Cancers of the Head & Neck
Early-stage head and neck cancers often are treated by surgery or radiation and have a high cure rate. By mid-stage, doctors may use a combination of surgery and radiation, chemotherapy and radiation, or all three approaches combined as their treatment regimen.
(C) Patient with tongue tumor, side view, within the red outline. It is a CT scan fused with PET scan. Tumor shows up as bright area from PET imaging.
(B) A mask system that hinders head movement during radiation therapy to make the treatments reproducible each day
Diagnosis and Treatment Options
The stage of the cancer is important, and is rated from I to IV. Staging is the determination of tumor extent – how large the tumor is and if it has spread.
Depending on the stage, recommendations regarding treatment can be made. Staging involves a careful physical exam by the physician, and use of imaging studies such as CT scan, MRI, and PET scanning.
Radiation treatment to the head and neck area is given for a variety of malignant conditions. These treatments typically last for a total of 5 to 8 weeks and may be administered once per day or twice per day five days per week. Usually a custom mask is made to stablize the head, so as to avoid movement, so the same area is treated accurately each day (Image B).
We are entering an exciting era in the treatment of head and neck cancer – on many fronts. One of the exciting areas we are now witnessing is the fusion of imaging, radiation and treatment planning technologies. Such fusion allows one to determine the precise location of the tumor for radiation treatment planning.
(E) High Dose Radiation (Blue) wrapped around a gross tumor volume (Red), sparing critical anatomy such as spinal cord show in green
(D) 7 Fields IMRT Plan. Radiation beams come from 7 different directions in this case to carefully sculpt the dose to tumor and spare normal tissue as much as possible
Image C shows how the marriage of detailed imaging with radiation treatment planning has helped to more effectively target tumors with greater accuracy. In this case it is a PET scan fused with a CT scan.
The technology to target the radiation beam to the tumor is now much greater with the advent of IMRT (intensity modulated radiation therapy) (see D and E). The technique results in less “collateral damage” from radiation therapy – and less dose to the normal tissues means less side effects. Moreover with IGRT (image guided radiation therapy) we can now image the tumor before each treatment to ensure accuracy of the treatment even more.
For more information see: CyberKnife Centers of San Diego
