title: The potential of helical tomotherapy in the treatment of head and neck cancer.
abstract: A decade after its first introduction into the clinic, little is known about the clinical impact of helical tomotherapy (HT) on head and neck cancer (HNC) treatment. Therefore, we analyzed the basics of this technique and reviewed the literature regarding HT's potential benefit in HNC. The past two decades have been characterized by a huge technological evolution in photon beam radiotherapy (RT). In HNC, static beam intensity-modulated radiotherapy (IMRT) has shown superiority over three-dimensional conformal RT in terms of xerostomia and is considered the standard of care. However, the next-generation IMRT, the rotational IMRT, has been introduced into the clinic without any evidence of superiority over static beam IMRT other than being substantially faster. Of these rotational techniques, HT is the first system especially developed for IMRT in combination with image-guided RT. HT is particularly promising for the treatment of HNC because its sharp dose gradients maximally spare the many radiosensitive organs at risk nearby. In addition, HT's integrated computed tomography scan assures a very precise dose administration and allows for some adaptive RT. Because HT is specifically developed for IMRT in combination with (integrated) image-guidance, it allows for precise dose distribution ("dose painting"), patient setup, and dose delivery. As such, it is an excellent tool for difficult HNC irradiation. The literature on the clinical results of HT in HNC all show excellent short-term (≤2 years) results with acceptable toxicity profiles. However, properly designed trials are still warranted to further substantiate these results.
authors.affiliation: Department of Radiotherapy, University Radiotherapy Antwerp, Antwerp, Belgium. dirk.vangestel@zna.be
authors.forename: Dirk
authors.initials: D
authors.lastname: Van Gestel
authors.forename: Dirk
authors.initials: D
authors.lastname: Verellen
authors.forename: Lien
authors.initials: L
authors.lastname: Van De Voorde
authors.forename: Bie
authors.initials: B
authors.lastname: de Ost
authors.forename: Geert
authors.initials: G
authors.lastname: De Kerf
authors.forename: Olivier
authors.initials: O
authors.lastname: Vanderveken
authors.forename: Carl
authors.initials: C
authors.lastname: Van Laer
authors.forename: Danielle
authors.initials: D
authors.lastname: Van den Weyngaert
authors.forename: Jan B
authors.initials: JB
authors.lastname: Vermorken
authors.forename: Vincent
authors.initials: V
authors.lastname: Gregoire
mesh_terms: D006258:Head and Neck Neoplasms / Q000473:pathology / Q000532:radiotherapy*; D006801:Humans; D011879:Radiotherapy Dosage; D061089:Radiotherapy, Image-Guided / Q000379:methods*; D050397:Radiotherapy, Intensity-Modulated / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D014057:Tomography, X-Ray Computed
keywords: Head and neck cancer; Helical tomotherapy