Oncologic outcomes for head and neck skin malignancies treated with protons

Jidapa Bridhikitti, Jason K. Viehman, W. Scott Harmsen, Adam C. Amundson, Satomi Shiraishi, Daniel W. Mundy, Jean Claude M. Rwigema, Lisa A. McGee, Samir H. Patel, David M. Routman, Scott C. Lester, Michelle A. Neben-Wittich, Yolanda I. Garces, Daniel J. Ma, Robert L. Foote

Research output: Contribution to journalArticlepeer-review


Purpose: Radiation therapy (RT) is the standard treatment for patients with inoperable skin malignancies of the head and neck region (H&N), and as adjuvant treatment post surgery in patients at high risk for local or regional recurrence. This study reports clinical outcomes of intensity-modulated proton therapy (IMPT) for these malignancies. Materials and Methods: We retrospectively reviewed cases involving 47 patients with H&N malignancies of the skin (squamous cell, basal cell, melanoma, Merkel cell, angiosarcoma, other) who underwent IMPT for curative intent between July 2016 and July 2019. Overall survival was estimated via Kaplan-Meier analysis, and oncologic outcomes were reported as cumulative incidence with death as a competing risk. Results: The 2-year estimated local recurrence rate, regional recurrence rate, local regional recurrence rate, distant metastasis rate, and overall survival were 11.1% (95% confidence interval [CI], 4.1%-30.3%), 4.4% (95% CI, 1.1%-17.4%), 15.5% (95% CI, 7%-34.3%), 23.4% (95% CI, 5.8%-95.5%), and 87.2% (95% CI, 75.7%- 100%), respectively. No patient was reported to have a grade 3 or higher adverse event during the last week of treatment or at the 3-month follow-up visit. Conclusion: IMPT is safe and effective in the treatment of skin malignancies of the H&N.

Original languageEnglish (US)
Pages (from-to)294-303
Number of pages10
JournalInternational Journal of Particle Therapy
Issue number1
StatePublished - Jun 1 2021


  • Adverse events
  • Intensity-modulated proton therapy
  • Oncologic outcomes
  • Skin cancer

ASJC Scopus subject areas

  • Atomic and Molecular Physics, and Optics
  • Radiology Nuclear Medicine and imaging


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