title: Intensity-modulated radiation therapy for head and neck carcinoma.
abstract: 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.
authors.affiliation: Radiation Oncology Department, Université Catholique de Louvain, St-Luc University Hospital, B-1200 Brussels, Belgium. vincent.gregoire@imre.ucl.ac.be
authors.forename: Vincent
authors.initials: V
authors.lastname: Grégoire
authors.forename: Wilfried
authors.initials: W
authors.lastname: De Neve
authors.forename: Avraham
authors.initials: A
authors.lastname: Eisbruch
authors.forename: Nancy
authors.initials: N
authors.lastname: Lee
authors.forename: Danielle
authors.initials: D
authors.lastname: Van den Weyngaert
authors.forename: Dirk
authors.initials: D
authors.lastname: Van Gestel
mesh_terms: D004307:Dose-Response Relationship, Radiation; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects; D012062:Relative Biological Effectiveness; D047368:Tumor Burden / Q000528:radiation effects