本論文旨在比較接受質子治療(proton therapy)與光子治療(photon therapy)的鼻咽癌患者在臨床結果、治療相關副作用和生活品質(quality of life)等方面的差異。本研究者結合回溯性和前瞻性數據，評估這兩種治療方式的臨床療效及患者自我報告的結果。研究發現，質子治療在腫瘤治療方面表現出優異的效果，且顯著降低了嚴重副作用的發生率，包括口腔黏膜炎和需要使用鼻胃管的比例。其可歸因於質子治療具備更精確的劑量分布，能有效減少對周圍健康組織，特別是複雜解剖區域如鼻咽部周圍的損害。
患者自我健康報告的結果進一步顯示，接受質子治療的患者出現較少的口腔相關症狀，如黏膜炎、張口困難，且進食相關的生活品質明顯改善，強調了質子治療在減少相關症狀的優勢。儘管如此，質子治療與光子治療在一般生活品質、鼻竇及耳部生活品質等方面，並未有顯著差異。此外，研究指出社會經濟地位對治療選擇具有影響，因為收入較高的患者更傾向於選擇質子治療，這與質子治療的高昂費用有關，而該費用並未完全納入健保給付範圍。
儘管質子治療在放射治療的急性期內展現了顯著的優勢，特別是在減少嚴重的口腔副作用和改善進食相關生活品質方面，但仍需進行長期研究來探討其在鼻竇、耳科結果及一般生活品質上的差異。未來的研究應著重於設計完善的隨機對照試驗，以驗證這些發現，並進一步評估質子治療在鼻咽癌治療中的成本效益。

This dissertation aimed to compare the clinical outcomes, treatment-related adverse events (AEs), and quality of life (QoL) in nasopharyngeal carcinoma (NPC) patients treated with proton therapy (IMPT) versus photon therapy (VMAT). Using a combination of retrospective and prospective data, the researcher assessed the oncologic efficacy and patient-reported outcomes between the two modalities. Proton therapy was found to be associated with superior oncologic outcomes and a significant reduction in severe AEs, including mucositis and the need for feeding tube placement. These results are attributed to proton therapy’s superior dose distribution, which minimizes damage to surrounding healthy tissues, particularly in the complex anatomical regions of the nasopharynx.
Patient-reported outcomes further highlighted fewer oral-related symptoms, such as mucositis, and improved eating-related QoL in the IMPT group, emphasizing proton therapy's potential in relieving treatment-related symptoms. Despite these findings, no significant differences were observed between IMPT and VMAT in terms of generic QoL, sinonasal, or otologic outcomes. Additionally, the study noted that socioeconomic status (SES) influenced treatment selection, as higher SES patients were more likely to receive IMPT due to its higher financial cost, which is not fully covered by national health insurance.
While IMPT demonstrates clear benefits during the acute phase of radiotherapy, particularly in reducing severe oral AEs and improving eating-related QoL, further long-term studies are required to investigate its potential advantages in sinonasal and otologic outcomes, as well as generic QoL. Future research should also prioritize well-designed randomized controlled trials to validate these findings and assess the cost-effectiveness of proton therapy in NPC treatment.

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