Reduced Side Effects, Increased Potential for Cure in Some
Cancers of the head, neck and skull base are difficult to treat, depending upon the proximity of the tumor to the many essential organs in the region. By reducing radiation dose to these organs, proton therapy can decrease side effects, and/or allow higher doses of radiation to increase the chance of cure.
Current indications for proton therapy for head, neck and skull base tumors, and the benefits of proton treatment, include:
Oropharyngeal cancers (tonsil, base of tongue, soft palate, etc.)
- Lowers the rates of feeding tube usage, as well as the burden of taste and appetite changes, as compared to IMRT 
- Results in less weight loss, dry mouth and fatigue, and quicker return to work [2,3]
Paranasal Sinus cancers (maxillary sinus, nasal cavity, ethmoid sinus, etc.)
- Lowers the risk of tumor recurrence as compared to treatment with conventional radiation 
Skull base tumors (chordomas, chondrosarcomas, etc.)
- Allows for optimal dosage to increase the chance of cure 
- Allows for curative doses while sparing normal tissues that have previously been irradiated, with promising results 
1. Sio, T. T., Lin, H. K., Shi, Q., Gunn, G. B., Cleeland, C. S., Lee, J. J., ... & Rosenthal, D. I. (2016). Intensity modulated proton therapy versus intensity modulated photon radiation therapy for oropharyngeal cancer: first comparative results of patient-reported outcomes. International Journal of Radiation Oncology* Biology* Physics, 95(4), 1107-1114.
2. Ahn PH, Sharma S, Zhou O, Lukens JN, Lin A. A Comparative Quality of Life Cohort of Oropharyngeal Squamous Cell (OPSCC) Patients treated with Volumetric Modulated Radiation Therapy (VMAT) versus Proton Pencil Beam Scanning (PBS). American Society for Radiation Oncology. Oral Presentation: October 2015
3. Sharma S, Zhou O, Thompson R, Lukens JN, Lin A, Ahn PH. A Comparative Study of Patient Reported Xerostomia and Dysgeusia in Oropharyngeal Squamous Cell Carcinoma (OPSCC) Treated with Volumetric Modulated Arc Therapy (VMAT) or Proton Pencil Beam Scanning (PBS) American Society for Radiation Oncology. Oral Presentation: October 2015
4. Patel, S. H., Wang, Z., Wong, W. W., Murad, M. H., Buckey, C. R., Mohammed, K., ... & Foote, R. L. (2014). Charged particle therapy versus photon therapy for paranasal sinus and nasal cavity malignant diseases: a systematic review and meta-analysis. The Lancet Oncology, 15(9), 1027-1038.
5. Schulz-Ertner, D., & Tsujii, H. (2007). Particle radiation therapy using proton and heavier ion beams. Journal of clinical oncology, 25(8), 953-964.
6. Romesser, P. B., Cahlon, O., Scher, E. D., Hug, E. B., Sine, K., DeSelm, C., ... & Lee, N. Y. (2016). Proton beam reirradiation for recurrent head and neck cancer: multi-institutional report on feasibility and early outcomes. International Journal of Radiation Oncology* Biology* Physics, 95(1), 386-395.