Proton therapy, the latest evolution in radiation oncology can help better management of cancer of the tongue, neck and head. The tissues surrounding these organs are delicate and integrated to control varied functions that localized radiation therapy like proton therapy delivers better treatment outcomes without causing any secondary damage.
Proton therapy is gaining importance in cancer management due to its effective localized treatment minimizing the possibility of long-term complications, which are often caused by conventional X-Ray radiation therapies.
This therapy involves the radiation of proton (subatomic particles) beams and directly targets the tumor or the cancerous area to be treated without irradiating the healthy surrounding tissues and organs.
Evolution of radiation oncology:
Intensity Modulated Radiation Therapy (IMRT) has enabled a great scope for target-specific treatment modality using photon beams. These continuously deposit energy while traversing the target tissue but those beyond the primary target also receive a small dose of radiation, which is not desired.
While, in proton therapy, the high energy proton particles deliver their entire energy only on the target tissue or organ depositing almost zero dose radiation to the secondary tissues. In comparison, proton therapy can be considered superior to other treatment modalities where the possibility of targeting the radiation is much higher.
Managing cancer of the tongue, neck and head with proton therapy:
The complex anatomy of head and neck demands multispecialty expertise as the cancers in these areas are rare. However, cancer in head, neck and tongue can arise from 20 different sites like mouth, throat, nose, salivary glands, voice box, skin and sinuses which are tough to treat by normal radiation therapies. The delicate nature of the tissues poses a high risk of developing serious complications.
Proton therapy causes lesser complications:
Normal radiotherapy causes severe side effects seriously impacting the quality of life. Let us consider the tongue which is intricately placed in the oral cavity and is connected with sensitive and delicate organs like lips, salivary glands, cheek, jawbone, thyroid gland and even spinal cord.
Unfortunately, tumors located in tongue demands higher doses of radiation. Treating these areas is highly challenging because radiation is bound to affect the surrounding healthy tissues. The patient if given normal radiation often suffers from painful mouth sores, difficulty in swallowing, significant loss of taste and extremely dry mouth. Sometimes it can also lead to permanent loss of hearing. This can be minimized through proton therapy.
Remotely located tumors in the brain cannot be treated with normal radiotherapy as there are high chances of damaging optic nerves which may lead to permanent blindness. Proton therapy is very effective in such cases as it will target the tumor only leaving other tissues unscathed.
Improved localized radiation:
The pencil-beam scanning technique of proton therapy further concentrates the radiation on the targeted site which is even better than other types of proton therapy that involves passively scattered protons.
Better scope for multiple doses of radiation:
One dose of radiation is often not quite enough to control cancer. In case more than one dose is required, proton therapy is more advantageous as the controlled radiation can be directed to the targeted site only. Naturally, this results in higher cure rates as there are much lesser chances of recurrence.
Reduced chance of secondary cancers:
Proton therapy reduces the chances of secondary cancers in the surrounding organs and tissues which are often caused by repeat doses of X-Ray radiation.
Delivering less toxicity is the key advantage:
Proton therapy is yet to find widespread applications as clinical trials are still on to confirm its superiority to IMRT. Though IMRT has provided much improved results in the domain of treating head and neck cancer, but proton therapy seems to be a better modality.
A study with 81 patients at MD Anderson reported better treatment outcome with proton therapy. Therefore, this therapy holds a great future for treating head, neck and tongue cancer. It is worth creating more proton therapy centers for the benefit of patients.
