Altered-fractionated radiotherapy in locally advanced head and neck cancer

作者：Bernier Jacques^*; Horiot Jean Claude

来源：Current Opinion in Oncology, 2012, 24(3): 223-228.

DOI：10.1097/CCO.0b013e32834ea6fe

• chemo-radiotherapy
• fractionation
• head and neck
• intensity-modulated radiation therapy
• locally advanced

Purpose of review
To revisit the biologic rationale, the clinical methodology, the outcome and perspectives of altered fractionation in head and neck oncology.
Recent findings
Various prospective trials and meta-analyses clearly underline the major benefit patients with locally advanced disease draw from hyperfractionation and the need for an adequate selection of time-dose Factors to optimize therapeutic index for accelerated regimens. In addition, the advent of high-precision techniques such as intensity-modulated radiation therapy is bound to favor the development of more intensive regimens of irradiation in the management of locally advanced head and neck squamous cell carcinomas.
Summary
Altered fractionation, both as stand-alone strategy or as part of approaches combining radiation to systemic treatments, is offering a lot of opportunities to the radiation oncologist. Its role is likely to gain ground in all high-risk patients not amenable to systemic treatments, or for whom the high toxicity of chemotherapy is not justified, in case, for instance, of intermediate-risk disease.

• 出版日期2012-5