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"Head and neck tumors are among the diagnoses for which the benefit of proton therapy is very high." MUDr. Jiří Kubeš Ph.D., Senior Physician
Proton therapy is the optimal solution for selected types of head and neck tumors.
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The Highest Chance Of Being Cured

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The Highest Chance Of Being Cured

Proton Therapy For Head And Neck Tumors

The goal of modern oncological treatment is to ensure patients the maximum chance of recovery while minimising adverse effects related to the treatment. Such an objective may be achieved by means of proton therapy. Proton therapy is gentler because it can reduce the exposure of surrounding tissues and organs to unwanted radiation and thus limits the risk of treatment-related complications.

Proton therapy is exceptional, in particular, because it demonstrably reduces the risk of side effects associated with other types of treatment while also rendering excellent treatment results. It is very beneficial, especially for the treatment of paranasal sinus tumors, where it enables delivery of the dose necessary for tumor destruction. It also reduces the risk of swallowing difficulties and the vast majority of our patients are able to undergo radiation in an outpatient manner while preserving swallowing functions. 

 

Proton Therapy Is Used To Treat:

  • nasopharynx;
  • paranasal sinuses;
  • salivary glands;
  • tonsils;
  • eye socket;
  • middle and inner ear.

The Proton Therapy Center in Prague has developed unique and innovative treatment procedures minimising undesirable exposure of the surrounding tissues, such as the optic and auditory nerve, retina, spinal cord, etc., to radiation. The benefits of proton radiotherapy for head and neck cancer may already be seen in the course of treatment when the vast majority of patients are able to undergo treatment without hospitalisation and various invasive procedures (such as the insertion of feeding tubes into the stomach).

Proton Therapy Reduces The Risk Of Vision And Hearing Damage
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Proton therapy is a precise and gentle head and neck cancer treatment method with minimal side effects. Proton therapy enables precise targeting of the proton beam at the target area (tumor or tumor bed) and minimises exposure of surrounding tissues and organs to radiation. Thanks to proton therapy, it is possible to irradiate patients with tumors located in areas that are difficult to treat, for example, near the optic and auditory nerves or spinal cord.

Modern Diagnostic Examinations
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Part of the Proton Therapy Center is also the Department of Radiodiagnostics and Nuclear Medicine. In addition to treatment, patients can undergo diagnostic examinations such as Magnetic Resonance Imaging (MRI) and Positron Emission Tomography in combination with Computed Tomography (PET/CT).

An accurate diagnostic process is fundamental for the right decision about treatment, the correct indication for radiation therapy, determination of the target volume and doses.

 

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How To Choose The Optimal Treatment

How To Choose The Most Suitable Treatment

In order to select the optimal treatment, it is imperative to get comprehensive and comprehensible information. Ask not only about the most advanced treatment methods but also treatment-related side effects. They may significantly affect the quality of your life during and after treatment.

We are here to help you.

If radiation is considered as part of your treatment, inquire about all the options available. Our physicians have many years of experience in radiotherapy. Moreover, they are experienced in both standard (photon) and proton radiation therapy; therefore, they will be able to answer all your questions pertaining to your decision on your treatment.

  • Think about the options you have.
  • You don’t have to decide immediately.
  • The treatment you choose has a fundamental influence on the quality of life not only during but also after treatment.

Keep in mind that your decision will significantly affect your future life. Our physicians are prepared to answer all of your questions related to PROTON THERAPY; therefore, do not hesitate to contact us immediately.

 

I Know My Chances Of Healing And Treatment Options

  • What treatment has my attending physician recommended?
  • Has the physician informed me about the risks and complications associated with currently used treatments?
  • Has the physician informed me about proton therapy?
  • Has the physician informed me about the risks and complications associated with standard radiation methods?

You can send your medical documentation for assessment of the suitability of proton therapy by e-mail to pacient@ptc.cz. Alternatively, you can contact our treatment coordinators, who are prepared to answer all of your questions related to proton therapy. You can call them at +420 222 999 031.

 

 The only thing YOU need to do is to come to US in time. WE are ready to help you.

How Proton Therapy Works
How Proton Therapy Works
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What Is Proton Therapy?

Proton therapy is an effective, accurate and gentle cancer treatment method with minimal side effects. Thanks to the precise targeting of the proton beam directly to the tumor, the occurrence of side effects is significantly reduced. This gives proton therapy patients a chance to enjoy a quality life even after cancer treatment without an increased risk of late toxicity, which can appear several years after irradiation (10, 15 or even 20 years).

Proton Therapy Provides A High Chance Of Being Cured
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Modern, Effective And Safe Oncological Treatment

The goal of modern oncological treatment is to ensure the maximum chance of recovery for patients while minimising adverse effects related to the treatment. Currently, this can be achieved by proton therapy. Unlike conventional radiotherapy, which uses photons for tumor cell irradiation and destruction, proton therapy is more advanced and uses protons. These particles give proton therapy its many advantages. The biggest advantage, compared to conventional radiotherapy, is its accuracy and its ability to protect healthy tissues.

The commonly used photon beam goes through the body and emits a significant portion of its energy in the regions in front of and behind the tumor.

Protons have a certain physical property called the Bragg peak, which means they emit significantly lower amounts of energy on their way to the tumor, thus minimising their impact on healthy tissues behind the tumor.

How We Treat You
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Few patients are aware of the complexity of the technology hidden below the Proton Therapy Center, which ultimately allows us to treat cancer gently. Protons, the positively charged elementary nuclei of the hydrogen atom, are accelerated in the cyclotron to approximately half the speed of light. This provides them with energy to destroy tumours up to 30 centimetres deepThen the protons are directed via a strong magnetic field into a very narrow beam and transferred to the tumour with high precision. As protons impact tumour tissue, they release energy, ionise, and damage the DNA of the affected cell. When the protons damage the tumour repeatedly, the cancer cells stop dividing or immediately die.

 

How We Can Irradiate Tumors With Millimeter Accuracy

Pencil Beam Scanning (PBS) marks the exact distribution of the proton beam dose and is currently the absolute peak in proton therapy technology. PBS irradiates the target area with millimeter accuracy with minimal damage to surrounding healthy tissues and organs. With this irradiation method, the thin (pencil) beam is directed to the appropriate point of the target volume by means of a magnetic field. Highly precise control of this magnetic field achieves gradual irradiation of the entire tumor site.

To illustrate how PBS works, imagine the task of colouring in a circle on a piece of paper with a pencil. As you fill in the circle, you will focus on making sure that you do not cross the borders. PBS also focuses on staying within the borders of the area being treated. That is why side effects with proton therapy are minimal.

Why Choose Proton Therapy?

Advantages Of Proton Therapy Over Conventional Radiotherapy

Proton therapy:

  • allows us to significantly reduce the dose of undesirable radiation to the brain, and thus prevent the risk of development of memory impairment;
  • allows us to significantly reduce the dose of undesirable radiation to the spinal cord by up to 80%, and thus prevent the development of myelopathy accompanied by movement impairment or even paralysis;
  • allows us to significantly reduce the dose to all optic structures (macula, cornea, retina, optic nerve), and thus mitigate the risk of visual impairment or loss;
  • also mitigates the risk of hearing impairment or loss, namely at high frequencies;
  • allows us to reduce the dose to the structure of swallowing pathways, and thus decrease the probability of swallowing difficulties, saliva production disorder, and necessary insertion of a nutrition feeding tube into the stomach (PEG).

 

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Proton therapy is gentler because it can reduce the exposure of surrounding tissues and organs to unwanted radiation and thus limits the risk of treatment-related complications.

Risks of standard radiation are minimised in proton therapy. Head and neck radiation ranks among the most demanding treatment types both for patients and physicians. In the area of the head and neck, there are too many organs sensitive to radiation which may be damaged, meanwhile high doses are needed to destroy the tumor. Standard radiotherapy is not always able to tackle this issue.

Head and neck tumors are localised in close proximity to many risky structures which have a significantly lower ionising radiation tolerance (spinal cord, salivary glands, brain stem, swallowing pathways, eyes, optic nerve, etc.), which means that in case of photon therapy, it is not always possible to apply a sufficient amount of radiation without damaging these organs.

International treatment protocols and organisations, such as ASTRO (American Society for Therapeutic Radiology and Oncology), recommend considering proton radiotherapy for selected head and neck diagnoses.

Based on worldwide experience and long-term results in treated patients, it is clear that patients after proton treatment have a higher quality of life compared to those who have undergone other treatments.

 

Did you know that the benefits of proton irradiation are based on the physical principles and properties of protons?

Protons target the tumor directly, which allows us to protect healthy tissues and organs from adverse effects.

Unlike conventional radiotherapy, which uses photons for tumor cell irradiation and destruction, proton therapy is more advanced and uses protons.

The commonly used photon beam goes through the body and emits a significant portion of its energy in the regions in front of and behind the tumor. Protons have a certain physical property called the Bragg peak, which means they emit significantly lower amounts of energy on their way to the tumor, thus minimising their impact on healthy tissues behind the tumor. The greatest advantage of proton therapy is that, unlike common radiotherapy, it is precise and able to protect healthy tissues.

How Proton Therapy Is Conducted

The experience of our doctors, our technology, excellent results and professional approach bring you the maximum chance of being cured.

 

Initial Assessment

In order for our medical team to assess a patient for suitability, we require some medical information (from you). Your treatment coordinator will inform you of exactly what information we require. Usually, we will also request to see scans, such as an MRI, CT, or PET scan. This information can be requested from the hospital or clinic and is often given to the patient on a CD. We can provide you with login details to upload the CD to our secure server. Alternatively, you can mail it to us.

Any information you already have about your diagnosis and previous treatments is very helpful and it is a good idea to provide us with as much information as possible in your initial enquiry. Your case will then be reviewed by our medical team at the daily indication board meeting. Your treatment coordinator will get back to you with the outcome, or possibly a request for more information if the oncologists require it to make their final decision.

You do not need to travel to Prague for the assessment.

 

Treatment Planning

When you come to Prague for treatment, you will first have a consultation to discuss the side effects and outcomes of treatment in your specific case, as well as the concrete treatment plan. The doctor also explains what to expect during and after the treatment. Finally, all of your questions are answered.

The first stage of treatment involves the diagnostic scans here at the Proton Therapy Center (MRI and/or CT, preparation of the fixation device, etc.). Precise treatment planning is crucial for treatment success. Therefore, a team of clinical physicists and physicians prepares a radiation plan tailored to each patient according to which proton therapy will take place. The irradiation plan also determines from which directions and with what intensity the proton beam will irradiate the tumor. This process is very complex, and it typically takes one week to finalise before treatment can commence.

 

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The treatment is outpatient, and you come to the Proton Therapy Center for radiation and regular check-ups during treatment. One visit takes about 60 minutes, while the radiation is a matter of a few minutes. Prior to each radiation session, we carefully check your position using X-ray scans and carry out certain other checks necessary to commence irradiating. At least once a week, you undergo check-ups with the physician who will go through the treatment progress with you and check your condition.

Individual treatment doses are given each day, Monday to Friday. Treatment cannot be interrupted except for serious health reasons.

 

We Use The Pencil Beam Scanning Technology

Pencil Beam Scanning (PBS) marks the exact distribution of the proton beam dose and is currently the absolute peak in proton therapy technology. PBS irradiates the target area with millimeter accuracy with minimal damage to surrounding healthy tissues and organs.

 

brozura-pbs-obr.png (1.11 MB)

 

The treatment is outpatient and, in most cases, lasts from 25 to 35 business days, according to the regime determined by the physician on the basis of the initial assessment and other diagnostic tests.

The World Prefers Protons

Proton therapy is an increasingly recognized and preferred method in the world. The results of the world's proton centers and the Prague Proton Therapy Center clearly confirm that proton therapy opens up completely new possibilities for the treatment of cancer.

Proton therapy is not a new method. Since 1991, the first exclusively clinical (not academic) workplace located at Loma Linda University, California, USA has treated many tens of thousands of cancer patients using proton therapy. Proton therapy is a technologically mature treatment proven by almost three decades of clinical operation. 

Despite many years of proton radiotherapy being used for the treatment of selected types of cancer, some healthcare professionals are still of the opinion that the higher radiation doses used in standard (photon) radiotherapy to which healthy tissues are exposed do not justify the use of proton beam therapy.

New clinical data is available from extensive studies suggesting that the frequency of acute toxicity (complications monitored for 90 days after initiation of treatment) is significantly lower in proton irradiation than in a comparable group of patients treated with photon radiotherapy.

A team of physicians from the University of Washington monitored almost 1,500 patients with various types of cancer, of whom about 400 underwent proton beam therapy while the rest were irradiated with state-of-the-art photon radiotherapy techniques. All the patients from this group were irradiated and at the same time were administered concomitant chemoradiotherapy. The study researchers focused on the emergence of toxicity at grade III and higher, which already requires hospitalisation and intensive medical treatment and care.

The study has shown that the observed toxicity (the complications associated with irradiation) in patients treated with protons is two-thirds lower than in the group treated with photon radiotherapy.

Specifically, serious adverse complications were reported by 11.5% of patients irradiated with protons as compared with 27.6% of patients irradiated with photons.

*Link: medicalnewstoday.com...

About Head And Neck Tumors

Head and neck tumors refer especially to tumors affecting the lips, oral cavity, nose, nasopharynx, paranasal sinuses, pharynx, salivary glands, and local lymphatic tissue. In addition, there are tumors growing from the skin in this area, tumors in the ears and eye sockets, and also tumors of the thyroid gland, blood vessels, and nerves.

The incidence of such tumors increases with a patient’s age; tumors in this region are typical for people over 50 years of age.

There are approximately 2,500 new cases per year in the Czech Republic. The recovery rates vary considerably depending on the type of cancer and its stage. However, if the disease is detected at an early stage, treatment is usually more successful, with fewer complications, and a lower risk of developing adverse effects.

Formation of tumors in the head and neck can have a variety of causes; however, external factors have the biggest impact. A large proportion of tumors occur in cigarette smokers, and it has been proved that occurrences are more frequent when tobacco and alcohol are overused simultaneously. Carcinogenicity has also been proven in marijuana. Some types of viruses contact with carcinogenic substances at work, or exposure to radiation also play a role in the formation of these tumors. Poor oral cavity hygiene and nutrition can be a factor as well.

The treatment of head and neck tumors requires a multidisciplinary approach. A comprehensive treatment strategy must be determined by a team of specialists, including an otorhinolaryngologist, radiation or clinical oncologist, pathologist, and radiologist. 

In most head and neck tumors, their surgical removal is of paramount importance. Surgery or radiotherapy alone is sufficient for approximately 40% of patients. For the remaining 60% of patients, combined surgery, radiotherapy, and chemotherapy treatment must be used. In some cases, biological therapy or immunotherapy can also be used.

Radiotherapy plays an irreplaceable role in the comprehensive treatment of head and neck cancer. We will help you find your bearings in this difficult life situation, and together we will find a solution and create an individualised treatment plan for you.