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Journal of Oncology
Volume 2011 (2011), Article ID 690595, 13 pages
http://dx.doi.org/10.1155/2011/690595
Review Article

Adaptive Radiation Therapy for Head and Neck Cancer—Can an Old Goal Evolve into a New Standard?

1Department of Radiation Medicine, North Shore-LIJ Health System, 270-05 76th Avenue, New Hyde Park, NY 11040, USA
2Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Unit 94, 1515 Holcombe Blvd., Houston, TX 77030, USA

Received 8 April 2010; Accepted 21 June 2010

Academic Editor: Loren K. Mell

Copyright © 2011 David L. Schwartz and Lei Dong. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Current head and neck intensity-modulated radiotherapy (IMRT) techniques cause significant toxicity. This may be explained in part by the fact that IMRT cannot compensate for changes in the location of disease and normal anatomy during treatment, leading to exposure of at-risk bystander tissues to higher-than-anticipated doses. Adaptive radiotherapy (ART) is a novel approach to correct for daily tumor and normal tissue variations through online or offline modification of original IMRT target volumes and plans. ART has been discussed on a conceptual level for many years, but technical limitations have hampered its integration into routine care. In this paper, we review the key anatomic, dosimetric, and treatment delivery issues at play in current investigational development of head and neck ART. We also describe pilot findings from initial clinical deployment of head and neck ART, as well as emerging pathways of future research.