Abstract
Background and objective Fast neutron radiotherapy (NRT) is a high linear energy transfer (LET) particle therapy that offers a local control (LC) advantage over low-LET X-rays in the treatment of advanced and unresectable salivary gland malignancies. However, in tumors approximating the base of skull (BOS), target volumes may be underdosed to minimize toxicity to the central nervous system (CNS). In this setting, a proton beam boost to the underdosed part of the tumor may improve LC. We report our early experience with a hybrid neutron-proton approach in patients with BOS involvement. Materials and methods We retrospectively reviewed 29 patients with locally advanced and unresectable salivary gland tumors involving the BOS between 2014-2018. The median age of the patients was 56 years, with the majority of them having adenoid cystic carcinomas (ACC) (79%) with advanced T4a/b disease (86%), pathologic perineural invasion (PNI) (55.2%), and orbital invasion (34.5%). Five patients (17.2%) were cases of re-irradiation. Surgical resection was attempted in 15 patients (51.7%), of which none achieved negative margins. The median neutron dose was 18.4 neutron Gray (nGy) with a sequential proton boost (PB) with a median dose of 25 Gy [...Continue Reading
References
Nov 1, 1988·International Journal of Radiation Oncology, Biology, Physics·T W GriffinM H Maor
Sep 30, 1993·International Journal of Radiation Oncology, Biology, Physics·G E LaramoreL W Davis
Apr 28, 2001·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·P E HuberR Engenhart-Cabillic
Sep 17, 2003·Archives of Otolaryngology--head & Neck Surgery·James G DouglasGeorge E Laramore
Feb 6, 2004·Head & Neck·William M MendenhallDouglas B Villaret
Dec 4, 2004·Otolaryngology--head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery·Alen N CohenThomas C Calcaterra
Jun 8, 2006·Radiation Oncology·M W MünterJ Debus
Aug 15, 2006·International Journal of Radiation Oncology, Biology, Physics·Allen M ChenDavid W Eisele
Nov 23, 2006·Archives of Otolaryngology--head & Neck Surgery·Pascal PommierAnnie W Chan
Nov 21, 2007·Head & Neck·James G DouglasGeorge E Laramore
Nov 22, 2007·International Journal of Radiation Oncology, Biology, Physics·Daniel R GomezNancy Y Lee
Dec 4, 2014·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Masaru TakagiNobukazu Fuwa
Feb 3, 2015·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Alexandra D JensenJürgen Debus
Jul 15, 2015·Radiotherapy and Oncology : Journal of the European Society for Therapeutic Radiology and Oncology·Alexandra D JensenJürgen Debus
Jan 23, 2017·Oral Oncology·Michelle S GentileAnnie W Chan
Mar 23, 2017·The Laryngoscope·Safina AliIan Ganly
Feb 8, 2018·International Journal of Radiation Oncology, Biology, Physics·Nor Shazrina SulaimanUNKNOWN Japan Carbon-Ion Radiation Oncology Study Group
Apr 12, 2018·Physics in Medicine and Biology·Gregory B MoffittGeorge E Laramore