Skip to main content

Advertisement

Log in

Adaptive Radiotherapy for Head Neck Cancer

  • Technical Note
  • Published:
Journal of Maxillofacial and Oral Surgery Aims and scope Submit manuscript

Abstract

Changes in patient anatomy may occur either from a tumour volume, position or function of a specific organ at risk, or target volume, weight loss or a reduction in postoperative oedema, and may vary between patients. Adaptive radiotherapy aims to correct morphological variations by realizing one or more plans during the treatment course. Imaging is used to detect these variations, thereby deciding on a potential replanning. At present, adaptive radiotherapy for head neck cancer (HNC) mainly deals with treatment response, such as weight loss or tumor shrinkage. Therefore a properly timed repeat CT scan during treatment is a suitable basis for plan adaptation to account for treatment response.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. McClelland JR, Hughes S, Modat M, Qureshi A, Ahmad S, Landau DB, Ourselin S, Hawkes DJ (2011) Inter-fraction variations in respiratory motion models. Phys Med Biol 56(1):251–272

    Article  CAS  PubMed  Google Scholar 

  2. Hansen EK, Bucci MK, Quivey JM, Weinberg V, Xia P (2006) Repeat CT imaging and replanning during the course of IMRT for head-and-neck cancer. Int J Radiat Oncol Biol Phys 64(2):355–362

    Article  PubMed  Google Scholar 

  3. Cook IJ, Dodds WJ, Dantas RO, Massey B, Kern MK, Lang IM, Brasseur JG, Hogan WJ (1989) Opening mechanisms of the human upper esophageal sphincter. Am J Physiol 257(5 Pt 1):G748–G759

    CAS  PubMed  Google Scholar 

  4. Dantas RO, Kern MK, Massey BT, Dodds WJ, Kahrilas PJ, Brasseur JG, Cook IJ, Lang IM (1990) Effect of swallowed bolus variables on oral and pharyngeal phases of swallowing. Am J Physiol 258(5 Pt 1):G675–G681

    CAS  PubMed  Google Scholar 

  5. Leonard RJ, Kendall KA, McKenzie S, Gonçalves MI, Walker A (2000) Structural displacements in normal swallowing: a videofluoroscopic study. Dysphagia 15(3):146–152

    Article  CAS  PubMed  Google Scholar 

  6. Barker JL Jr, Garden AS, Ang KK, O’Daniel JC, Wang H, Court LE, Morrison H, Rosenthal DI, Chao KS, Tucker SL, Mohan R, Dong L (2004) Quantification of volumetric and geometric changes occurring during fractionated radiotherapy for head-and-neck cancer using an integrated CT/linear accelerator system. Int J Radiat Oncol Biol Phys 59:960–970

    Article  PubMed  Google Scholar 

  7. Geets X, Daisne JF, Tomsej M, Duprez T, Lonneux M, Grégoire V (2006) Impact of the type of imaging modality on target volumes delineation and dose distribution in pharyngo-laryngeal squamous cell carcinoma: comparison between pre- and per-treatment studies. Radiother Oncol 78:291–297

    Article  PubMed  Google Scholar 

  8. Geets X, Tomsej M, Lee JA, Duprez T, Coche E, Cosnard G, Lonneux M, Grégoire V (2007) Adaptive biological image guided IMRT with anatomic and functional imaging in pharyngo-laryngeal tumors: impact on target volume delineation and dose distribution using helical tomotherapy. Radiother Oncol 85:105–115

    Article  PubMed  Google Scholar 

  9. Grégoire Vincent, Jeraj Robert, Lee JA, O’Sullivan B (2012) Radiotherapy for head and neck tumours in 2012 and beyond: conformal, tailored, and adaptive? Lancet Oncol 13:e292–e300

    Article  PubMed  Google Scholar 

  10. Han C, Chen YJ, Liu A, Schultheiss TE, Wong JY (2008) Actual dose variation of parotid glands and spinal cord for nasopharyngeal cancer patients during radiotherapy. Int J Radiat Oncol Biol Phys 70(4):1256–1262. doi:10.1016/j.ijrobp.2007.10.067 Epub 2008 Jan 30

    Article  PubMed  Google Scholar 

  11. Vásquez Osorio EM, Hoogeman MS, Al-Mamgani A, Teguh DN, Levendag PC, Heijmen BJ (2008) Local anatomic changes in parotid and submandibular glands during radiotherapy for oropharynx cancer and correlation with dose, studied in detail with nonrigid registration. Int J Radiat Oncol Biol Phys 70(3):875–882. doi:10.1016/j.ijrobp.2007.10.063

    Article  PubMed  Google Scholar 

  12. Robar JL, Day A, Clancey J, Kelly R, Yewondwossen M, Hollenhorst H, Rajaraman M, Wilke D (2007) Spatial and dosimetric variability of organs at risk in head-and-neck intensity-modulated radiotherapy. Int J Radiat Oncol Biol Phys 68(4):1121–1130 Epub 2007 Mar 29

    Article  PubMed  Google Scholar 

  13. O’Daniel JC, Garden AS, Schwartz DL, Wang H, Ang KK, Ahamad A, Rosenthal DI, Morrison WH, Asper JA, Zhang L, Tung SM, Mohan R, Dong L (2007) Parotid gland dose in intensity-modulated radiotherapy for head and neck cancer: is what you plan what you get? Int J Radiat Oncol Biol Phys 69(4):1290–1296

    Article  PubMed  PubMed Central  Google Scholar 

  14. Lee C, Langen KM, Lu W, Haimerl J, Schnarr E, Ruchala KJ, Olivera GH, Meeks SL, Kupelian PA, Shellenberger TD, Mañon RR (2008) Assessment of parotid gland dose changes during head and neck cancer radiotherapy using daily megavoltage computed tomography and deformable image registration. Int J Radiat Oncol Biol Phys 71(5):1563–1571. doi:10.1016/j.ijrobp.2008.04.013 Epub 2008 Jun 4

    Article  PubMed  Google Scholar 

  15. Hansen EK, Bucci MK, Quivey JM, Weinberg V, Xia P (2006) Repeat CT imaging and replanning during the course of IMRT for head-and-neck cancer. Int J Radiat Oncol Biol Phys 64(2):355–362 Epub 2005 Oct 26

    Article  PubMed  Google Scholar 

  16. Zhao L, Wan Q, Zhou Y, Deng X, Xie C, Wu S (2011) The role of replanning in fractionated intensity modulated radiotherapy for nasopharyngeal carcinoma. Radiother Oncol 98:23–27

    Article  PubMed  Google Scholar 

  17. Schwartz DL, Garden AS, Shah SJ, Chronowski G, Sejpal S, Rosenthal DI et al (2013) Adaptive radiotherapy for head and neck cancer: dosimetric results from a prospective clinical trial. Radiother Oncol 106:80–84

    Article  PubMed  Google Scholar 

  18. Castadot P, Lee JA, Geets X, Grégoire V (2010) Adaptive radiotherapy of head and neck cancer. Semin Radiat Oncol 20(2):84–93. doi:10.1016/j.semradonc.2009.11.002

    Article  PubMed  Google Scholar 

  19. Purdy JA (2004) Current ICRU definitions of volumes: limitations and future directions. Semin Radiat Oncol 14(1):27–40

    Article  PubMed  Google Scholar 

  20. Hong TS, Tomé WA, Chappell RJ, Chinnaiyan P, Mehta MP, Harari PM (2005) The impact of daily setup variations on head-and-neck intensity-modulated radiation therapy. Int J Radiat Oncol Biol Phys 61(3):779–788

    Article  PubMed  Google Scholar 

  21. van Kranen S, van Beek S, Mencarelli A, Rasch C, van Herk M, Sonke JJ (2010) Correction strategies to manage deformations in head-and-neck radiotherapy. Radiother Oncol 94(2):199–205. doi:10.1016/j.radonc.2009.12.016 Epub 2010 Jan 18

    Article  PubMed  Google Scholar 

  22. van Kranen S, van Beek S, Rasch C, van Herk M, Sonke JJ (2009) Setup uncertainties of anatomical sub-regions in head-and-neck cancer patients after offline CBCT guidance. Int J Radiat Oncol Biol Phys 73:1566–1573

    Article  PubMed  Google Scholar 

  23. Zhang L, Garden AS, Lo J, Ang KK, Ahamad A, Morrison WH, Rosenthal DI, Chambers MS, Zhu XR, Mohan R, Dong L (2006) Multiple regions-of-interest analysis of setup uncertainties for head-and-neck cancer radiotherapy. Int J Radiat Oncol Biol Phys 64:1559–1569

    Article  PubMed  Google Scholar 

  24. Schwartz DL, Dong L (2011) Adaptive radiation therapy for head and neck cancer: can an old goal evolve into a new standard? J Oncol. doi:10.1155/2011/690595

    PubMed Central  Google Scholar 

  25. Veiga C, McClelland J, Moinuddin S, Lourenço A, Ricketts K, Annkah J, Modat M, Ourselin S, D’Souza D, Royle G (2014) Toward adaptive radiotherapy for head and neck patients: feasibility study on using CT-to-CBCT deformable registration for “dose of the day” calculations. Med Phys 41(3):031703

    Article  PubMed  Google Scholar 

  26. Brown E, Owen R, Harden F, Mengersen K, Oestreich K, Houghton W, Poulsen M, Harris S, Lin C, Porceddu S (2015) Predicting the need for adaptive radiotherapy in head and neck cancer. Radiother Oncol. doi:10.1016/j.radonc.2015.06.025

    Google Scholar 

  27. Ahn PH, Chen CC, Ahn AI, Hong L, Scripes PG, Shen J, Lee CC, Miller E, Kalnicki S, Garg MK (2011) Adaptive planning in intensity-modulated radiation therapy for head and neck cancers: single institution experience and clinical implications. Int J Radiat Oncol Biol Phys 80:677–685

    Article  PubMed  Google Scholar 

  28. Beltran M, Ramos M, Rovira JJ, Perez-Hoyos S, Sancho M, Puertas E (2012) Dose variations in tumor volumes and organs at risk during IMRT for head-and-neck cancer. J Appl Clin Med Phys. 13(6):3723. doi:10.1120/jacmp.v13i6.3723

    PubMed  Google Scholar 

  29. Capelle L, Mackenzie M, Field C, Parliament M, Ghosh S, Scrimger R (2012) Adaptive radiotherapy using helical tomotherapy for head and neck cancer in definitive and postoperative settings: initial results. Clin Oncol 24:208–215

    Article  CAS  Google Scholar 

  30. Chen AM, Daly ME, Cui J, Mathai M, Benedict S, Purdy JA (2014) Clinical outcomes among head and neck cancer patients treated with intensity-modulated radiotherapy with and without adaptive re-planning. Head Neck 36:1541–1546

    Article  PubMed  Google Scholar 

  31. van Kranen S, Mencarelli A, van Beek S, Rasch C, van Herk M, Sonke JJ (2013) Adaptive radiotherapy with an average anatomy model: evaluation and quantification of residual deformations in head and neck cancer patients. Radiother Oncol 109(3):463–468

    Article  PubMed  Google Scholar 

  32. Kupelian P, Sonke JJ (2014) Magnetic resonance-guided adaptive radiotherapy: a solution to the future. Semin Radiat Oncol 24:227–232

    Article  PubMed  Google Scholar 

  33. de Boer HC, de Koste JRVS, Creutzberg CL, Visser AG, Levendag PC, Heijmen BJ (2001) Electronic portal image assisted reduction of systematic set-up errors in head and neck irradiation. Radiother Oncol 61(3):299–308

    Article  PubMed  Google Scholar 

  34. van Lin EN, van der Vight L, Huizenga H, Kaanders JH, Visser AG (2003) Set-up improvement in head and neck radiotherapy using a 3D off-line EPID-based correction protocol and a customised head and neck support. Radiother Oncol 68(2):137–148

    Article  PubMed  Google Scholar 

  35. Wang J, Bai S, Chen N, Xu F, Jiang X, Li Y, Xu Q, Shen Y, Zhang H, Gong Y, Zhong R, Jiang Q (2009) The clinical feasibility and effect of online cone beam computer tomography-guided intensity-modulated radiotherapy for nasopharyngeal cancer. Radiother Oncol 90(2):221–227. doi:10.1016/j.radonc.2008.08.017 Epub 2008 Oct 17

    Article  PubMed  Google Scholar 

  36. Mohan R, Zhang X, Wang H, Kang Y, Wang X, Liu H, Ang KK, Kuban D, Dong L (2005) Use of deformed intensity distributions for on-line modification of image-guided IMRT to account for interfractional anatomic changes. Int J Radiat Oncol Biol Phys 61(4):1258–1266

    Article  PubMed  Google Scholar 

  37. Schwartz DL, Garden AS, Shah SJ, Chronowski G, Sejpal S, Rosenthal DI, Chen Y, Zhang Y, Zhang L, Wong PF, Garcia JA, Kian Ang K, Dong L (2013) Adaptive radiotherapy for head and neck cancer: dosimetric results from a prospective clinical trial. Radiother Oncol 106(1):80–84. doi:10.1016/j.radonc.2012.10.010 Epub 2013 Jan 29

    Article  PubMed  Google Scholar 

  38. Wu Q, Chi Y, Chen PY, Krauss DJ, Yan D, Martinez A (2009) Adaptive replanning strategies accounting for shrinkage in head and neck IMRT. Int J Radiat Oncol Biol Phys 75:924–932

    Article  PubMed  Google Scholar 

  39. Kuo YC, Wu TH, Chung TS, Huang KW, Chao KS, Su WC, Chiou JF (2006) Effect of regression of enlarged neck lymph nodes on radiation doses received by parotid glands during intensity-modulated radiotherapy for head and neck cancer. Am J Clin Oncol 29(6):600–605

    Article  PubMed  Google Scholar 

  40. Dogan N (2007) Improvements of head and neck IMRT patient plans via repeat CT imaging and re-planning. Int J Radiat Oncol Biol Phys 69:S431

    Article  Google Scholar 

  41. de la Zerda A, Armbruster B, Xing L (2007) Formulating adaptive radiation therapy (ART) treatment planning into a closed-loop control framework. Phys Med Biol 52(14):4137–4153 Epub 2007 Jun 14

    Article  PubMed  Google Scholar 

  42. Xing L, Siebers J, Keall P (2007) Computational challenges for image-guided radiation therapy: framework and current research. Semin Radiat Oncol 17(4):245–257

    Article  PubMed  Google Scholar 

  43. Brock KK, Kaus MR (2007) Deformable image registration for radiation therapy planning: algorithms and applications. In: Leondes CT (ed) Biomechanical systems technology—volume 1: computational methods. World Scientifi c, Singapore, pp 1–28

    Google Scholar 

  44. Castadot P, Lee JA, Parraga A, Geets X, Macq B, Gregoire V (2008) Comparison of 12 deformable registration strategies in adaptive radiation therapy for the treatment of head and neck tumors. Radiother Oncol 89:1–12

    Article  PubMed  Google Scholar 

  45. Simone CB, Ly D, Dan TD, Ondos J, Ning H, Belard A, O’Connell J, Miller RW, Simone NL (2011) Comparison of intensity-modulated radiotherapy, adaptive radiotherapy, proton radiotherapy, and adaptive proton radiotherapy for treatment of locally advanced head and neck cancer. Radiother Oncol 101:376–382

    Article  PubMed  PubMed Central  Google Scholar 

  46. Tsuji SY, Hwang A, Weinberg V, Yom SS, Quivey JM, Xia P (2010) Dosimetric evaluation of automatic segmentation for adaptive IMRT for head-and-neck cancer. Int J Radiat Oncol Biol Phys 77(3):707–714

    Article  PubMed  Google Scholar 

  47. QuonH RichmonJD (2012) Treatment deintensification strategies for HPV associated head and neck carcinomas. Otolaryngol Clin North Am 45(4):845–861. doi:10.1016/j.otc.2012.04.007

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shrikant Balasaheb Mali.

Ethics declarations

Conflict of interest

None.

Human and Animal Rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mali, S.B. Adaptive Radiotherapy for Head Neck Cancer. J. Maxillofac. Oral Surg. 15, 549–554 (2016). https://doi.org/10.1007/s12663-016-0881-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12663-016-0881-y

Keywords

Navigation