allows the beam to deliver a predefined dose with high accuracy directly into the tumour. Healthy tissue lying in front of tumours (approximately 30% of the absorbed energy protons) is preserved and there is complete protection of healthy tissue behind the tumour because it does not absorb any energy. It also allows for an increased dose to the tumour target volume, thereby increasing the likelihood of local disease control. At a given dose, unwanted side effects on healthy tissue are reduced.

  • Increased preservation of surrounding healthy tissue with a reduced risk of toxicity and costs associated with treatment of postirradiation toxicity (artificial nutrition, including the introduction of percutaneous endoscopic gastrostomy, hormone replacement hypofunction during postirradiation pituitary and thyroid gland, treatment of skin defects after RT treatment of xerostomia, which is caused by impaired salivary glands after photon radiotherapy)
  • Reduction of late side effects significantly affecting the quality of life of patients, such as permanent swallowing difficulties and PEG dependence, hearing disorders, radiation-induced cognitive dysfunction, and in some cases xerostomia, which is caused by damage to the salivary glands after radiotherapy.
  • Improved local disease control with reduced costs for rescue treatment (chemotherapy, biological targeted biological therapy)

“Proton therapy significantly reduces the level of toxicity. It means that the number of hospitalisations and the use of a PEG tube after proton treatment is almost zero“ says Dr Kubes, Medical Director of the Prague Proton Therapy Center.

When comparing conventional and proton RT, there is a clear benefit in reducing the burden on the healthy tissues while increasing the dose delivered to the tumour. This dose reduction is not limited to a single organ, it is a complete reduction of radiation exposure to healthy tissues. The level of this reduction is individual.

In properly selected indications, proton radiotherapy allows the administration of high doses of radiation in combination with chemotherapy, with minimal risk of hospitalisation, percutaneous endoscopic gastrostomy and treatment with opioid analgesics.

To learn more about proton therapy for head, neck & orofacial tumours, or to find out if you are a suitable candidate for treatment at our centre, contact us today. Our team will get back to you with a detailed response as soon as possible.

* Suitability for treatment at our centre must be determined by our medical team.