PTC CLINIC
Information for Healthcare Professionals

ENT tumors are a common diagnosis treated at proton centers around the world. The reason is the complexity of the target volumes, which often do not allow the administration of curative doses while respecting the tolerated doses to critical organs. In addition to increasing curability, the aim is to reduce late adverse effects and emphasize the quality of life of the patients.

Indications of proton therapy in the treatment of ENT tumors at the PTC center fall in the “list of indications of proton therapy” as prepared by the PTC board of experts (including radiation oncologists and other specialists). They are based on usual indications at proton centers in the world and recommended by professional organizations involved in proton radiotherapy.

Indications of proton therapy and strategies of radiation therapy:

• Tumors of the paranasal sinuses
• Nasopharyngeal tumors
• Tumors of the salivary glands
• Tumors of the tonsils, especially HPV16 +
• Benign ENT tumors after exhaustion of other treatment options
• Reiradiace

Proton radiotherapy allows a significant reduction in doses to critical structures in the head and neck, in particular to:

• Salivary glands
• Brain stem
• Brain, in particular structures responsible for cognitive functions (hippocampus, periventricular area)
• Inner ear
• Optic tracts
• Midline structures – constrictors of the pharynx, esophagus, larynx
• Chewing muscles and temporomandibular joint

The level of dose reduction is highly individual. Generally, the structures that achieve maximum benefits from proton radiotherapy are those located more distant from the target volume or the contralateral structures.

For indications of proton therapy in ENT tumors worldwide, see:

• MD Anderson Cancer Centre – http://www.mdanderson.org/patient-and-cancer-information/proton-therapy-center/conditions-we-treat/head-and-neck-cancers/index.html
• Scripps proton therapy center, San Diego – http://www.scripps.org/services/cancer-care__proton-therapy/conditions-treated__proton-therapy-for-head-and-neck-cancers
• Loma Linda Proton therapy center, California – http://www.protons.com/proton-therapy/proton-treatments/other-conditions.page?
• University of Florida – http://www.floridaproton.org/cancers-treated/head-neck-cancer