Revisiting the dose constraints for head and neck OARs in the current era of IMRT

Oral Oncol. 2018 Nov:86:8-18. doi: 10.1016/j.oraloncology.2018.08.018. Epub 2018 Sep 8.

Abstract

Head and neck cancer poses a particular challenge in radiation therapy, whilst being an effective treatment modality it requires very high doses of radiation to provide effective therapy. This is further complicated by the fact that the head and neck region contains a large number of radiosensitive tissues, often resulting in patients experiencing debilitating normal tissue complications. In the era of intensity-modulated radiation therapy (IMRT) treatments can be delivered using non-uniform dose distributions selectively aimed at reducing the dose to critical organs-at-risk while still adequately covering the tumor target. Dose-volume constraints for the different risk organs play a vital role in one's ability to devise the best IMRT treatment plan for a head and neck cancer patient. To this end, it is pivotal to have access to the latest and most relevant dose constraints available and as such the goal of this review is to provide a summary of suggested dose-volume constraints for head and neck cancer RT that have been published after the QUANTEC reports were made available in early 2010.

Keywords: Dose constraints; Dose objectives; Head and neck; IMRT; Organs at risk.

Publication types

  • Review

MeSH terms

  • Dose-Response Relationship, Radiation
  • Head / radiation effects
  • Head and Neck Neoplasms / radiotherapy*
  • Humans
  • Incidence
  • Neck / radiation effects
  • Organs at Risk / radiation effects*
  • Radiation Injuries / epidemiology
  • Radiation Injuries / etiology
  • Radiation Injuries / prevention & control*
  • Radiotherapy Dosage
  • Radiotherapy, Intensity-Modulated / adverse effects*
  • Radiotherapy, Intensity-Modulated / methods