title: Organ-sparing radiation therapy for head and neck cancer.
abstract: To improve locoregional tumor control and survival in patients with locally advanced head and neck cancer (HNC), therapy is intensified using altered fractionation radiation therapy or concomitant chemotherapy. However, intensification of therapy has been associated with increased acute and late toxic effects. The application of advanced radiation techniques, such as 3D conformal radiation therapy and intensity-modulated radiation therapy, is expected to improve the therapeutic index of radiation therapy for HNC by limiting the dose to critical organs and possibly increasing locoregional tumor control. To date, Review articles have covered the prevention and treatment of radiation-induced xerostomia and dysphagia, but few articles have discussed the prevention of hearing loss, brain necrosis, cranial nerve palsy and osteoradionecrosis of the mandible, which are all potential complications of radiation therapy for HNC. This Review describes the efforts to prevent therapy-related complications by presenting the state of the art evidence regarding advanced radiation therapy technology as an organ-sparing approach.
authors.affiliation: Department of Radiation Oncology, Cancer Hospital, Fudan University, Shanghai 200032, China.
authors.forename: XiaoShen
authors.initials: X
authors.lastname: Wang
authors.forename: ChaoSu
authors.initials: C
authors.lastname: Hu
authors.forename: Avraham
authors.initials: A
authors.lastname: Eisbruch
mesh_terms: D020516:Brachial Plexus Neuropathies / Q000209:etiology / Q000517:prevention & control; D001921:Brain / Q000473:pathology / Q000528:radiation effects; D003389:Cranial Nerve Diseases / Q000209:etiology / Q000517:prevention & control; D003680:Deglutition Disorders / Q000209:etiology / Q000517:prevention & control; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D034381:Hearing Loss / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008336:Mandibular Diseases / Q000209:etiology / Q000517:prevention & control; D009336:Necrosis; D059351:Organ Sparing Treatments / Q000379:methods*; D058958:Organs at Risk / Q000528:radiation effects*; D010025:Osteoradionecrosis / Q000209:etiology / Q000517:prevention & control; D011832:Radiation Injuries / Q000517:prevention & control*; D011878:Radiotherapy / Q000009:adverse effects / Q000379:methods*; D011879:Radiotherapy Dosage; D014987:Xerostomia / Q000209:etiology / Q000517:prevention & control