Matching intensity-modulated radiation therapy to an anterior low neck field.
When using intensity-modulated radiation therapy (IMRT) to treat head and neck cancer with the primary site above the level of the larynx, there are two basic options for the low neck lymphatics: to treat the entire neck with IMRT, or to match the IMRT plan to a conventional anterior "low neck" field. In view of the potential advantages of using a conventional low neck field, it is important to look for ways to minimize or manage the problems of matching IMRT to a conventional radiotherapy field. Treating the low neck with a single anterior field and the standard larynx block decreases the dose to the larynx and often results in a superior IMRT plan at the primary site. The purpose of this article is to review the most applicable studies and to discuss our experience with implementing a technique that involves moving the position of the superior border of the low neck field several times during a single treatment fraction.
Amdur
Robert J
RJ
Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL 32160, USA. amdurrj@shands.ufl.edu
Liu
Chihray
C
Li
Jonathan
J
Mendenhall
William
W
Hinerman
Russell
R
D006258:Head and Neck Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D007830:Larynx / Q000528:radiation effects; D011832:Radiation Injuries / Q000517:prevention & control; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*