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The Oncologist, Vol. 12, No. 5, 555-564, May 2007; doi:10.1634/theoncologist.12-5-555
© 2007 AlphaMed Press

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Head and Neck Cancers

Intensity-Modulated Radiation Therapy for Head and Neck Carcinoma

Vincent Grégoirea, Wilfried De Neveb, Avraham Eisbruchc, Nancy Leed, Danielle Van den Weyngaerte, Dirk Van Gestele

aRadiation Oncology Department and Center for Molecular Imaging and Experimental Radiotherapy, Université Catholique de Louvain, St-Luc University Hospital, Brussels, Belgium; bRadiation Oncology Department, Ghent University Hospital, Gent, Belgium; cDepartment of Radiation Oncology, University of Michigan, Ann Arbor, Michigan, USA; dDepartment of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA; eDepartment of Radiotherapy, Middelheim General Hospital, Antwerp, Belgium

Key Words. Radiotherapy • Head and neck cancer • IMRT

Correspondence: Vincent Grégoire, M.D., Ph.D., Radiation Oncology Department, St-Luc University Hospital, 10 Avenue Hippocrate, B-1200 Brussels, Belgium. Telephone: 32-2-764-94-43; Fax: 32-2-764-94-25; e-mail: vincent.gregoire{at}imre.ucl.ac.be

Intensity-modulated radiation therapy (IMRT) for head and neck tumors refers to a new approach that aims at increasing the radiation dose gradient between the target tissues and the surrounding normal tissues at risk, thus offering the prospect of increasing the locoregional control probability while decreasing the complication rate. As a prerequisite, IMRT requires a proper selection and delineation of target volumes. For the latter, recent data indicate the potential of functional imaging to complement anatomic imaging modalities. Nonrandomized clinical series in paranasal sinuses and pharyngolaryngeal carcinoma have shown that IMRT was able to achieve a very high rate of locoregional control with less morbidity, such as dry-eye syndrome, xerostomia, and swallowing dysfunction. The promising results of IMRT are likely to be achieved when many treatment conditions are met, for example, optimal selection and delineation of the target volumes and organs at risk, appropriate physical quality control of the irradiation, and accurate patient setup with the use of onboard imaging. Because of the complexity of the various tasks, it is thus likely that these conditions will only be met in institutions having large patient throughput and experience with IMRT. Therefore, patient referral to those institutions is recommended.

Disclosure of potential conflicts of interest is found at the end of this article.




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A. M. Allen and R. B. Tishler
Commentary: IMRT for Head and Neck Cancer: Many Chapters Left to Write
Oncologist, May 1, 2007; 12(5): 565 - 568.
[Abstract] [Full Text] [PDF]


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