Pediatric patients with head and neck sarcoma can be treated with proton beam therapy and experience similar outcomes with less impact on quality of life (QoL) compared with standard photon radiation, according to research published in Pediatric Blood & Cancer (online October 23, 2017; doi:10.1002/pbc.26858).
For solid tumors in the head and neck such as soft-tissue sarcoma, neuroblastoma, and thyroid cancer, treatment usually involves a combination of chemotherapy, radiation, surgery, and post-operative radiation. However, sensitivity in the head and neck area causes treatment to lower patient QoL through loss of appetite, difficulty swallowing, or mucositis.
Jennifer Vogel, MD, resident in Radiation Oncology, University of Pennsylvania School of Medicine, and colleagues analyzed data of pediatric patients with head and neck malignancies treated with proton beam therapy to evaluate acute toxicities and early outcomes. A total of 69 patients were assessed who were treated at the University hospital or Children’s Hospital of Philadelphia from 2010 to 2016. Among this patient population, 50% (n = 35) had rhabdomyosarcoma, 7% (n = 10) had Ewing sarcoma, and 33% (n = 24) had a variety of other cancers affecting the head and neck area.
Treatment-related toxicities were measured on a scale from 1 to 5, with 5 being the most severe.
After a 12-month follow-up period, researchers reported that 93% of patients were still alive, and 92% did not experience recurrence at their primary disease site.
Results of the analysis showed that no patients exhibited toxicities above grade 3. The most severe toxicities at grade 3 were loss of appetite (22%), difficulty swallowing (7%), and mucositis (4%). Compared to standard photon radiation, typical rates of grade 3 of 4 mucositis in rhabdomyosarcoma is 46%.
“These data show photon therapy is not only effective, it is also more tolerable for patients,” said Christine Hill-Kayser, MD, chief of Pediatric Radiation Oncology Service, University of Pennsylvania School of Medicine, in a press release (October 23, 2017). “This study shows this treatment is safe and offers practice guidelines for delivering head and neck proton therapy in the pediatric population.”
Long-term follow up of the patients in the study is underway to evaluate disease control and late-developing toxicities.—Zachary Bessette