You have the right to decide about your treatment together with your doctor

To make the right decision, it is important to have information about the results of the treatment you choose. You should not forget that your decision will significantly affect your future life. Our doctors and the entire PTC team are ready to answer all your questions related to proton therapy. Do not hesitate to contact us as soon as possible.

By simply comparing the risks and benefits generally associated with conventional and proton radiotherapy, you can conclude that proton therapy improves the patient’s chances of a cure without unnecessary side effects and complications associated with conventional radiation.

You can influence the treatment decision. Take the first step and contact us to see if proton therapy is suitable for you.

The priority is to protect healthy organs.

The comparison of proton radiotherapy and conventional photon radiotherapy gives a clear answer regarding the main advantages of modern treatment. Proton therapy, which allows a high radiation dose to be aimed precisely at the tumor with millimeter accuracy, improves the patient’s chances of a cure. It achieves higher efficacy, less damage to healthy tissues, and a reduced number of side effects, thus providing a higher chance of faster recovery and better quality of life after treatment.

The added value of proton therapy is that it spares healthy tissues and thus:
– reduces the risk of serious swallowing difficulties, and eliminates the need for the insertion of a feeding tube (a tube inserted into the stomach to provide food and fluids) in most patients.

– minimizes the risk of hearing and vision impairment, as protons can reduce undesirable irradiation in the area of the inner ear and optic nerves.

– causes no disorders of memory, attention, speed of thinking, cognition or speech, as there is no irradiation of the brain tissue.

Proton therapy has lower risks than conventional photon irradiation

Conventional photon radiotherapy for head and neck cancer is one of the most toxic regimens in oncology. Compared with commonly used photon therapy, proton therapy, and especially pencil beam scanning technology, allows for higher doses of radiation directly into the tumor, while better defining this dose to protect healthy tissues. Therefore, this technique is highly beneficial even for complicated head and neck tumors.

Patients with an advanced disease have the highest risk of developing acute and late-onset post-radiation complications. These complications occur to a greater extent in photon therapy due to the irradiation of large volumes of healthy tissues in this sensitive area.

The key to successful treatment is early diagnosis. With proton therapy, you can also preserve your sight, hearing and taste. Due to the accuracy of the proton beam, you have a higher chance of a cure. Protons are able to target the tumor on its own and accurately distribute the dose of radiation needed to destroy the tumor.

How proton therapy works

Uncompromisingly accurate targeting = better dose distribution.  The exact dose distribution has its name: Pencil Beam Scanning (PBS) and is currently the absolute peak of proton therapy. Pencil Beam Scanning (PBS) works such that it only irradiates a defined area. Not more. By delivering repeated high-precision radiation targeted with millimeter accuracy directly to the tumor bed after resection, PBS destroys the tumor cells without damaging any surrounding organs and tissues due to the physical properties of the protons. PBS preserves healthy tissues. This also applies to the tissues in the direction of the beam in front of the tumor, which are only minimally irradiated.

To compare PBS with other techniques, imagine your focus and meticulous care when you are using crayons to paint a defined object on a piece of paper. For example, a circle. You will always try consistently not to cross its borders. That is how PBS works. In addition, you will have 100% confidence that they will “paint” only what is needed. This is why the adverse effects of proton therapy are minimal.

In the case of head and neck cancer treatment, proton therapy can reduce the dose to the spinal cord by up to 80%, the dose to the swallowing tract by up to 50%. The dose to the brainstem and nerve structures of the brain can even be reduced to zero.

What exactly does risk minimization mean for head and neck cancer?

Proton therapy:

• is able to deliver the required therapeutic dose to the tumor while reducing the dose of radiation to the brainstem, optic chiasm and optic nerve;
• reduces the doses to the middle and inner ear, reduces or eliminates the risk of hearing loss, especially in high frequency areas;
• reduces the doses to the swallowing tract structures, thus reducing the likelihood of swallowing difficulties, including the need for PEG tube feeding;
• can be performed unilaterally, thus eliminating the irradiation of structures on the opposite side of the neck (swallowing muscles, salivary gland, inner ear, etc.), and the functions of these structures will be retained.

A sufficient dose of radiation is always needed for tumor destruction. The proton beam can be accurately aimed directly at the tumor to deliver the energy necessary for its destruction. No more radiation is passed behind the tumor. The tissues and organs behind the tumor are preserved.

In the case of conventional radiation, a compromise must be sought. Why? Because the high dose of radiation delivered to the tumor also means higher irradiation of healthy tissues in the vicinity. This can lead to complications and undesirable effects. Limit doses of radiation to individual organs are established, and conventional radiation must seek a compromise between the necessary dose needed to destroy the tumor and the risk of damage to healthy organs.

Proton beam therapy is a safer and more effective treatment compared to conventional radiation therapy. The goal of radiation therapy is to destroy the tumor while protecting the healthy tissues. This can be achieved by proton therapy, unlike conventional irradiation. Conventional radiotherapy always hits a part of the healthy tissue in the surrounding areas, where irradiation is not desirable.

Proton beams can irradiate the tumor while delivering no dose to the corresponding critical organ. A zero dose means a zero risk of adverse reactions. No patient will ever experience such adverse effects. Due to their physical properties, proton beams are able to stop in the tumor, thus significantly reducing the unwanted exposure of healthy tissues and organs.

Some advocates of conventional (photon) radiotherapy sometimes use a “magic formula” of “limit doses” to the critical organs. What does this mean? A patient is told that a limit dose to the critical organs will be observed. This is actually an “agreement” that we are accepting exposure of vital organs to unwanted radiation, but with a certain limit. But the patient is further told that adherence to the “limit dose” is associated with up to a 5% risk of adverse reactions. In addition, the risk increases with time, which means the longer a patient survives after irradiation, the higher the probability of adverse reactions.

Think carefully. The limit dose may not always be safe. And more importantly, safer and easily accessible proton therapy is available to rule out the risk.

The difference is seen with the naked eye in the graphical representation of irradiation plans.

The objective of the treatment is to deliver the required dose of radiation to the tumor (100%). Equally important, however, is not to irradiate the surrounding healthy tissues and organs. These requirements are met by proton therapy, which protects the eyes, brainstem, salivary glands and other important organs. Conventional irradiation, however, would affect them, and the patient is at risk of unpleasant complications.

Proton therapy is an increasingly recognized and preferred method in the world. The advantages are obvious and therefore new and new centers are opened and planned. At present, 71 centers are opened, 42 centers are just before the opening, and dozens more are planned. In visionary terms, we could predict with a relatively high degree of probability that proton beam irradiation will replace now frequently used conventional radiation therapy in the future.

The results and experience of the world’s proton centers also unambiguously confirm that proton therapy opens up entirely new possibilities in the treatment of head and neck tumors and offers patients a chance for a complete cure. Proton therapy can deliver the highest dose of radiation to the tumor, safely and without risks for the surrounding tissues. The added value of proton therapy compared to conventional (photon) therapy is that it spares healthy tissues around the tumor. This protects the neurocognitive functions (intellect, memory, speed of thinking), swallowing function, vision, hearing and speech.

Did you know that…?

Proton therapy is recommended for head and neck cancer by world authorities, such as ASTRO (American Society for Therapeutic Radiology and Oncology) and the Czech professional association SROBF (Association of Radiation Oncology, Biology and Physics). Proton therapy offers a brand new chance for a cure, even to patients with very poorly treatable tumors located near healthy tissues and with limited radiation tolerance (optic nerve, retina, optic chiasm, brainstem, spinal cord).

It can be used as a radical therapy for localized or locally advanced neoplasms of paranasal sinuses, nasopharynx, and salivary glands, and as an adjuvant or salvage radiotherapy after surgery.