Treatment of Head and Neck Cancers Using Radiotherapy

Radiotherapy is one of the major treatments for head and neck cancers. This chapter discusses the importance of radiotherapy in treating the common types of head and neck cancers, which can be used as a primary treatment or as a postoperative adjuvant treatment to increase the survival of head and neck cancer patients. Because head and neck cancers are likely to be closely surrounded by radiation-sensitive vital organs, the dosimetric superiority of intensity-modulated radiotherapy (IMRT) to achieve highly conformal dose to the planning target volume (PTV) and avoidance of organs at risk (OARs) helps maintain the cornerstone role of radiotherapy in treating the disease. The rationale of IMRT and the treatment planning technique are introduced. Treatment planning of radiotherapy is one of the key procedures in IMRT. The inverse planning process involves many decision-making steps, including PTV and OAR delineation, beam arrangement settings, objective function setting, etc. These important steps are all illustrated in the chapter, with a specific discussion of planning challenges relevant to head and neck cancers. Finally, the promises for further development of IMRT in terms of OARs dose sparing and PTV dose escalation are briefly discussed and reviewed