Intensity-Modulated Radiation Therapy and Intensity-Modulated Proton Therapy—2 Effective Treatment Modalities for Nasopharyngeal Cancer

Menée sur la période 2016-2019 auprès de 77 patients atteints d'un carcinome rhinopharyngé non métastatique (67 % d'hommes ; âge médian : 48,7 ans ; durée médiane de suivi : 30,3 mois), cette étude compare l'efficacité, du point de vue de la survie sans échec locorégionale, et la toxicité de 2 traitements avec modulation d'intensité, l'un par protonthérapie et l'autre par radiothérapie

Résumé en anglais

Elsewhere in JAMA Network Open, Li et al report their institutional experience to examine survival and toxic effects among patients with nasopharyngeal cancer treated with photon-based intensity-modulated radiation therapy (IMRT) or intensity-modulated proton radiotherapy (IMPT). The study found excellent disease control outcomes in patients treated with either modality. There was a modest reduction in grade 2 and higher toxic effects seen among patients treated with IMPT.IMPT is a powerful technology with great promise to improve the delivery of radiation to tumors while sparing normal tissue. A largely unanswered question regarding IMPT is whether there is a significant benefit in terms of tumor control and toxic effects between it and IMRT. Ideally, large randomized clinical trials could be performed to directly determine what benefits, if any, exist for IMPT vs IMRT, but unfortunately, these studies have been difficult to perform. In recognition of the elusiveness of randomized clinical trials comparing IMPT with IMRT, other methods have been used to ascertain the potential clinical benefit of IMPT. This includes retrospective studies with statistical techniques to attempt to account for differences in patient and disease characteristics between treatment groups.