title: Radiobiological basis and clinical results of the simultaneous integrated boost (SIB) in intensity modulated radiotherapy (IMRT) for head and neck cancer: A review.
abstract: The simultaneous integrated boost (SIB)-IMRT technique allows the simultaneous delivery of different dose levels to different target volumes within a single treatment fraction. The most significant aspect associated with SIB-IMRT is related to the fractionation strategy, concerning two time-dose parameters: (1) the shortening of the overall treatment time (OTT); (2) the increase of fraction size (FS) to the boost volume. The SIB-IMRT technique represents, therefore, a new way to investigate the accelerated fractionation in definitive treatment of head and neck (H&N) cancers. The aims of this paper are the following: (1) to briefly review the influence of OTT and FS on H&N tumors and on acutely and late responding normal tissues; (2) to review the results of clinical studies of accelerated radiotherapy not employing IMRT in H&N cancer; (3) to review the clinical experiences of the SIB-IMRT technique and to compare the different SIB regimes in terms of radiobiological efficacy.
authors.affiliation: Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy. ester.orlandi@istitutotumori.mi.it
authors.forename: Ester
authors.initials: E
authors.lastname: Orlandi
authors.forename: Mauro
authors.initials: M
authors.lastname: Palazzi
authors.forename: Emanuele
authors.initials: E
authors.lastname: Pignoli
authors.forename: Carlo
authors.initials: C
authors.lastname: Fallai
authors.forename: Antonella
authors.initials: A
authors.lastname: Giostra
authors.forename: Patrizia
authors.initials: P
authors.lastname: Olmi
mesh_terms: D000818:Animals; D002277:Carcinoma / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D011853:Radiobiology; D011880:Radiotherapy Planning, Computer-Assisted / Q000379:methods; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D012062:Relative Biological Effectiveness; D013997:Time Factors