{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T08:24:53Z","timestamp":1792571093610,"version":"4.5.0"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"1107","license":[{"start":{"date-parts":[[2020,1,30]],"date-time":"2020-01-30T00:00:00Z","timestamp":1580342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,3,1]]},"abstract":"<jats:p>Patients with squamous cell carcinoma of the oropharynx are generally treated with (chemo) radiation. Patients with oropharyngeal cancer have better survival than patients with squamous cell carcinoma of other head and neck subsites, especially when related to human papillomavirus. However, radiotherapy results in a substantial percentage of survivors suffering from significant treatment-related side-effects. Late radiation-induced side-effects are mostly irreversible and may even be progressive, and particularly xerostomia and dysphagia affect health-related quality of life. As the risk of radiation-induced side-effects highly depends on dose to healthy normal tissues, prevention of radiation-induced xerostomia and dysphagia and subsequent improvement of health-relatedquality of life can be obtained by applying proton therapy, which offers the opportunity to reduce the dose to both the salivary glands and anatomic structures involved in swallowing.<\/jats:p>\n               <jats:p>This review describes the results of the first cohort studies demonstrating that proton therapy results in lower dose levels in multiple organs at risk, which translates into reduced acute toxicity (i.e. up to 3 months after radiotherapy), while preserving tumour control. Next to reducing mucositis, tube feeding, xerostomia and distortion of the sense of taste, protons can improve general well-being by decreasing fatigue and nausea. Proton therapy results in decreased rates of tube feeding dependency and severe weight loss up to 1\u2009year after radiotherapy, and may decrease the risk of radionecrosis of the mandible. Also, the model-based approach for selecting patients for proton therapy in the Netherlands is described in this review and future perspectives are discussed.<\/jats:p>","DOI":"10.1259\/bjr.20190955","type":"journal-article","created":{"date-parts":[[2020,1,23]],"date-time":"2020-01-23T18:27:42Z","timestamp":1579804062000},"source":"Crossref","is-referenced-by-count":37,"title":["Reduced radiation-induced toxicity by using proton therapy for the treatment of oropharyngeal cancer"],"prefix":"10.1093","volume":"93","author":[{"given":"Tineke W.H.","family":"Meijer","sequence":"first","affiliation":[{"name":"Department of Radiation Oncology, University Medical Center Groningen , Groningen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan","family":"Scandurra","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Medical Center Groningen , Groningen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johannes A.","family":"Langendijk","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, University Medical Center Groningen , Groningen , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,1,30]]},"reference":[{"key":"2024050215322232200_b1","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1056\/NEJMoa0912217","article-title":"Human papillomavirus and survival of patients with oropharyngeal cancer","volume":"363","author":"Ang","year":"2010","journal-title":"N Engl J Med Overseas Ed"},{"key":"2024050215322232200_b2","doi-asserted-by":"crossref","first-page":"2102","DOI":"10.1200\/JCO.2011.38.4099","article-title":"Tobacco smoking and increased risk of death and progression for patients with p16-positive and p16-negative oropharyngeal cancer","volume":"30","author":"Gillison","year":"2012","journal-title":"JCO"},{"key":"2024050215322232200_b3","doi-asserted-by":"crossref","first-page":"3770","DOI":"10.1200\/JCO.2007.14.6647","article-title":"Impact of late treatment-related toxicity on quality of life among patients with head and neck cancer treated with radiotherapy","volume":"26","author":"Langendijk","year":"2008","journal-title":"JCO"},{"key":"2024050215322232200_b4","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1016\/j.ijrobp.2007.04.021","article-title":"Impact of radiation-induced xerostomia on quality of life after primary radiotherapy among patients with head and neck cancer","volume":"69","author":"Jellema","year":"2007","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024050215322232200_b5","doi-asserted-by":"crossref","first-page":"343","DOI":"10.1016\/j.radonc.2012.07.001","article-title":"Three-Dimensional conformal radiotherapy (3D-CRT) versus intensity modulated radiation therapy (IMRT) in squamous cell carcinoma of the head and neck: a randomized controlled trial","volume":"104","author":"Gupta","year":"2012","journal-title":"Radiother Oncol"},{"key":"2024050215322232200_b6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ijrobp.2008.07.059","article-title":"Intensity-Modulated radiotherapy reduces radiation-induced morbidity and improves health-related quality of life: results of a nonrandomized prospective study using a standardized follow-up program","volume":"74","author":"Vergeer","year":"2009","journal-title":"Int J Radiat Oncol Biol Phys"},{"key":"2024050215322232200_b7","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.radonc.2013.05.007","article-title":"Selection of patients for radiotherapy with protons aiming at reduction of side effects: the model-based approach","volume":"107","author":"Langendijk","year":"2013","journal-title":"Radiother Oncol"},{"key":"2024050215322232200_b8","doi-asserted-by":"crossref","unstructured":"ICRU\n          \n.\nPrescribing, recording, and reporting Proton-Beam\n.\nICRU Report 78. 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