Head and Neck Tumors

Radiation therapy or concomitant chemoradiotherapy may be administered with curative intent in most locally or locoregionally advanced ear, nose, and throat (ENT) and orofacial tumors, either after surgery or as a single modality.

The goal of radiation therapy is to deliver a sufficient tumoricidal dose to the tumor and to the involved lymph nodes, as well as to areas with a risk of subclinical involvement (the area surrounding the tumor, sentinel lymph nodes), while minimizing the dose to the surrounding healthy organs. The tolerance of these healthy tissues to irradiation is very similar to that of tumor cells and therefore any undesirable effects of the radiation therapy in this area are very serious.

Proton radiotherapy differs from photon radiotherapy by the absorption of ionizing radiation in the tissues. In the area of medium and low doses of radiation, proton radiotherapy has a better dose distribution, while in the area of high doses proton radiotherapy has a similar dose distribution as compared to photon radiotherapy. Low and medium doses of radiation are a source of late and very late side effects of radiotherapy. Therefore the use of proton radiotherapy should be considered in situations where the patient is expected to recover and have a long life expectancy.

Another situation, in which the use of protons is appropriate, is when the cancer located near healthy tissues, which can be damaged by conventional radiation or when photon radiotherapy does not allow the application of safe doses sufficient to eradicate the tumor.

Advantages of proton therapy in ENT tumor irradiation:

• Allows us to significantly reduce the dose of undesirable radiation to the brain, and thus prevent the risk of development of memory impairment.
• Allows us to significantly reduce the dose of undesirable radiation to the spinal cord by up to 80%, and thus prevent the development of myelopathy accompanied by movement impairment or even paralysis.
• Allows us to significantly reduce the dose to all optic structures (macula, cornea, retina, optic nerve), and thus mitigate the risk of visual impairment or loss.
• Mitigates the risk of hearing impairment or loss, namely at high frequencies.
• Allows us to reduce the dose to the structure of swallowing pathways, and thus decrease the probability of swallowing difficulties, saliva production disorder, and necessary insertion of a nutrition feeding tube into the stomach (PEG).