Takeaway from Multidisciplinary 2020 Head and Neck Cancers Symposium

A dosimetric comparison of proton versus photon irradiation for pediatric glomus tumor – Vidal et al.

👉 Most notable are the lower doses to ipsilateral (left) cochlea, right-sided structures, and expanded cord with the proton plan. The mean oral cavity dose was also significantly lower. 
Dosimetric superiority of protons in the skull base region is largely due to the absence of dose deposition distal to the target, or “exit dose”. This phenomenon is explained by the distinctive Bragg Peak that protons have which allows for a rapid fall-off of the irradiation dose beyond the target. Contralateral structures were significantly spared with the proton plan. As previously established, proton beam therapy remains the therapy of choice for pediatric patients given their long term survival and concerns for secondary malignancy, as well as lower doses to most if not all normal structures of interest.

Long-Term Update of Proton Beam Re-Irradiation for Recurrent Head and Neck Cancer – Lee et al.

👉 Proton Therapy re-irradiation of the head and neck provides effective tumor control with acceptable acute and late toxicity profiles, likely secondary to the decreased dose to surrounding normal, albeit previously irradiated tissue.

Proton Therapy for Non-Skull Base Head and Neck Adenoid Cystic Carcinoma – Lee et al.

👉 Proton Therapy is a feasible option for ACC for the non-skull based head and neck in the definitive and postoperative setting, offering low rates of acute and late toxicities. Patients with metastatic disease also had acceptable outcomes and local treatment was well tolerated.

Improved Outcomes by proton beam radiation for nasal cavity and paranasal sinus malignances – Fan et al.

👉 Proton Therapy offers durable local control and survival in patients with nasal cavity and paranasal sinus malignancy. Even patients with recurrent tumor or with prior radiation history could achieve encouraging outcomes.

Chemosensory Outcomes in Nasopharyngeal Cancer Patients Treated with Proton Beam Therapy: A Prospective Longitudinal Study – Slater et al.

👉 with Proton Therapy the long-term chemosensory outcomes are preserved.

Proton Therapy for Nasopharyngeal Cancer: A Matched Case-control Study of Intensity-Modulated Proton Therapy and Intensity-Modulated Photon Therapy – Li et al.

👉 IMPT showed dosimetry advantages over  IMRT and lower rates of acute toxicities while both had comparable  treatment outcomes.

Outcomes following Proton Therapy for Squamous Cell Carcinoma of the Larynx – Ausat et al.

👉 Proton Therapy for SCC of the larynx demonstrates a high rate of overall survival, local-regional control, and disease-free survival with low toxicity profile.

Outcomes of Major Salivary Gland Tumors Treated with Proton Beam Radiation Therapy – Zakeri et al.

👉 rates of locoregional control were high and treatment was well tolerated.

Intensity Modulated Proton Therapy (IMPT) to the Parotid
Gland: A Seven-Year Experience – Hanania et al.

👉 IMPT for treatment 724 of the parotid gland manifests in low rates of acute and chronic toxicity 725 while maintaining dosimetric coverage and high rates of biological control. 726 Skin V30 may predict for radiation dermatitis.

Redefine End-of-range RBE of Protons Based on Long-term Clinical Outcome – Zhan et al.

👉 RBE in brain is 1.18

Abstracts published in International Journal of Radiation Oncology • Biology • Physics, Volume 106, Issue 5, April 1, 2020

https://www.redjournal.org/issue/S0360-3016(20)X0004-6


In Muscat, the SAH team met with the Minister of Health, with the UICC board and with the Oman Cancer Association to prepare the 2020 World Cancer Congress.

The beginning of the year has been pretty busy for the SAH Team, advocating around the world so all patients can get the right treatment at the right time.

In Muscat, the SAH team has been honored to meet with Dr Ahmed Mohammed Obaid Al Saidi , the Minister of Health of the Sultanate of Oman, with H.R.H. Princess Dina Mired of Jordan, President of the Union for International Cancer Control (UICC), and with Dr Wahid Al Kharusi, President of the Oman Cancer Association, (OCA) to prepare the 2020 World Cancer Congress.

The UICC is the largest cancer federation in the world, internationally recognized for its excellence.

UICC is the largest global organization solely dedicated to reducing the global cancer burden, promoting greater equity, and integrating cancer control into the world health and development agenda.

It is the only global cancer organisation in the world representing all cancer types and entire cancer spectrum, uniting a common voice for cancer in the international space through its formal relations with the World Health Organisation – WHO

UICC connects the most influential decision leaders in cancer control through its platforms, and addresses unmet needs and building the capacity of its 1000+ members in 170 countries.

UICC is holding its first-ever global Cancer Congress in the Middle East Region in Muscat Oman on October 20-22, 2020.

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“The World Cancer Congress is an award-winning global conference organized by UICC, which encourages effective knowledge transfer, and best practices exchange amongst over 3,500 cancer control and public health experts from 130 countries.

 It aims to strengthen the participants’ actions and impact on national, regional, and international scales through a multidisciplinary program that features the latest successful interventions in cancer prevention, diagnosis, treatment, and care.

It will be the first time that the Congress is held in our region. Under the theme ‘The way forward’, it aims to highlight the need for the region and other parts of the world to work towards reducing the burden of cancer.

The 2020 edition of the Congress is hosted by the Oman Cancer Association (OCA) and the National Oncology Centre, Royal Hospital Muscat. It will take place in the Oman Convention and Exhibition Center.

Stakeholders from the entire cancer control spectrum, health ministers, mayors, finance ministers, oncologists, representatives from NGOs, patient groups, universities, and the private sector will engage in debates and conversations about public health and cancer issues.”

HRH PRINCESS DINA MIRED
Very warm thanks to Dr Wahid Al Kharusi and his wife who organized a cordial barbecue to close the meetings session.

SAH, UICC and OCA share the same goal :

Together delivering better patient treatment and care for cancer


In 2020, SAH will keep advocating, explaining the benefits of Proton Therapy, and fighting to make sure that the patients who need the most that treatment can get it on time.

SAH Care held its first 2020 follow-up clinics in Bahrain

Last week, SAH has conducted patient follow-up clinics in Bahrain for patients previously treated in the US, and held a guest lecture about Proton Therapy at King Hamad University Hospital.

In 2011, SAH has signed an agreement with the Ministry of Health of the Kingdom of Bahrain to take patient who qualify for Proton Therapy to partner centers in the US for Cancer Treatment. For each patient, once the treatment plan has been discussed and validated by the local oncologists, by the Overseas Treatment Committee, and by the SAH Care Team, SAH Care organizes the travel and treatment at one partnering facilities. Twice a year, the SAH physicians come in the Middle-East & Africa region to see the patients they have treated with Proton Therapy in the US.

Dr Atman Pai has conducted last week those patient follow-up clinics in Bahrain.

Bahraini pediatric patients previously treated by SAH Care in the US have been seen at Salmaniya Medical Complex. Dr khulood and her team have outstandingly coordinated the consultations with our young patients.

Adult patients have been seen at King Hamad University Hospital with the remarkable Dr Hanadi Malik, Radiation Oncologist at KHUH.

SAH also held a lecture about Proton Therapy at King Hamad University Hospital presenting a practical approach to Proton Therapy.

Proton therapy has gained acceptance throughout the world, but it remains difficult to define which patients benefit the most of Proton Therapy.

Utilizing proton therapy is quickly becoming the best practice for pediatric radiation oncology services. Proton Therapy is a form a radiation therapy which aggressively treats the tumor while substantially reducing side effects that could impact the child’s development and quality of life. This advanced cancer therapy has been proven to protect vital organs, important tissues, nerves, and glands during treatment, while also decreasing the estimated risk of secondary malignancies.

Proton Therapy is also very beneficial for adult patients with cancer that occurs near vital organs. It can be precisely and narrowly targeted specifically on cancerous tumors and tissues, applying intense amounts of radiation only to the affected area. This advanced therapy is most commonly used for localized cancer and tumors that have not spread, or metastasized, to other distant parts of the body.

Proton Therapy is ideally suited as well to minimize toxicity to previously irradiated organs. It offers dosimetric advantages for normal tissue sparing and it provides effective tumor control with acceptable acute and late toxicity profiles because of the decreased dose to the surrounding normal, albeit previously irradiated, tissue. Proton beam therapy can be a safe and effective curative reirradiation strategy, with acceptable rates of toxicity and durable disease control.

In 2020, we’ll keep advocating, explaining the benefits of Proton Therapy, and fighting to make sure that the patients who need the most this treatment can get it on time.