Health Problem: Head and neck cancer (HNC) accounts for approximately 4% of all cancers in the United States, with an estimated 65,410 new HNC diagnoses during 2019 and an estimated 14,620 deaths from the disease. HNC can have a negative impact on a person’s quality of life by affecting basic functions such as swallowing, hearing, and speaking.

Technology Description: A form of external beam radiation treatment (EBRT), proton beam therapy (PBT) uses a sophisticated 3-dimensional stereotaxic planning and delivery system to precisely target protons (positively charged, heavy subatomic particles) to bombard a specific tumor mass. Whereas proton and photon techniques should have similar tumor control abilities, PBT is believed to lead to improved sparing of normal tissues, with concomitant reduction in acute and late toxicities.

Controversy: While numerous dosimetry/treatment planning studies suggest that the precision of PBT allows for improved sparing of normal tissues surrounding a tumor resulting in lower rates of acute (short-term) and late (long-term) toxicity compared with standard therapies, there is uncertainty regarding clinical effectiveness and safety. Due to the limited number of facilities that provide PBT, this therapy may not be easily accessible to all patients.

Key Questions: Questions regarding PBT include:

  • Is PBT effective in treating patients with HNC?

  • Is PBT safe in patients with HNC?

  • Have definitive patient selection criteria been identified for PBT in patients with HNC?

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