Novel Technological Aspects of Radiation Therapy in Head and Neck Cancer
Branislav JEREMI?1,Ivane KILADZE2,Gökhan ÖZYİĞİT3,Nenad FILIPOVI?4,Pavol DUBINSKY5
1University of Kragujevac Faculty of Medicine, Kragujevac-Serbia
2Department of Medical Oncology, Caucasus Medical Centre, Tbilisi-Georgia
3Department of Radiation Oncology, Hacettepe University, Faculty of Medicine, Ankara-Turkey
4BioIRC, Center for Biomedical Engineering, Kragujevac-Serbia
5Department of Radiation Oncology, East Slovakia Institute of Oncology, Kosice-Slovakia
DOI : 10.5505/tjo.2020.2579 Radiation therapy (RT) is an important treatment modality in head and neck cancer (HNC) irrespective of stage, histology, and location of the primary tumor in both curative and palliative setting, with or without other treatment modalities such as surgery or chemotherapy. Based on advances with better imaging and introduction of sophisticated software for treatment and planning systems, radiation oncology of HNC witnessed major advantages resulting in both improved local control and better sparing of organs at risk. From computed tomography to magnetic resonance imaging and introduction of positron emission tomography with various radiotracers it became possible not only to diagnose and stage HNC with more confidence but also to introduce these technologies in RT treatment planning, and to use it during the RT course for the evaluation of response and additionally sculpture RT fields. Furthermore, it became possible to predict outcome based on anatomic and metabolic changes in HNC. Community of radiation oncologists successfully adopted transition from two-dimensional to three-dimensional RT and then to intensity modulated RT, as well as stereotactic radiotherapy (either single- or multi-fraction) regimens. There is renewed interest in heavy particles with both neutrons, carbon-ions and protons, the latter two being used more frequently in the recent years. This review article summarizes the most important accepts of novel RT technologies in HNC. Keywords : Head and neck cancer; radiotherapy, treatment