title: Reducing radiation-related morbidity in the treatment of nasopharyngeal carcinoma.
abstract: While radiation therapy is the mainstay of treatment for nasopharyngeal carcinoma, the anatomic location of the nasopharynx in close proximity to radiation-sensitive organs such as the salivary glands, optic nerves and chiasm, cochlea, brainstem and temporal lobes presents a special challenge. Technological approaches to reducing the morbidity of nasopharyngeal cancer irradiation have been historically successful with the evolution from 2D techniques to increasingly conformal forms of radiation therapy. This report reviews normal tissue dose constraints and major considerations in target delineation for patients with nasopharyngeal cancer in the intensity-modulated radiation therapy era. Furthermore, this report discusses more contemporary approaches to toxicity reduction such as the judicious reduction or omission of radiation to low-risk regions and the potential role of particle beam therapy.
authors.affiliation: Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Jason W
authors.initials: JW
authors.lastname: Chan
authors.affiliation: Department of Radiation Oncology, University of Washington, Seattle, WA, USA.
authors.forename: Upendra
authors.initials: U
authors.lastname: Parvathaneni
authors.affiliation: Department of Radiation Oncology, University of California San Francisco, San Francisco, CA, USA.
authors.forename: Sue S
authors.initials: SS
authors.lastname: Yom
mesh_terms: D001921:Brain / Q000473:pathology / Q000528:radiation effects; D002277:Carcinoma; D006319:Hearing Loss, Sensorineural / Q000209:etiology; D006801:Humans; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000150:complications* / Q000532:radiotherapy; D009336:Necrosis / Q000209:etiology; D009901:Optic Nerve Diseases / Q000209:etiology; D011832:Radiation Injuries / Q000473:pathology; D011879:Radiotherapy Dosage; D011880:Radiotherapy Planning, Computer-Assisted; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects*; D014987:Xerostomia / Q000209:etiology
keywords: field size reduction; nasopharyngeal cancer; particle therapy; radiation therapy; radiation-related morbidity