Survival Outcomes and Toxicity in Nasopharyngeal Carcinoma: Proton vs Photon Therapy Lifetime Comparison

Tuesday, October 1, 2024

8:18 AM – 8:24 AM EDT

Location: MBCC, 208

Disclosure(s):

Ching-Nung Wu, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Sheng-Dean Luo, MD, PhD, FACS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: Data to evaluate proton therapy's impact on survival among nasopharyngeal carcinoma (NPC) patients remain scant. This investigation aimed to discern the long-term survival advantage of proton therapy over photon therapy and to measure its efficacy quantitatively.

Methods: Employing a retrospective design spanning multiple institutions, this study drew upon NPC patient data from the Chang Gung Research Database, focusing on those who received definitive radiotherapy from 2016 to 2021. We compared oncological outcomes and treatment-related toxicities associated with proton and photon therapy. To adjust for confounding factors and diagnostic years, a 1:1 frequency matching strategy was implemented. The assessment of oncologic outcomes and toxicities utilized Cox proportional hazards modeling. Kaplan–Meier analysis estimated the survival function and its extrapolation over a lifetime, facilitating the calculation of life expectancy (LE) differences between the therapies.

Results: Among 1,557 NPC patients, proton therapy correlated with improved overall and disease-free survival relative to photon therapy. Post-matching analysis on 552 patients revealed balanced characteristics across groups. The proton therapy cohort demonstrated a substantial reduction in all-cause mortality (adjusted hazard ratio, aHR = 0.31) and disease recurrence (aHR = 0.5). Incidence of feeding tube placement was notably less in the proton therapy group (aHR = 0.31). The projected LE difference favoring the proton group over the photon group was 19.5 years.

Conclusions: Proton therapy yields markedly better overall and disease-free survival outcomes than photon therapy in NPC patients. The lifetime survival difference offers tangible proof of proton therapy's benefit for NPC treatment.

Presenting Author(s)

Ching-Nung Wu, MD

Assistant Professor
Kaohsiung Chang Gung Memorial Hospital
Kaohsiung, Kaohsiung, Taiwan (Republic of China)

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

JW

Jung-Der Wang, PhD

Department of Occupational and Environmental Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan, United States

Disclosure information not submitted.
CL

Chung-Ying Lin, PhD

Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan, United States

Disclosure information not submitted.
WC

Wei-Chih Chen, MD

Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, United States

Disclosure information not submitted.
TC

Tai-Jan Chiu, MD

Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, United States

Disclosure information not submitted.
Sheng-Dean Luo, MD, PhD, FACS

Professor, Department of Otolaryngology
Kaohsiung Chang Gung Memorial Hospital
Kaohsiung, Kaohsiung, Taiwan (Republic of China)

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
YW

Yu-Ming Wang, MD

Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, United States

Disclosure information not submitted.

Senior Author(s)

YW

Yu-Ming Wang, MD

Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan, United States

Disclosure information not submitted.