{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T21:26:23Z","timestamp":1793568383071,"version":"4.5.0"},"reference-count":25,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T00:00:00Z","timestamp":1788393600000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["P30 CA008748"],"award-info":[{"award-number":["P30 CA008748"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Proton beam radiotherapy (PBRT) offers dosimetric advantages over intensity-modulated radiation therapy (IMRT), but prospective randomized data in the postoperative unilateral head and neck cancer setting remain limited. We conducted a multicenter, randomized phase 2 trial comparing PBRT and IMRT for patients with resected, well-lateralized head and neck cancers requiring unilateral adjuvant radiotherapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Adult patients were randomized 1:1 to receive PBRT or IMRT to 60\u2009Gy (relative biological effectiveness) in 30 fractions, with elective regions treated to 54\u2009Gy. The primary endpoint was clinician-reported acute grade \u22652 oral mucositis through 3\u2009months after radiotherapy. Secondary endpoints included other acute and late treatment-related toxicities, patient-reported outcomes and health-related quality of life, and oncologic outcomes, including disease control and survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Ninety-eight patients were analyzable (PBRT, n\u2009=\u200954; IMRT, n\u2009=\u200944) with a median follow-up of 27.2\u2009months. Acute grade \u22652 oral mucositis occurred less frequently with PBRT than IMRT (7.4% vs 22.7%, P\u2009=\u2009.03), as did acute grade \u22652 dysgeusia (9.3% vs 31.8%, P\u2009=\u2009.005). Rates of grade \u22653 dermatitis and grade \u22652 dysphagia were similar between groups, and late toxicities were uncommon with no grade 3 events. Patient-reported outcomes mirrored these findings, although confidence intervals were wide. Three-year local control, progression-free survival, and overall survival were high and were no different between arms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings indicate that PBRT reduces clinician-graded acute mucosal toxicity compared with IMRT in unilateral postoperative head and neck radiotherapy, in the context of some numerical but not statistically significant differences in patient-reported outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical trial registration number<\/jats:title>\n                    <jats:p>https:\/\/clinicaltrials.gov\/study\/NCT02923570.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djag257","type":"journal-article","created":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T11:27:23Z","timestamp":1786706843000},"source":"Crossref","is-referenced-by-count":0,"title":["A phase 2 randomized study of proton therapy vs intensity-modulated radiation therapy in patients with unilateral head and neck cancer"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6119-0889","authenticated-orcid":false,"given":"Edward Christopher","family":"Dee","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center , New York, NY,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noah S","family":"Kalman","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Miami Cancer Institute, Herbert Wertheim College of Medicine, Florida International University , Miami, FL,","place":["United 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