Patient-Reported Outcomes, Physician-Reported Toxicities, and Treatment Outcomes in a Modern Cohort of Patients with Sinonasal Cancer Treated Using Proton Beam Therapy.

Abstract Background and Purpose To report on the physician-assessed toxicities (PATs) and patient-reported outcomes (PROs) in a prospective cohort of patients treated using proton beam therapy (PBT). Methods and Materials From 2011-2019, PBT-treated patients with a sinonasal malignancy were enrolled with a primary endpoint of toxicity assessment. PATs and PROs were assessed at baseline, acute (during PBT), subacute (within 90 days after PBT), and chronic time-points. PATs were graded using Common Terminology Criteria for Adverse Events. PROs were assessed using Xerostomia-Related Quality-of-Life Scale (XeQoLS), MD Anderson Dysphagia Inventory (MDADI), and Functional Assessment of Cancer Therapy (FACT). PRO changes from baseline to follow-up were defined as significantly different based on a paired t-test plus a minimally clinically important difference. Results Sixty-four patients had a median follow-up of 33 months (interquartile range: 10-52 months). The most common histology was olfactory neuroblastoma (28%) and the majority of patients had T4 disease (46%). There was one acute G3 neurologic PAT (blurred vision) which resolved and no late G3-4 neurologic PATs. Feeding tube placement occurred in 6% of patients. There were no significant chronic PRO changes from baseline. Significant worsening from baseline was noted in the XeQoLS acute-subacute physical functioning, pain, personal/psychological distress, and social function; acute-subacute MDADI physical function; and acute-subacute FACT head/neck subscale. The three-year local control, disease-free survival, and overall survival rates were 88%, 76%, and 82%, respectively. Conclusions We demonstrate low grade ≥3 toxicity and encouraging disease outcomes with PBT. PROs suggest significant changes in the acute-subacute period without chronic sequelae.