2024-03-28T11:19:41Zhttps://eprints.lib.hokudai.ac.jp/dspace-oai/requestoai:eprints.lib.hokudai.ac.jp:2115/821372022-11-17T02:08:08Zhdl_2115_20043hdl_2115_137Analysis of acute-phase toxicities of intensity-modulated proton therapy using a model-based approach in pharyngeal cancer patients1000000431362Yasuda, KoichiMinatogawa, HidekiDekura, YasuhiroTakao, SeishinTamura, MasayaTsushima, NayutaSuzuki, TakayoshiKano, SatoshiMizumachi, TakatsuguMori, TakashiNishioka, KentaroShido, MotoyasuKatoh, NorioTaguchi, HiroshiFujima, NoriyukiOnimaru, RikiyaYokota, IsaoKobashi, KeijiShimizu, ShinichiHomma, AkihiroShirato, HirokiAoyama, Hidefumimetadata only accessIMPTpharyngeal cancerrobust optimization490Pharyngeal cancer patients treated with intensity-modulated proton therapy (IMPT) using a model-based approach were retrospectively reviewed, and acute toxicities were analyzed. From June 2016 to March 2019, 15 pharyngeal (7 naso-, 5 oro- and 3 hypo-pharyngeal) cancer patients received IMPT with robust optimization. Simulation plans for IMPT and intensity-modulated X-ray therapy (IMXT) were generated before treatment. We also reviewed 127 pharyngeal cancer patients with IMXT in the same treatment period. In the simulation planning comparison, all of the normal-tissue complication probability values for dysphagia, dysgeusia, tube-feeding dependence and xerostomia were lower for IMPT than for IMXT in the 15 patients. After completing IMPT, 13 patients completed the evaluation, and 12 of thesepatientshad a complete response. The proportions of patients who experienced grade 2 or worse acute toxicities in the IMPT and IMXT cohorts were 21.4 and 56.5% for dysphagia (P < 0.05), 46.7 and 76.3% for dysgeusia (P < 0.05), 73.3 and 62.8% for xerostomia (P = 0.43), 73.3 and 90.6% formucositis (P = 0.08) and 66.7 and 76.4% for dermatitis (P = 0.42), respectively. Multivariate analysis revealed that IMPT was independently associated with a lower rate of grade 2 or worse dysphagia and dysgeusia. After propensity score matching, 12 pairs of IMPT and IMXT patients were selected. Dysphagia was also statistically lower in IMPT than in IMXT (P < 0.05). IMPT using a model-based approach may have clinical benefits for acute dysphagia.Oxford University Press2021-03engjournal articleNAhttp://hdl.handle.net/2115/82137https://doi.org/10.1093/jrr/rraa1300449-3060Journal of Radiation Research622329337