{"id":4226,"date":"2026-10-23T16:55:13","date_gmt":"2026-10-23T07:55:13","guid":{"rendered":"https:\/\/maj.emergency.co.jp\/?p=4226"},"modified":"2026-10-23T17:01:12","modified_gmt":"2026-10-23T08:01:12","slug":"understanding-proton-beam-therapy-for-head-and-neck-cancer-through-real-cases-tongue-cancer-floor-of-mouth-cancer-and-adenoid-cystic-carcinoma-%ef%bd%9e-southern-tohoku-proton-therapy-center","status":"publish","type":"post","link":"https:\/\/maj.emergency.co.jp\/en\/cancer_treatment-en\/cat170_en\/4226","title":{"rendered":"Understanding Proton Beam Therapy for Head and Neck Cancer Through Real Cases: Tongue Cancer, Floor of Mouth Cancer, and Adenoid Cystic Carcinoma \uff5e Southern TOHOKU Proton Therapy Center"},"content":{"rendered":"\n

What do we hope for when we are diagnosed with head and neck cancer ?<\/p>\n\n\n\n

Not only successful treatment, but also the chance to regain our quality of life and sense of self after treatment.<\/p>\n\n\n\n

We introduce a treatment approach centered on proton therapy\u2014a path toward regaining the joy of eating, the sense of taste, and the freedom to speak.<\/p>\n\n\n\n

These clinical cases were provided by the Southern TOHOKU Proton Therapy Center, whose treatment achievements were highlighted in the Nikkei series \u201cGiven One Year to Live: A Patient with Maxillary Sinus Cancer Entrusts His Life to the Words \u2018You\u2019ll Be Fine\u2019,\u201d<\/a> which began on August 29, 2026.<\/p>\n\n\n\n

Here, you\u2019ll find insights to help you envision the future for yourself and your loved ones.<\/p>\n\n\n\n

Case 1<\/strong><\/h2>\n\n\n\n
\n
\"\"<\/figure>\n\n\n\n

4<\/strong> 40-year-old Female<\/strong><\/p>\n\n\n\n


<\/p>\n<\/div>\n\n\n\n

\n
\n
    \n
  • Tongue Cancer (Left-sided Tongue Squamous Cell Carcinoma)<\/strong><\/strong><\/li>\n\n\n\n
  • A Case in Which the Patient Declined Surgery and Chose Proton Beam Therapy Combined with Intra-Arterial Chemotherapy<\/strong><\/li>\n<\/ul>\n<\/div><\/div>\n<\/div><\/div>\n\n\n\n
    \"\"<\/figure>\n\n\n\n

    Diagnosis<\/strong><\/p>\n\n\n\n

    \n
    \n

    \u30fbLeft-sided tongue squamous cell carcinoma<\/p>\n\n\n\n

    \u30fbcT4aN1M0<\/p>\n<\/div>\n\n\n\n

    \n

    TNM classification indicating the extent of cancer progression.<\/em><\/p>\n\n\n\n

    The tumor had spread into surrounding tissues and metastasized to cervical lymph nodes, but no distant metastasis was detected.<\/p>\n<\/div>\n\n\n\n

    Path to Diagnosis<\/strong><\/p>\n\n\n\n

    The patient sought medical attention because of persistent oral ulcers and was diagnosed with tongue cancer.<\/p>\n\n\n\n

    Because she did not wish to undergo surgery with reconstructive procedures, she was treated with a combination of systemic chemotherapy, radiation therapy, proton beam therapy, and intra-arterial chemotherapy<\/strong>.<\/p>\n\n\n\n

    <\/p>\n\n\n\n

    Treatment Details<\/strong><\/p>\n\n\n\n

    \n
    \n

    Total radiation dose: 69 Gy<\/strong>\u3000 <\/p>\n<\/div>\n\n\n\n

    \u30fbSystemic chemotherapy (5-FU + cisplatin)<\/p>\n\n\n\n

    \u30fbX-ray radiotherapy: 36 Gy \/ 20 fractions<\/p>\n\n\n\n

    \u30fbProton beam therapy: 33 Gy(RBE) \/ 15 fractions<\/p>\n\n\n\n

    \u30fbIntra-arterial chemotherapy (cisplatin): 5 sessions<\/p>\n<\/div>\n\n\n\n

    \u203bGy is a unit of radiation dose that indicates the amount of radiation energy absorbed by body tissues.<\/em><\/p>\n\n\n\n

    \"\"<\/figure>\n<\/div><\/div>\n\n\n\n
    \n

    During Treatment<\/strong><\/p>\n\n\n\n

    \n

    \u30fbMucositis<\/p>\n\n\n\n

    \u30fbTemporary dysphagia<\/p>\n\n\n\n

    \u30fbTaste disturbance<\/p>\n\n\n\n

    Because of these treatment-related effects, a PEG tube was temporarily placed. She regained the ability to eat orally two months after treatment, and the PEG tube was removed six months after treatment.<\/strong><\/p>\n<\/div>\n\n\n\n

    After Treatment<\/strong><\/p>\n\n\n\n

      \n
    • PET imaging performed 6 months after treatment showed complete disappearance of FDG uptake.<\/li>\n\n\n\n
    • Oral intake was resumed 2 months after treatment<\/li>\n\n\n\n
    • The patient has remained free of recurrence for more than 10 years following treatment.<\/li>\n<\/ul>\n\n\n\n

      <\/p>\n\n\n\n

      Case 2 <\/strong><\/h2>\n\n\n\n
      \n
      \n
      \"\"<\/figure>\n\n\n\n

      66-year-old Male (Wine Sommelier)<\/strong><\/p>\n\n\n\n


      <\/p>\n<\/div>\n<\/div>\n\n\n\n

        \n
      • Floor of Mouth Cancer (Squamous Cell Carcinoma of the Floor of the Mouth)<\/strong><\/li>\n\n\n\n
      • A Treatment Case Chosen by a Patient Who Prioritized the Preservation of Oral Function<\/strong><\/li>\n<\/ul>\n<\/div>\n\n\n\n
        \n

        \u30fbSquamous cell carcinoma of the floor of the mouth<\/p>\n\n\n\n

        \u30fbcT4aN2cM0<\/p>\n\n\n\n

        The cancer had spread to surrounding tissues and to lymph nodes on both sides of the neck, but no distant metastasis was detected.<\/em><\/p>\n<\/div>\n\n\n\n

        \"\"<\/figure>\n\n\n\n
        \n

        Path to Diagnosis<\/strong><\/p>\n\n\n\n

        The patient presented with a tumor in the floor of the mouth and swallowing difficulties and was diagnosed at a university hospital.<\/p>\n\n\n\n

        Because preserving oral function was important for his profession, he chose a treatment approach combining radiation therapy, proton beam therapy, and intra-arterial chemotherapy as an alternative to surgery.<\/p>\n\n\n\n

        <\/p>\n\n\n\n

        Treatment Details<\/strong><\/p>\n\n\n\n

        Total radiation dose: 66 Gy<\/strong><\/p>\n\n\n\n

        \u30fbIntensity-Modulated Radiation Therapy (IMRT): 40 Gy \/ 20 fractions<\/p>\n\n\n\n

        \u30fbProton beam therapy: 26 Gy(RBE) \/ 13 fractions<\/p>\n\n\n\n

        \u30fbIntra-arterial chemotherapy (cisplatin): 4 sessions<\/p>\n\n\n\n

        \n
        \n
        \"\"<\/figure>\n<\/div>\n<\/div>\n\n\n\n

        During Treatment<\/strong><\/p>\n\n\n\n

        \n

        \u30fbMucositis<\/p>\n\n\n\n

        \u30fbTemporary taste disturbance<\/p>\n\n\n\n

        Although these symptoms occurred, oral intake remained possible throughout treatment.<\/p>\n<\/div>\n\n\n\n

        After Treatment<\/strong><\/p>\n\n\n\n

          \n
        • Favorable local tumor control was confirmed 1 year after treatment<\/li>\n\n\n\n
        • The patient returned to normal daily activities and was able to continue working as a chef. However, continued alcohol consumption was considered a contributing factor, and a new primary tongue cancer developed during follow-up 3 years after treatment. The lesion was detected at an early stage and was treated surgically.<\/li>\n<\/ul>\n\n\n\n

          Case 3<\/strong><\/h2>\n<\/div>\n\n\n\n
          \n
          \"\"<\/figure>\n\n\n\n

          42-year-old Male<\/strong><\/strong><\/p>\n<\/div>\n\n\n\n

            \n
          • Adenoid Cystic Carcinoma of the Right Hard Palate<\/strong><\/strong><\/li>\n\n\n\n
          • A Case of Proton Beam Therapy for a Tumor Extending to the Skull Base<\/strong><\/strong><\/li>\n<\/ul>\n\n\n\n

            Diagnosis<\/strong><\/p>\n\n\n\n

            \n

            \u30fbAdenoid cystic carcinoma of the right hard palate<\/p>\n\n\n\n

            \u30fbcT4bN0M0<\/p>\n\n\n\n

            Advanced hard palate cancer extending to the skull base, without lymph node or distant metastasis.<\/em><\/p>\n<\/div>\n\n\n\n

            \"\"<\/figure>\n\n\n\n

            Path to Diagnosis<\/strong><\/p>\n\n\n\n

            The patient presented with swelling of the upper palate and was diagnosed with palatal adenoid cystic carcinoma<\/strong>.
            Because the tumor had extended to the skull base and was considered unsuitable for surgical resection, combined treatment with proton beam therapy and intra-arterial chemotherapy was performed.<\/p>\n\n\n\n

            Treatment Details<\/strong><\/p>\n\n\n\n

            \n

            \u30fbProton beam therapy: 70.4 Gy(RBE) \/ 32 fractions<\/p>\n\n\n\n

            \u30fbIntra-arterial chemotherapy (cisplatin): 6 sessions<\/p>\n\n\n\n

            \u30fbCatheter placement through the superficial temporal artery<\/p>\n<\/div>\n\n\n\n

            \n
            \n
            \n
            \n
            \"\"<\/figure>\n<\/div>\n<\/div>\n<\/div>\n<\/div><\/div>\n\n\n\n

            After Treatment<\/strong><\/strong><\/p>\n\n\n\n

              \n
            • Tumor regression was confirmed 1 year after treatment<\/li>\n\n\n\n
            • Although bilateral lung metastases developed, both lesions were successfully controlled with proton beam therapy.<\/strong><\/li>\n\n\n\n
            • Radiation-related brain necrosis was observed 5 years after treatment, but the condition subsequently stabilized, and 10 years have now passed since treatment.<\/strong><\/li>\n<\/ul>\n\n\n\n

              <\/p>\n\n\n\n

              Each patient has unique priorities and expectations for life after treatment. <\/p>\n\n\n\n

              Treatment-related side effects and long-term outcomes can vary considerably, and not all patients will experience the same results. Nevertheless, as illustrated by the cases presented here, a combination of proton beam therapy and intra-arterial chemotherapy may be a treatment option for selected patients, depending on their medical condition and personal preferences.<\/p>\n\n\n\n

              We hope that these cases will provide useful insights and serve as a helpful reference for patients and their families as they consider their treatment options.<\/p>\n\n\n\n

              <\/p>\n","protected":false},"excerpt":{"rendered":"

              What do we hope for when we are diagnosed with head and neck cancer ? Not only successful treatment, but also […]<\/p>\n","protected":false},"author":5,"featured_media":4194,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_locale":"en_US","_original_post":"https:\/\/maj.emergency.co.jp\/?p=4161","footnotes":""},"categories":[851],"tags":[],"class_list":["post-4226","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-cat170_en","en-US"],"acf":[],"aioseo_notices":[],"aioseo_head":"\n\t\t\n\t\n\t\n\t\n\t\n\t\t\n\n\t\t