title: Radiotherapy for head and neck tumours in 2012 and beyond: conformal, tailored, and adaptive?
abstract: Intensity-modulated radiation therapy (IMRT) is a conformal irradiation technique that enables steep dose gradients. In head and neck tumours this approach spares parotid-gland function without compromise to treatment efficacy. Anatomical and molecular imaging modalities may be used to tailor treatment by enabling proper selection and delineation of target volumes and organs at risk, which in turn lead to dose prescriptions that take into account the underlying tumour biology (eg, human papillomavirus status). Therefore, adaptations can be made throughout the course of radiotherapy, as required. Planned dose increases to parts of the target volumes may also be used to match the radiosensitivity of tumours (so-called dose-painting), assessed by molecular imaging. For swift implementation of tailored and adaptive IMRT, tools and procedures, such as accurate image acquisition and reconstruction, automatic segmentation of target volumes and organs at risk, non-rigid image and dose registration, and dose summation methods, need to be developed and properly validated.
authors: Department of Radiation Oncology, Université Catholique de Louvain, Cliniques Universitaires Saint-Luc, Brussels, Belgium. vincent.gregoire@uclouvain.be
authors: Vincent
authors: V
authors: Grégoire
authors: Robert
authors: R
authors: Jeraj
authors: John Aldo
authors: JA
authors: Lee
authors: Brian
authors: B
authors: O'Sullivan
mesh_terms: D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000532:radiotherapy*; D006801:Humans; D049268:Positron-Emission Tomography; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18