[Intensity-modulated radiotherapy for head and neck cancer. Dose constraint for salivary gland and mandible]

Abstract

Intensity-modulated radiation therapy (IMRT) is the gold standard for head and neck irradiation. It allows better protection to the organs at risk such as salivary glands and mandible, and can reduce the frequency of xerostomia, trismus and osteoradionecrosis. At the time of treatment planning, the mean dose to a single parotid gland should be kept below 26Gy, the mean dose to a single submandibular gland below 39Gy, the mean dose to the mandible below 60 to 65Gy and the D2% to a single temporomandibular joint below 65Gy. These dose constraints could be further improved with data extracted from cohorts of patients receiving IMRT exclusively. The dose administered to the target volumes should not be lessened to spare the salivary glands or mandible.

Keywords: Glandes salivaires; Head and neck cancer; Intensity-modulated radiotherapy; Mandible; Mandibule; Organ at risk; Organes à risque; Radiothérapie conformationnelle avec modulation d’intensité; Salivary gland; Tumeurs des VADS.