The Potential of Helical Tomotherapy in the Treatment of Head and Neck Cancer |
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Authors: | Dirk Van Gestel Dirk Verellen Lien Van De Voorde Bie de Ost Geert De Kerf Olivier Vanderveken Carl Van Laer Danielle Van den Weyngaert Jan B Vermorken Vincent Gregoire |
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Institution: | 1. Department of Radiotherapy, University Radiotherapy Antwerp, Antwerp, Belgium;2. Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium;3. Department of Radiation Oncology, Ghent University Hospital, Ghent, Belgium;4. Department of Otolaryngology and Head and Neck Surgery and;5. Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium;6. Faculty of Medicine, Antwerp University, Antwerp, Belgium;7. Radiation Oncology Department, Center for Molecular Imaging and Experimental Radiotherapy, St.‐Luc University Hospital, Brussels, Belgium |
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Abstract: | A decade after its first introduction into the clinic, little is known about the clinical impact of helical tomotherapy (HT) on head and neck cancer (HNC) treatment. Therefore, we analyzed the basics of this technique and reviewed the literature regarding HT's potential benefit in HNC. The past two decades have been characterized by a huge technological evolution in photon beam radiotherapy (RT). In HNC, static beam intensity‐modulated radiotherapy (IMRT) has shown superiority over three‐dimensional conformal RT in terms of xerostomia and is considered the standard of care. However, the next‐generation IMRT, the rotational IMRT, has been introduced into the clinic without any evidence of superiority over static beam IMRT other than being substantially faster. Of these rotational techniques, HT is the first system especially developed for IMRT in combination with image‐guided RT. HT is particularly promising for the treatment of HNC because its sharp dose gradients maximally spare the many radiosensitive organs at risk nearby. In addition, HT's integrated computed tomography scan assures a very precise dose administration and allows for some adaptive RT. Because HT is specifically developed for IMRT in combination with (integrated) image‐guidance, it allows for precise dose distribution (“dose painting”), patient setup, and dose delivery. As such, it is an excellent tool for difficult HNC irradiation. The literature on the clinical results of HT in HNC all show excellent short‐term (≤2 years) results with acceptable toxicity profiles. However, properly designed trials are still warranted to further substantiate these results. |
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Keywords: | Head and neck cancer Helical tomotherapy |
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