What information can we gain from performing adaptive radiotherapy of head and neck cancer patients from the past 10 years? |
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| Institution: | 1. Radiotherapy Department II, Greater Poland Cancer Center, Poznan, Poland;2. Department of Electroradiology, University of Medical Science, Poznan, Poland;3. Radiotherapy Ward I and Department I, Greater Poland Cancer Center, Poznan, Poland;4. Department of Medical Physics, Greater Poland Cancer Center, Poznan, Poland;1. Department of radiation oncology, centre François-Baclesse, Caen, France;2. Department of surgery, centre François-Baclesse, Caen, France;3. CAC, Nantes, France;4. ISC, Avignon, France;5. CHE, Nice, France;6. CJP, Clermont-Ferrand, France;7. AP–HP, Pitié-Salpêtrière, Paris, France;8. CHU, Amiens, France;9. CHU, Lyon, France;10. CHU, Bordeaux, France;11. Institut Lorraine, Nancy, France;12. CHU HEGP, Paris, France;13. Oncopole, Toulouse, France;14. CPS, Strasbourg, France;15. CHU Tenon, Paris, France;p. CHU, Tours, France;q. COL, Lille, France;r. CJB, Le Mans, France;s. CLB, Lyon, France;t. CHU, Brest, France;u. Institut Godinot, Reims, France;v. CHU, Besançon Montbéliard, France;w. CHB, Rouen, France;x. CHU, Grenoble, France;y. CGFL, Dijon, France;z. CHU, Marseille, France;11. Department of ENT surgery, CHU Caen, Caen, France;12. Unicaen, Normandie Université, Caen, France;13. GORTEC, France;1. Radiation Oncology Department, Portuguese Institute of Oncology of Porto, R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal;2. Cancer Epidemiology Group, Portuguese Institute of Oncology of Porto, R. Dr. António Bernardino de Almeida 865, 4200-072 Porto, Portugal;1. Department of Radiotherapy Center, Shanxi Provincial Cancer Hospital, No. 3 of Zhigongxinjie Street, Xinghualing District, Taiyuan, 030000, China;2. Department of Cancer Center, Shanxi Bethune Hospital, Taiyuan, 030000, China |
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| Abstract: | The aim of the review was to present the current literature status about replanning regarding anatomical and dosimetric changes in the target and OARs in the head and neck region during radiotherapy, to discuss and to analyze factors influencing the decision for adaptive radiotherapy of head and neck cancer patients. Significant progress has been made in head and neck patients’ evaluation and qualification for adapted radiotherapy over the past ten years. Many factors leading to anatomical and dosimetric changes during treatment have been identified. Based on the literature, the most common factors triggering re-plan are weight loss, tumor and nodal changes, and parotid glands shrinkage. The fluctuations in dose distribution in the clinical area are significant predictive factors for patients’ quality of life and the possibility of recovery. It has been shown that re-planning influence clinical outcomes: local control, disease free survival and overall survival. Regarding literature studies, it seems that adaptive radiotherapy would be the most beneficial for tumors of immense volume or those in the nearest proximity of the OARs. All researchers agree that the timing of re-planning is a crucial challenge, and there are still no clear consensus guidelines for time or criteria of re-planning. Nowadays, thanks to significant technological progress, the decision is mostly made based on observation and supported with IGRT verification. Although further research is still needed, adaptive strategies are evolving and now became the state of the art of modern radiotherapy. |
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| Keywords: | Radiotherapy planning Re-planning Adaptive radiotherapy Head and neck cancer Image-guided radiation therapy Planification de la radiothérapie Re-planification Radiothérapie adaptative Cancer de la tête et du cou Radiothérapie guidé par l’image |
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