The Phase 3 TORPEdO trial compared intensity-modulated proton therapy (IMPT) with standard intensity-modulated radiation therapy (IMRT) in 205 patients with locally advanced oropharyngeal cancer. Both groups received the same radiation dose and chemotherapy. The study aimed to see if proton therapy could reduce side effects by sparing healthy tissues.
IMPT showed a slight functional advantage in measures of swallowing tube dependence and severe weight loss at 12 months. However, severe weight loss was higher in the IMPT group because fewer patients had feeding tubes placed early in treatment. Long-term tube dependence was low and similar in both groups, and quality of life measures like swallowing, chewing, and taste were comparable.
Overall, both IMPT and IMRT were effective for cancer control and long-term function. While proton therapy may reduce radiation to healthy tissues, IMRT remains a reliable standard where proton therapy is not available.