Fan M, Kang JJ, Lee A, et al. - Given that improvement in outcomes could be achieved in cases with nasal cavity (NC) and paranasal sinus (PNS) cancers via using proton therapy (PT), researchers here reported the largest series to date using intensity-modulated proton therapy (IMPT) in the treatment of these patients. They assessed a total of 86 consecutive patients (68 of whom were radiation-naive and 18 of whom were reirradiated) who received PT to median doses of 70 grays and 67 grays relative biological effectiveness, respectively, between 2013 and 2018. IMPT receipt was recorded in nearly 53%. For all patients, the median follow-up was 23.4 months (range, 1.7-69.3 months) and for surviving patients, the median follow-up was 28.1 months (range, 2.3-69.3 months). The 2-year local control (LC), distant control, disease-free survival, and overall survival rates for radiation-naive patients were 83%, 84%, 74%, and 81%, respectively, and for reirradiated patients were 77%, 80%, 54%, and 66%, respectively. Outcomes suggest the achievement of remarkable LC using PT in patients with nasal cavity and paranasal sinus cancers. In this study, they encountered lower grade 3 toxicities than historical reports. IMPT was identified to have the potential to improve the therapeutic ratio in these malignancies.