[Intensity-modulated radiotherapy for head and neck cancer. Dose constraint for salivary gland and mandible].
Intensity-modulated radiation therapy (IMRT) is the gold standard for head and neck irradiation. It allows better protection to the organs at risk such as salivary glands and mandible, and can reduce the frequency of xerostomia, trismus and osteoradionecrosis. At the time of treatment planning, the mean dose to a single parotid gland should be kept below 26Gy, the mean dose to a single submandibular gland below 39Gy, the mean dose to the mandible below 60 to 65Gy and the D2% to a single temporomandibular joint below 65Gy. These dose constraints could be further improved with data extracted from cohorts of patients receiving IMRT exclusively. The dose administered to the target volumes should not be lessened to spare the salivary glands or mandible.
Institut interrégional de cancérologie, centre Jean-Bernard, clinique Victor-Hugo, 9, rue Beauverger, 72000 Le Mans, France. Electronic address: pointr_y@yahoo.fr.
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Pointreau
Institut interrégional de cancérologie, centre Jean-Bernard, clinique Victor-Hugo, 9, rue Beauverger, 72000 Le Mans, France; Institut de cancérologie de l'Ouest Paul-Papin, 15, rue André-Boquel, 49055 Angers cedex 02, France.
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Lizée
Centre de haute énergie, institut niçois de cancérologie et d'imagerie, 10, boulevard Pasteur, 06000 Nice, France.
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Bensadoun
Département de radiothérapie, institut du cancer de Montpellier, 208, avenue des Apothicaires, parc Euromédecine, 34298 Montpellier cedex 5, France.
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Boisselier
Département de radiothérapie, centre Léon-Bérard, 28, rue Laennec, 69008 Lyon, France.
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Racadot
Département de radiothérapie, centre Antoine-Lacassagne, 33, avenue Valombrose, 06189 Nice, France.
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Thariat
Service de radiothérapie et de curiethérapie, institut universitaire du cancer de Toulouse-Oncopole, 1, avenue Irène-Joliot-Curie, 31100 Toulouse, France.
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Graff
D004307:Dose-Response Relationship, Radiation; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008334:Mandible / Q000528:radiation effects; D058958:Organs at Risk; D010025:Osteoradionecrosis / Q000209:etiology / Q000517:prevention & control; D011879:Radiotherapy Dosage; D050397:Radiotherapy, Intensity-Modulated; D012469:Salivary Glands / Q000528:radiation effects; D013704:Temporomandibular Joint / Q000528:radiation effects; D014313:Trismus / Q000209:etiology / Q000517:prevention & control; D014987:Xerostomia / Q000209:etiology / Q000517:prevention & control
Glandes salivaires; Head and neck cancer; Intensity-modulated radiotherapy; Mandible; Mandibule; Organ at risk; Organes à risque; Radiothérapie conformationnelle avec modulation d’intensité; Salivary gland; Tumeurs des VADS