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Is MFO-IMPT Robust Enough for the Treatment of Head and Neck Tumors? A 2- Year Outcome Analysis Following Proton Therapy On the First 50 Oropharynx Patients at the MD Anderson Cancer Center

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S Frank

S Frank*, A Garden , M Anderson , D Rosenthal , W Morrison , B Gunn , C Fuller , J Phan , X Zhang , F Poenisch , R Wu , H Li , A Gautam , N Sahoo , M Gillin , X Zhu , MD Anderson Cancer Ctr., Houston, TX


SU-E-T-529 (Sunday, July 12, 2015) 3:00 PM - 6:00 PM Room: Exhibit Hall

Multi-field optimization intensity modulated proton therapy (MFO-IMPT) for oropharyngeal tumors has been established using robust planning, robust analysis, and robust optimization techniques. While there are inherent uncertainties in proton therapy treatment planning and delivery, outcome reporting are important to validate the proton treatment process. The purpose of this study is to report the first 50 oropharyngeal tumor patients treated de-novo at a single institution with MFO-IMPT.

The data from the first 50 patients with squamous cell carcinoma of the oropharynx treated at MD Anderson Cancer Center from January 2011 to December 2014 on a prospective IRB approved protocol were analyzed. Outcomes were analyzed to include local, regional, and distant treatment failures. Acute and late toxicities were analyzed by CTCAE v4.0.

All patients were treated with definitive intent. The median follow-up time of the 50 patients was 25 months. Patients by gender were male (84%) and female (16%). The average age was 61 years. 50% of patients were never smokers and 4% were current smokers. Presentation by stage; I-1, II-0, III-9, IVA-37 (74%), IVB-3. 88% of patients were HPV/p16+. Patients were treated to 66-70 CGE. One local failure was reported at 13 months following treatment. One neck failure was reported at 12 months. 94% of patients were alive with no evidence of disease. One patient died without evidence of disease. There were no Grade 4 or Grade 5 toxicities.

MFO-IMPT for oropharyngeal tumors is robust and provides excellent outcomes 2 years after treatment. A randomized trial is underway to determine if proton therapy will reduce chronic late toxicities of IMRT.

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