Current Cancer Therapy Reviews - Volume 10, Issue 4, 2014

Radiotherapy plays a critical role in the nodal management of patients with head and neck cancer. The indications, dose fractionation schedules, and results of postoperative radiation therapy (PORT) and elective nodal management (ENI) in various head and neck cancers are reviewed and summarized with common themes identified.

Radiation therapy has been a major modality employed in the treatment of head and neck (H&N) cancer for decades. In that time, radiation technology has evolved considerably. Thirty years ago radiation therapy for H&N cancer consisted of two-dimensional techniques using plain field radiographs, bony anatomy, and hand drawn blocks [1]. Beam set ups were generally quite simple and plans generally consisted of opp Read More

Technological advancements in robotics, imaging and stereotactic localization have made extracranial radiosurgery possible. Stereotactic body radiation therapy (SBRT) utilizes specially modified linear accelerators to deliver radiation to precisely defined anatomic targets. Radiation is delivered in one to five fractions at high doses per fraction compared to conventional radiation therapy techniques. SBRT was first utilize Read More

Purposes: To improve normal tissue sparing for head-and-neck (H&N) image-guided radiotherapy (IGRT) by employing treatment plans with tighter margins for CTV 2 and 3, and documenting the delivered dose throughout the entire treatment course. Methods: Ten H&N cases treated with simultaneous integrated boost on a TomoTherapy unit (Accuray Inc.) were analyzed. Dose-limiting critical structures included brainstem, Read More

Radiation therapy aims to deliver high radiation dose to tumor target with minimal exposure to surrounding normal tissue. However, he physics of energy decomposition and mechanical limitations restrict the achievable dose distribution, necessitating tradeoffs between target coverage and normal tissue sparing. Treatment planning is the process of obtaining control parameters to yield such a dose pattern. Dose volume hist Read More

Purpose: For patients with early stage lateralized head and neck cancer, unilateral radiotherapy has been shown a superior treatment than bilateral radiotherapy. Unilateral treatment not only maintains the same level of tumor control, it reduces treatment related toxicity. To take the advantage of treating a lateralized and smaller volume, radiotherapy has experienced evolution from mixed photon/electron fields, to wedge pair a Read More

It is now well-established that human papillomavirus (HPV)-associated squamous cell carcinoma, which comprises an increasing proportion of all oropharyngeal cancers, represents a unique entity with distinct clinical and molecular characteristics. Data also has emerged demonstrating that patients with HPVpositive head and neck cancer have an improved prognosis compared to their HPV-negative counterparts, with several Read More