{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:47:44Z","timestamp":1787240864591,"version":"build-2736575974"},"reference-count":32,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T00:00:00Z","timestamp":1721001600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Head &amp; Neck"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    To comprehensively evaluate the therapeutic efficacy and safety when utilizing proton therapy (PT) versus intensity\u2010modulated radiation therapy (IMRT) in head and neck cancer patients. Pubmed, ScienceDirect, Embase, Scopus, and Web of Science were systematically searched for studies on comparative PT and IMRT outcomes. We performed a random effect model meta\u2010analysis to estimate the hazard ratio (HR) and odds ratio (OR) for efficacy and safety outcome variables between PT and IMRT. From 641 identified articles, 11 studies met the inclusion criteria, comprising 3087 patients (606 treated with PT and 2481 with IMRT). On toxicity analysis, PT is associated with decreased acute grade 1 nausea (OR\u2009=\u20090.34, 95% CI: 0.13\u20130.84,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.02) compared to IMRT. In grade 2 toxicity, PT showed significant advantages over IMRT in mucositis (OR\u2009=\u20090.44,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001), dysgeusia (OR\u2009=\u20090.35,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.02), dysphagia (OR\u2009=\u20090.36,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001), fatigue (OR\u2009=\u20090.29,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001), pain (OR\u2009=\u20090.34,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.01), and weight loss (OR\u2009=\u20090.54,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.02). Proton therapy also exhibited increased safety in grade 3 dysphagia incidence (OR\u2009=\u20090.44,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001) compared to IMRT. PT demonstrated improved overall survival (OS) compared to IMRT across multiple time points: 1\u2010year OS (HR\u2009=\u20090.43,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.02), 2\u2010year OS (HR\u2009=\u20090.44,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.0001), and 5\u2010year OS (HR\u2009=\u20090.78,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.004). In terms of disease\u2010free survival (DFS), PT also showed improved outcomes at 2\u2010year DFS (HR\u2009=\u20090.65,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.03) and 5\u2010year DFS (HR\u2009=\u20090.81,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.03). Proton therapy demonstrated superior overall survival (OS), disease\u2010free survival (DFS), and better local control rate (LCR) compared to IMRT. The data also showed better safety outcomes in PT patients, particularly when involving grade 2 acute toxicity events.\n                  <\/jats:p>","DOI":"10.1002\/hed.27877","type":"journal-article","created":{"date-parts":[[2024,7,15]],"date-time":"2024-07-15T06:59:04Z","timestamp":1721026744000},"page":"2616-2631","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Efficacy and safety of proton therapy versus intensity\u2010modulated radiation therapy in the treatment of head and neck tumors: A systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6998-1658","authenticated-orcid":false,"given":"Srivatsa Surya","family":"Vasudevan","sequence":"first","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Louisiana State University Health Sciences Center  Shreveport Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haya","family":"Deeb","sequence":"additional","affiliation":[{"name":"Department of Medicine, Faculty of Medicine Damascus University  Damascus Syria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuhya","family":"Katta","sequence":"additional","affiliation":[{"name":"Department of Academics Jonelta Foundation School of Medicine, University of Perpetual Help System Dalta  Las Pi\u00f1as Philippines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay","family":"Olinde","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Louisiana State University Health Sciences Center  Shreveport Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Louisiana State University Health Sciences Center  Shreveport Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9028-8746","authenticated-orcid":false,"given":"Ameya A.","family":"Asarkar","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Louisiana State University Health Sciences Center  Shreveport Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanford","family":"Katz","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology Willis\u2010Knighton Cancer Center  Shreveport Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cherie\u2010Ann O.","family":"Nathan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology \u2013 Head and Neck Surgery Louisiana State University Health Sciences Center  Shreveport Louisiana USA"},{"name":"Department of Surgery Overton Brooks Veterans Administration Medical Center  Shreveport Louisiana USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2016.02.044"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctrv.2010.08.004"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2015.12.008"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2018.11.015"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.radonc.2016.05.022"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.13205"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijrobp.2004.09.064"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meddos.2016.01.002"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.16009"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1002\/mp.16739"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.meddos.2021.02.001"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1080\/0284186X.2018.1543948"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0360\u20103016(02)02754\u20102"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_8_16_1","volume-title":"The 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