Intensity-modulated radiotherapy in head and neck cancers: In which direction are we heading?

Abstract

Radiotherapy (RT) is one of the treatment modalities, which most of the time used in the treatment of most head and neck cancers with/without chemotherapy either as a definitive treatment or adjuvant/postoperated or for symptoms palliation, but it is always accompanied by late sequelae such as xerostomia and dysphagia. These two major sequelae have a significant effect on patient′s quality of life even after cure of disease. However, with the advancement of modern techniques such as intensity-modulated RT (IMRT) which effectively spares the parotid glands has a significant effect, proven in randomized trials, for xerostomia as well as dysphagia. IMRT to spare dysphagia and aspiration related structure ( DARSs) has also been studied extensively. To improve the results further, nowadays, we focus on use of functional imaging at the time of RT planning and/or use of image guidance for the adaptation during RT treatment as well as focus on to reduce neurocognition effects of treatment by sparing brain.

Keywords

• Dysphagia
• head and neck cancer
• intensity-modulated radiotherapy
• sequelae
• xerostomia