Head and neck tumours

Tumours of the head and neck make up approximately 10% of malignant tumours in men and 5% in women. The typical sites affected are the oral cavity (lips, mobile tongue, floor of the mouth, gingival mucous membranes, and hard palate), pharynx (nasopharynx, oropharynx and hypopharynx), larynx, nasal cavities and paranasal sinuses, salivary glands (parotid, submandibular, sublingual, and minor salivary glands), thyroid, neck lymph nodes, skin, ear and temporal bone, orbit, skull base.

Most head and neck tumours are strictly linked to smoking cigarettes and alcohol consumption although a small percentage may have a viral infection as a triggering factor.

The choice of treatment depends on the type of tumour (isotype), the site in which it developed, the advancement of the disease, and the patient’s general condition. To define the best treatment for each case, a multidisciplinary approach is required, referring to a team of experts made up of: otolaryngologist, medical oncologist, radiation therapist, radiologist, and anatomopathologist nuclear doctor.

Radiation therapy is one of the primary therapeutical methods for treating tumours in the head and neck region, either exclusively, associated or not associated with chemotherapy as an alternative to destructive surgery in order to save the organ; after surgery if there is a residual illness or the risk of local relapse; or as a saving measure when there is a local relapse some time after surgery.

Proton therapy is a less invasive yet equally effective form of radiation therapy for the treatment of head and neck tumours. Considering the precision of proton beam therapy, it is possible to intervene on diseased tissue and better preserve healthy and delicate ones, with the goal being to decrease the risk of collateral effects such as loss of taste, salivary dryness, and difficulty eating during treatment, thus limiting the need for alternative, invasive feeding methods, while also reducing the risk  of complications such as osteonecrosis of the jaw, loss of sight or hearing, etc.

Proton therapy may be used to treat a wide range of head and neck tumours, including those involving:

• Nasopharynx
• Oropharynx
• Salivary glands (parotid and minor salivary glands)
• Nose and paranasal sinuses
• Lacrimal glands
• Skin tumours with perineural invasion
• Orbital tumours
• Tumour recurrences of previously irradiated lesions