Adaptive radiotherapy for head and neck cancer.

Details

Serval ID
serval:BIB_4D054507CBEA
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Adaptive radiotherapy for head and neck cancer.
Journal
Acta oncologica
Author(s)
Castelli J., Simon A., Lafond C., Perichon N., Rigaud B., Chajon E., De Bari B., Ozsahin M., Bourhis J., de Crevoisier R.
ISSN
1651-226X (Electronic)
ISSN-L
0284-186X
Publication state
Published
Issued date
10/2018
Peer-reviewed
Oui
Volume
57
Number
10
Pages
1284-1292
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Large anatomical variations can be observed during the treatment course intensity-modulated radiotherapy (IMRT) for head and neck cancer (HNC), leading to potential dose variations. Adaptive radiotherapy (ART) uses one or several replanning sessions to correct these variations and thus optimize the delivered dose distribution to the daily anatomy of the patient. This review, which is focused on ART in the HNC, aims to identify the various strategies of ART and to estimate the dosimetric and clinical benefits of these strategies.
We performed an electronic search of articles published in PubMed/MEDLINE and Science Direct from January 2005 to December 2016. Among a total of 134 articles assessed for eligibility, 29 articles were ultimately retained for the review. Eighteen studies evaluated dosimetric variations without ART, and 11 studies reported the benefits of ART.
Eight in silico studies tested a number of replanning sessions, ranging from 1 to 6, aiming primarily to reduce the dose to the parotid glands. The optimal timing for replanning appears to be early during the first two weeks of treatment. Compared to standard IMRT, ART decreases the mean dose to the parotid gland from 0.6 to 6 Gy and the maximum dose to the spinal cord from 0.1 to 4 Gy while improving target coverage and homogeneity in most studies. Only five studies reported the clinical results of ART, and three of those studies included a non-randomized comparison with standard IMRT. These studies suggest a benefit of ART in regard to decreasing xerostomia, increasing quality of life, and increasing local control. Patients with the largest early anatomical and dose variations are the best candidates for ART.
ART may decrease toxicity and improve local control for locally advanced HNC. However, randomized trials are necessary to demonstrate the benefit of ART before using the technique in routine practice.
Keywords
Head and Neck Neoplasms/mortality, Head and Neck Neoplasms/radiotherapy, Humans, Organs at Risk, Parotid Gland/radiation effects, Radiotherapy Dosage, Radiotherapy Planning, Computer-Assisted/methods, Radiotherapy, Intensity-Modulated, Spinal Cord/radiation effects
Pubmed
Web of science
Create date
16/10/2018 10:07
Last modification date
20/08/2019 14:01
Usage data