Radiotherapy for Head and Neck Cancer

Abstract

Treatment for patients with head and neck cancer requires a multidisciplinary approach. Radiotherapy is employed as a primary treatment or as an adjuvant to surgery. Each specific subsite dictates the appropriate radiotherapy techniques, fields, dose, and fractionation scheme. Quality of life is also an important issue in the management of head and neck cancer. The radiation-related complications have a tremendous impact on the quality of life. Modern radiotherapy techniques, such as intensity-modulated radiotherapy and image-guided radiotherapy, can offer precise radiation delivery and reduce the dose to the surrounding normal tissues without compromise of target coverage. In the future, efforts should be made in the exploration of novel strategies to improve treatment outcome in patients with head and neck cancer.

Compliance of post‐radiation therapy head and neck cancer patients with caries preventive protocols

“…Radiation therapy is frequently employed in the management of HNC . Optimal radiation doses depend on the tumour type, site and disease stage . Radiosensitive tumours such as lymphomas require relatively low doses of 30–36 Gy .…”

“…Radiosensitive tumours such as lymphomas require relatively low doses of 30–36 Gy . Carcinomas are not as radiosensitive . In general, primary tumours and gross lymphadenopathy require a total dose of 70 Gy or more .…”

“…Carcinomas are not as radiosensitive . In general, primary tumours and gross lymphadenopathy require a total dose of 70 Gy or more . Post‐surgery, radiation therapy doses of 60–66 Gy are usually required to eliminate any residual microscopic disease, aiding locoregional disease control .…”

“…In general, primary tumours and gross lymphadenopathy require a total dose of 70 Gy or more . Post‐surgery, radiation therapy doses of 60–66 Gy are usually required to eliminate any residual microscopic disease, aiding locoregional disease control . A reduction in salivary function is a common side‐effect of radiation therapy to the head and neck region .…”

New Developments in the Management of Laryngeal Cancer

“…Radiation oncology in the head and neck has evolved considerably over recent years with the advent of intensity-modulated XRT (IMRT) and volumetric arc therapy (VMAT), now favored over traditional threeand two-dimensional techniques, which are able to offer precise radiation delivery, while minimizing the dose to surrounding normal structures without compromise of target coverage. 37 Furthermore, image-guided planning and specific patient immobilization and positioning techniques with the use of a thermoplastic mask are able to expose the larynx and minimize dose delivery to surrounding tissues, while creating a reproducible set-up for the whole duration of XRT treatment. These new techniques avoid exposure to salivary glands, upper aerodigestive mucosa, and pharyngeal constrictors and several studies have reported reduced radiation-related side effects and improved functional and quality-of-life outcomes.…”