Lower-Neck Sparing Using Proton Therapy in Patients with Uninvolved Neck Nasopharyngeal Carcinoma: Is It Safe?
Undifferentiated carcinoma of the nasopharynx (NPC) is a rare disease, which usually occurs in the Asian population. Due to its anatomic location, it is characterised by rich lymph node drainage and has a high incidence of cervical node metastasis. However, cervical nodal metastasis commonly involve...
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| Format: | Article |
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MDPI AG
2022-06-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/12/3297 |
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| author | Francesca De Felice Alessandro Vai Anna Maria Camarda Nicola Alessandro Iacovelli Ester Orlandi |
| author_facet | Francesca De Felice Alessandro Vai Anna Maria Camarda Nicola Alessandro Iacovelli Ester Orlandi |
| author_sort | Francesca De Felice |
| collection | DOAJ |
| description | Undifferentiated carcinoma of the nasopharynx (NPC) is a rare disease, which usually occurs in the Asian population. Due to its anatomic location, it is characterised by rich lymph node drainage and has a high incidence of cervical node metastasis. However, cervical nodal metastasis commonly involves retropharyngeal nodes and level II nodes, followed by level III nodes. In recent years, innovations in terms of systemic treatments and radiotherapy techniques have improved oncological outcome and treatment-related toxicities. Therefore, there is a growing interest in de-intensification strategies of reducing volumes and treatment-related side effects, especially in patients with NPC with N0–N1-stage disease. Proton therapy could represent a valid alternative to Intensity Modulated Radiotherapy (IMRT) in the management of NPC in this setting. With this Commentary, we aim to explore the feasibility of Intensity Modulated Proton Therapy (IMPT) in upper-neck irradiation of NPC N1-stage disease. We selected an NPC patient with N1 disease and compared the original IMRT plan with the IMPT plan in terms of dosimetric parameters. IMPT offers a minimal dosimetric advantage over IMRT in the bilateral lower-neck sparing. Clinical trials are needed to evaluate the significance of these proposed suggestions and their applicability in non-endemic areas. |
| first_indexed | 2024-03-09T23:28:20Z |
| format | Article |
| id | doaj.art-7d378ab4bfed4b7199565737f38fa72b |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T23:28:20Z |
| publishDate | 2022-06-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-7d378ab4bfed4b7199565737f38fa72b2023-11-23T17:13:39ZengMDPI AGJournal of Clinical Medicine2077-03832022-06-011112329710.3390/jcm11123297Lower-Neck Sparing Using Proton Therapy in Patients with Uninvolved Neck Nasopharyngeal Carcinoma: Is It Safe?Francesca De Felice0Alessandro Vai1Anna Maria Camarda2Nicola Alessandro Iacovelli3Ester Orlandi4Radiation Oncology, Policlinico Umberto I, Department of Radiological, Oncological and Pathological Sciences, “Sapienza” University of Rome, Viale Regina Elena 326, 00161 Rome, ItalyRadiation Oncology, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Strada Campeggi 53, 27100 Pavia, ItalyRadiation Oncology, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Strada Campeggi 53, 27100 Pavia, ItalyRadiation Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Via G. Venezian 1, 20133 Milan, ItalyRadiation Oncology, Clinical Department, National Center for Oncological Hadrontherapy (CNAO), Strada Campeggi 53, 27100 Pavia, ItalyUndifferentiated carcinoma of the nasopharynx (NPC) is a rare disease, which usually occurs in the Asian population. Due to its anatomic location, it is characterised by rich lymph node drainage and has a high incidence of cervical node metastasis. However, cervical nodal metastasis commonly involves retropharyngeal nodes and level II nodes, followed by level III nodes. In recent years, innovations in terms of systemic treatments and radiotherapy techniques have improved oncological outcome and treatment-related toxicities. Therefore, there is a growing interest in de-intensification strategies of reducing volumes and treatment-related side effects, especially in patients with NPC with N0–N1-stage disease. Proton therapy could represent a valid alternative to Intensity Modulated Radiotherapy (IMRT) in the management of NPC in this setting. With this Commentary, we aim to explore the feasibility of Intensity Modulated Proton Therapy (IMPT) in upper-neck irradiation of NPC N1-stage disease. We selected an NPC patient with N1 disease and compared the original IMRT plan with the IMPT plan in terms of dosimetric parameters. IMPT offers a minimal dosimetric advantage over IMRT in the bilateral lower-neck sparing. Clinical trials are needed to evaluate the significance of these proposed suggestions and their applicability in non-endemic areas.https://www.mdpi.com/2077-0383/11/12/3297protonphotonIMRThead neck cancernasopharyngeal carcinomaprophylactic neck irradiation |
| spellingShingle | Francesca De Felice Alessandro Vai Anna Maria Camarda Nicola Alessandro Iacovelli Ester Orlandi Lower-Neck Sparing Using Proton Therapy in Patients with Uninvolved Neck Nasopharyngeal Carcinoma: Is It Safe? Journal of Clinical Medicine proton photon IMRT head neck cancer nasopharyngeal carcinoma prophylactic neck irradiation |
| title | Lower-Neck Sparing Using Proton Therapy in Patients with Uninvolved Neck Nasopharyngeal Carcinoma: Is It Safe? |
| title_full | Lower-Neck Sparing Using Proton Therapy in Patients with Uninvolved Neck Nasopharyngeal Carcinoma: Is It Safe? |
| title_fullStr | Lower-Neck Sparing Using Proton Therapy in Patients with Uninvolved Neck Nasopharyngeal Carcinoma: Is It Safe? |
| title_full_unstemmed | Lower-Neck Sparing Using Proton Therapy in Patients with Uninvolved Neck Nasopharyngeal Carcinoma: Is It Safe? |
| title_short | Lower-Neck Sparing Using Proton Therapy in Patients with Uninvolved Neck Nasopharyngeal Carcinoma: Is It Safe? |
| title_sort | lower neck sparing using proton therapy in patients with uninvolved neck nasopharyngeal carcinoma is it safe |
| topic | proton photon IMRT head neck cancer nasopharyngeal carcinoma prophylactic neck irradiation |
| url | https://www.mdpi.com/2077-0383/11/12/3297 |
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