BACKGROUND: Patients with dyskeratosis congenita (DC) have an increased risk of 
cancer, but also exhibit heightened radiation sensitivity. Proton therapy 
improves sparing of normal tissue, and thus may reduce radiation toxicity in 
patients with DC.
OBSERVATIONS: We present a pediatric patient with DC who was treated with 
adjuvant proton therapy for oropharyngeal cancer. He experienced more severe 
skin toxicity and mucositis than expected. With reduced fractions per week and 
extensive supportive care, he completed the full radiation course.
CONCLUSIONS: Proton therapy can improve normal tissue sparing, allowing 
successful delivery of radiation therapy in DC patients.