Overview

• Initial results presented at the ASTRO Annual Meeting report parity in one-year patient-reported quality of life, swallowing function, and feeding-tube dependence between proton therapy and IMRT.
• The UK randomized trial enrolled 205 patients between 2020 and 2023 in a 2:1 design to proton therapy (n=136) versus IMRT (n=69), all with concurrent cisplatin.
• Feeding-tube dependence at one year was 1.7% in both arms, with more severe weight loss in the proton group (18.2% vs. 5.7%), yielding a non-significant composite clinical endpoint difference (p=0.08).
• Patient-reported measures showed no meaningful differences at one year, including similar scores on the University of Washington Quality of Life and the MD Anderson Dysphagia Inventory.
• At a median 28.3-month follow-up, two-year freedom from local recurrence and overall survival were similarly high in both groups, and investigators credited strict national QA standards with high-quality IMRT performance.