IMRT - Biomarkers for dose escalation, dose de-escalation and personalized medicine in radiotherapy for head and neck cancer

Oral Oncol. 2018 Nov:86:91-99. doi: 10.1016/j.oraloncology.2018.09.001. Epub 2018 Sep 18.

Abstract

Radiotherapy (RT) is an integral component in the management of head and neck cancer. Despite progress in several respects, a noteworthy proportion of the treated patients do not achieve complete response after RT. Regardless of novel dose delivery technologies, RT for head and neck cancer is still associated with acute as well as late toxicity. These challenges could potentially be addressed by means of personalized treatment. In this paper, we discuss the possibilities for dose escalation, dose de-escalation and allocation to systemic concomitant treatment based on prognostic and predictive markers for tumor control as well as predictive markers for normal tissue radiosensitivity.

Keywords: Cancer stem cells; HPV; Head and neck cancer; Hypoxia; Personalized medicine; Radiogenomics; Radiotherapy; SNP; p16.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents, Immunological / therapeutic use
  • Biomarkers, Tumor / genetics*
  • Cetuximab / therapeutic use
  • Chemoradiotherapy / adverse effects
  • Chemoradiotherapy / methods
  • Chromosome Aberrations
  • Dose-Response Relationship, Radiation
  • Head and Neck Neoplasms / genetics
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Precision Medicine / adverse effects
  • Precision Medicine / methods*
  • Prognosis
  • Radiation Injuries / etiology
  • Radiation Injuries / prevention & control*
  • Radiation Tolerance / genetics
  • Radiation Tolerance / radiation effects
  • Radiotherapy Dosage
  • Radiotherapy, Intensity-Modulated / adverse effects
  • Radiotherapy, Intensity-Modulated / methods*
  • Survival Analysis
  • Treatment Outcome

Substances

  • Antineoplastic Agents, Immunological
  • Biomarkers, Tumor
  • Cetuximab