Intensity-modulated radiation therapy in head and neck cancers - Dosimetric advantages and update of clinical results

Intensity-modulated radiation therapy (IMRT) is an exciting new modality in radiation therapy. The head and neck region is an ideal target for this new technology for several reasons. First, IMRT offers the potential for improved tumor control through delivery of high doses to the target volume. Second, because of sharp dose gradients, IMRT results in the relative sparing of normal structures in the head and neck region. Third, organ motion is virtually absent in the head and neck region, so, with proper immobilization, treatment can be delivered accurately. Although this is a relatively new technology, preliminary studies show excellent dosimetric profiles and clinical results. Salivary gland sparing has also resulted in reduced incidence and severity of xerostomia. Early reports of improvement in tumor control with better side effect profiles versus conventional techniques are promising, but will need to be confirmed with longer follow-up.