Combined intensity-modulated radiotherapy plus raster-scanned XXXX ion boost for advanced @entity2347 of the @entity135 results in superior locoregional control and @entity1349 .

@entity1 @entity135 @entity137 @entity5 @entity2347 @entity18106 @entity505 @entity1349
BACKGROUND: Local control in @entity1 with @entity2347 ( @entity2347 ) of the @entity135 remains a challenge because of the relative radioresistance of these @entity5 . This prospective @entity505 ion pilot project was designed to evaluate the efficacy and @entity137 of intensity-modulated radiotherapy (IMRT) plus @entity505 ion (C12) boost ( @entity18106 therapy). The authors present the first analysis of long-term outcomes of raster-scanned C12 therapy compared with modern photon techniques. METHODS: @entity1 with inoperable or subtotally resected @entity2347 received C12 therapy within the pilot project. Whenever C12 was not available, @entity1 were offered IMRT or fractionated stereotactic radiotherapy (FSRT). @entity1 received either C12 therapy at a C12 dose of 3 Gray equivalents (GyE) per fraction up to 18 GyE followed by 54 Gray (Gy) of IMRT or IMRT up to a median total dose of 66 Gy. @entity137 was evaluated according to version 3 of the Common @entity137 Terminology for Adverse Events. Locoregional control (LC), progression-free survival (PFS), and @entity1349 ( @entity1349 ) were analyzed using the Kaplan-Meier method. RESULTS: Fifty-eight @entity1 received C12 therapy, and 37 received photons (IMRT or FSRT). The median follow-up was 74 months in the C12 group and 63 months in the photon group. Overall, 90% of @entity1 in the C12 group and 94% of those in the photon group had T4 @entity5 ; and the most common disease sites were paranasal sinus, parotid with skull base invasion, and nasopharynx. LC, PFS, and @entity1349 at 5 years were significantly higher in the C12 group (59.6%, 48.4%, 76.5%, respectively) compared with the photon group (39.9%, 27%, and 58.7%, respectively). There was no significant difference between @entity1 who had subtotally resected and inoperable @entity2347 . CONCLUSIONS: C12 therapy resulted in superior LC, PFS, and @entity1349 without a significant difference between @entity1 with inoperable and partially resected @entity2347 . Extensive and morbid resections in @entity1 with advanced @entity2347 may need to be reconsidered. The most common site of locoregional recurrence remains in field, and further C12 dose escalation should be evaluated.
