Photon versus Proton Therapy in the Management of Head and Neck Cancer: A Systematic Review
Bibliographic record
Abstract
Introduction: Head and Neck Cancers (HNC), particularly Head and Neck Squamous Cell Carcinoma (HNSCC), are major causes of cancer morbidity and mortality. Radiation therapy, commonly using photons, can damage surrounding healthy tissues. Proton Therapy (PT), with its ability to target tumours more precisely, may reduce toxicity and improve Quality Of Life (QOL). The present review compares the efficacy, toxicity, and QOL outcomes of proton versus photon therapies in HNSCC treatment. Aim: To evaluate and compare PT versus photon therapy in terms of therapeutic efficacy, adverse effects, and QOL in the management of HNC. Materials and Methods: A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Electronic searches were performed across PubMed, Scopus, Web of Science, Cochrane Library, and Google Scholar, including studies published from February 2016 to January 2024. Eligible studies involved adult patients diagnosed with HNSCC and compared PT with photon therapy. A total of five studies were included, and their quality was assessed using the Newcastle-Ottawa Scale. A narrative synthesis of findings was performed, focusing on QOL and toxicity profiles. Results: The PT demonstrated a significant dosimetric advantage over photon therapy, particularly in reducing radiation exposure to critical structures such as salivary glands and the spinal cord. Patients receiving PT showed a 40-50% improvement in QOL, with fewer instances of xerostomia, dental problems, and head and neck pain. In comparison, photon therapy resulted in higher rates of acute and chronic toxicity, including greater feeding tube dependence and increased use of opioid medications. PT was also associated with a reduced incidence of weight loss and a decreased need for pain management compared to photon therapy. Conclusion: The PT offers a significant dosimetric advantage over photon therapy, improving QOL and reducing toxicity in patients with HNC. While PT has shown promising results, further research with longer follow-up is needed to confirm its long-term benefits and refine treatment protocols. PT is a viable alternative to photon therapy and is recommended for patients with HNSCC, especially those requiring precise radiation delivers to critical structures.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.006 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".