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Lancet Phase III Trial Finds Proton Therapy Improves 5-Year Survival in Oropharyngeal Cancer

The multicenter study, the largest randomized comparison of IMPT versus IMRT, prompted investigators to urge wider access.

Overview

  • Five-year overall survival reached 90.9% with proton therapy versus 81.0% with conventional IMRT, a statistically significant difference.
  • Patients receiving IMPT had lower rates of severe side effects, including less feeding tube dependence, less dry mouth, fewer swallowing problems, and reduced severe lymphopenia.
  • The randomized trial enrolled 440 stage III/IV patients across 21 U.S. sites, offering the most robust head-to-head evidence to date for this setting.
  • The primary endpoint of three-year progression-free survival showed non-inferiority, with five-year PFS modestly favoring IMPT (81.3% vs 76.2%).
  • Study leaders and the National Association for Proton Therapy called for broader adoption and coverage, while some additional claims such as cost-effectiveness come from advocacy materials.