Adaptive Radiation Therapy for Head and Neck Cancer

In this chapter, we review characteristics of patients’ anatomy changes for head and neck cancers, and evaluate different adaptive radiotherapy scenarios. With intensity-modulated radiation therapy (IMRT; Purdy 2001; Wu et al. 2000), it is possible to treat very complicated target volumes at variable dose levels while sparing adjacent normal structures. This form of advanced radiation therapy technique has long been realized as an outstanding method for treating head and neck (HandN) cancer. It has been shown that IMRT is the most commonly used modality for HandN radiotherapy (RT; Mell, Roeske, and Mundt 2003). Implementation of IMRT requires adequate selection and delineation of target volumes based on different imaging modalities, appropriate specification and dose prescription regarding dose-volume constraints, and proper knowledge of setup uncertainties.