Proton beam radiotherapy head and neck cancer study design and endpoints

We thank Friborg et al for sharing Denmark's important contributions to the evidence base for proton beam therapy in head and neck cancer patients [1]. In the Danish model, head and neck squamous cell cancer (SCC) in all sub-sites excluding early T1-2N0M0 larynx were included. Patients are double planned with comparisons made between proton-photon dosimetry and a 5% superiority in the normal tissue complication probability (NTCP) model estimated risk for xerostomia and dysphagia is used to guide randomisation into DAHANCA35.