Comparing patient-reported wellness outcomes in head and neck cancer patients treated with proton vs photon therapy.

e23209 Background: Radiation therapy is a cornerstone in the treatment of head and neck cancers (HNC). Proton therapy offers a precise approach, delivering high-dose radiation directly to tumors while sparing healthy tissue. Emerging evidence suggests that proton therapy may significantly reduce toxicities and side effects compared to conventional radiation. In this study, we evaluated patient-reported wellness outcomes to assess the real-world impact of radiation type on quality of life and treatment tolerability. Methods: This retrospective study analyzed a total of 315 patients (299 treated with photon therapy, 16 with proton therapy) at the University of Miami from 2016 to 2023. We assessed demographic and clinicopathologic characteristics alongside key wellness metrics, including GAD-7, PHQ-9, PROMIS, and quality-of-life scores, which were collected in the clinic by nursing staff. Using descriptive statistics and independent-samples t-tests, we compared outcomes by radiation type, providing insight into the impact of treatment modality on patient well-being. Results: Patients receiving proton therapy were more likely to have early-stage disease (92.3% vs. 61.8%), demonstrated higher rates of no evidence of disease at last follow-up (87.5% vs. 75.6%), and had a 100% survival rate at last follow-up compared to 90% in the photon-treated group. PROMIS scores consistently suggested a trend toward lower symptom burden in proton-treated patients across multiple domains, including depression (44 vs. 49.12), fatigue (48.63 vs. 51.79), pain (47.81 vs. 54.64), and anxiety (53.06 vs. 55.04). While these differences did not reach statistical significance, they align with emerging evidence supporting improved overall well-being with proton therapy. Additionally, proton-treated patients reported better quality-of-life metrics, experiencing less fatigue (2.23 vs. 2.37), greater contentment with life (3.52 vs. 3.22), and an enhanced ability to enjoy life (3.6 vs. 3.5). These findings collectively support the potential of proton therapy to improve quality of life and reduce symptom burden compared to photon therapy in HNC. Conclusions: Trends in wellness scores suggest that proton therapy may offer meaningful benefits for patients with head and neck cancers, including lower levels of fatigue, depression, and anxiety, as well as improved overall quality of life. These promising findings highlight the potential of proton therapy to enhance patient well-being and demonstrate the need for further research with a larger cohort to fully capture its impact on patient-reported outcomes. Our study also highlights the importance of understanding wellness and psychosocial impact through structured wellness questionnaires, as these factors play a critical role in cancer care, influencing treatment tolerance, recovery, and overall patient outcomes.