Conservation of salivary function and new external head and neck radiation techniques

Abstract

New radiation therapy techniques seek to adapt dose distribution to three-dimensional tumor geometry, so as to deliver the lowest possible dose to normal tissue and at-risk organs. This is expected to enhance locoregional control and survival and to reduce complications and thereby improve quality of life. Post-radiation xerostomia significantly deteriorates quality of life. New external radiation techniques (such as intensity-modulated conformal radiation therapy, RapidArc VMAT arc therapy, tomotherapy, CyberKnife(®), protontherapy, use of carbon ions) applicable in ENT are reviewed. Preliminary data show interesting results in terms of salivary function with highly conformal techniques. In France, assessment is ongoing, financed under the Health Ministry's "Support for Expensive Innovatory Techniques" scheme (STIC [Soutien aux techniques innovantes coûteuses]), as routine use is growing rapidly.