Abstract
Radiation therapy (RT) remains the mainstay of treatment for NPC patients without evidence of metastases. The goal of radiation therapy is to cure patients while preserving normal tissue function. Results from randomized clinical trials support the intensification of therapy with chemotherapy in combination with RT for locally advanced disease presentations. Parallel to the changing landscape of combined modality therapy in the management of NPC, there has been a rapidly changing landscape of technical RT planning, treatment delivery and treatment verification. Intensity-modulated radiation therapy (IMRT) in combination with image-guided radiation therapy (IGRT) strategies offer the potential for increasing accuracy of RT and limiting radiation dose to normal tissues, thereby, increasing the probability of cure and optimal quality of life. This chapter will review the principles of radiation planning as they apply to advanced radiation therapeutic strategies, the fundamentals of IMRT and IGRT and the emerging body of data demonstrating excellent results from IMRT. As well, the potential of IGRT in the management of NPC will be discussed. With the expectations of excellent loco-regional control, future efforts must be directed toward limiting RT-relatedtoxicity. Despite excellent loco-regional control, some patients will still succumb to distant metastases. Evolving systemic strategies are being undertaken to reduce the probability of developing metastases. Combined modality therapy may cause more side effects. These efforts highlight the importance of reducing RT side effects. While RT can be used to re-treat patients with recurrent disease and palliate symptoms in incurable patients, this chapter will focus on the initial curative management of NPC.
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Keywords
- Planning Target Volume
- Radiat Oncol Biol Phys
- Nasopharyngeal Carcinoma
- Intensity Modulate Radiation Therapy
- Clinical Target Volume
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Kim, J. (2013). Radiotherapy of NPC: Current Strategies and Perspectives. In: Busson, P. (eds) Nasopharyngeal Carcinoma. Advances in Experimental Medicine and Biology, vol 778. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-5947-7_9
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