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01-01-2015 | Head and neck cancers | Book chapter | Article

10. Postoperative Intensity-Modulated Radiation Therapy for Head and Neck Cancers: A Case-Based Review

Authors: G. Brandon Gunn, M.D., Adam S. Garden, M.D.

Publisher: Springer Japan

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Abstract

Postoperative radiation therapy targets of the head and neck region are often adjacent to nearby critical and avoidance structures. Therefore, intensity-modulated radiation therapy (IMRT) is preferred over previous techniques primarily due to (1) the ability to conform the high-dose regions around geometrically complex targets, (2) the ability to build steep dose gradients between targets and nearby critical structures, and (3) the ability to generate relative sparing of various surrounding nontarget normal structures from clinically significant doses without compromise of desired target coverage. Compared to clinical target volume delineation of intact regions (i.e., unoperated or unviolated neck), postoperative clinical target volumes are generally broader, in that they cross adjacent disturbed anatomic boundaries, are inclusive of surgical tracts and suture lines, and come nearer to the patient surface. Here we provide an expanded case-based illustration of our current approach to postoperative IMRT target volume delineation and treatment planning for various disease sites within the head and neck.
Literature
1.
Beadle BM, Liao K-P, Elting LS et al (2014) Improved survival using intensity-modulated radiation therapy in head and neck cancers: a SEER-Medicare analysis. Cancer 120:702–710CrossRefPubMed
2.
Kam MKM, Leung S-F, Zee B et al (2007) Prospective randomized study of intensity-modulated radiotherapy on salivary gland function in early-stage nasopharyngeal carcinoma patients. J Clin Oncol Off J Am Soc Clin Oncol 25:4873–4879CrossRef
3.
Pow EHN, Kwong DLW, McMillan AS et al (2006) Xerostomia and quality of life after intensity-modulated radiotherapy vs. conventional radiotherapy for early-stage nasopharyngeal carcinoma: initial report on a randomized controlled clinical trial. Int J Radiat Oncol Biol Phys 66:981–991CrossRefPubMed
4.
Nutting CM, Morden JP, Harrington KJ et al (2011) Parotid-sparing intensity modulated versus conventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial. Lancet Oncol 12:127–136CrossRefPubMedCentralPubMed
5.
Ang KK, Trotti A, Brown BW et al (2001) Randomized trial addressing risk features and time factors of surgery plus radiotherapy in advanced head-and-neck cancer. Int J Radiat Oncol 51:571–578CrossRef
6.
Bernier J, Cooper JS, Pajak TF et al (2005) Defining risk levels in locally advanced head and neck cancers: a comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (# 9501). Head Neck 27:843–850CrossRefPubMed
7.
Dabaja B, Salehpour MR, Rosen I et al (2005) Intensity-modulated radiation therapy (IMRT) of cancers of the head and neck: comparison of split-field and whole-field techniques. Int J Radiat Oncol Biol Phys 63:1000–1005CrossRefPubMed
8.
David MB, Eisbruch A (2007) Delineating neck targets for intensity- modulated radiation therapy of head and neck cancer. What we learned from marginal recurrences? Front Radiat Ther Oncol 40:193–207CrossRefPubMed
9.
Grégoire V, Eisbruch A, Hamoir M et al (2006) Proposal for the delineation of the nodal CTV in the node-positive and the post-operative neck. Radiother Oncol J Eur Soc Ther Radiol Oncol 79:15–20CrossRef
10.
Chan AK, Huang SH, Le LW et al (2013) Postoperative intensity-modulated radiotherapy following surgery for oral cavity squamous cell carcinoma: patterns of failure. Oral Oncol 49:255–260CrossRefPubMed
11.
Gunn GB, Debnam JM, Fuller CD et al (2013) The impact of radiographic retropharyngeal adenopathy in oropharyngeal cancer. Cancer 119(17):3162–3169CrossRefPubMedCentralPubMed
12.
Chronowski GM, Garden AS, Morrison WH et al (2012) Unilateral radiotherapy for the treatment of tonsil cancer. Int J Radiat Oncol Biol Phys 83:204–209CrossRefPubMed
13.
Hoppe BS, Wolden SL, Zelefsky MJ et al (2008) Postoperative intensity-modulated radiation therapy for cancers of the paranasal sinuses, nasal cavity, and lacrimal glands: technique, early outcomes, and toxicity. Head Neck 30:925–932CrossRefPubMed
14.
Bristol IJ, Ahamad A, Garden AS et al (2007) Postoperative radiotherapy for maxillary sinus cancer: long-term outcomes and toxicities of treatment. Int J Radiat Oncol Biol Phys 68:719–730CrossRefPubMed
15.
Rosenthal DI, Barker JL Jr, El-Naggar AK et al (2004) Sinonasal malignancies with neuroendocrine differentiation: patterns of failure according to histologic phenotype. Cancer 101:2567–2573CrossRefPubMed
16.
Garden AS, Weber RS, Morrison WH et al (1995) The influence of positive margins and nerve invasion in adenoid cystic carcinoma of the head and neck treated with surgery and radiation. Int J Radiat Oncol Biol Phys 32:619–626CrossRefPubMed
17.
Garden AS, el-Naggar AK, Morrison WH et al (1997) Postoperative radiotherapy for malignant tumors of the parotid gland. Int J Radiat Oncol Biol Phys 37:79–85CrossRefPubMed
18.
Bhatia A, Rao A, Ang K-K et al (2010) Anaplastic thyroid cancer: clinical outcomes with conformal radiotherapy. Head Neck 32:829–836PubMed
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