Abstract
Abstract Purpose: To investigate the potential impact of anatomic change in the treatment of locally advanced oropharyngeal cancer with proton pencil beam scanning. Materials and Methods: Ten patients with locally advanced oropharyngeal cancer who previously received intensity-modulated radiation therapy (IMRT) and synchronous chemotherapy underwent replanning by using RapidArc IMRT and proton pencil beam scanning. Deformable image registration deformed the planning computed tomography (CT), target volumes, and organs at risk (OARs) contours onto each weekly cone-beam CT scan. Target and OARs volumes were reviewed and modified. Treatment plans were forward calculated onto each corrected cone-beam CT scan and dose-volume histograms produced for targets and OARs volumes. Results: Proton pencil beam scanning compared with RapidArc IMRT achieved lower mean doses to the contralateral parotid gland (14.8 Gy versus 20.6 Gy, P < .05) and oral cavity (31.5 Gy versus 43.0 Gy, P < .001). For proton pencil beam scann...
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