Optimierung der Strahlentherapie von Tumoren im Kopf-Hals-Bereich - biologische und technische Entwicklungen [article]

Thomas Kuhnt, Martin-Luther Universität, Universitäts- Und Landesbibliothek Sachsen-Anhalt
2018
Apart from surgery, radiotherapy (RXT) is the most important modality in the treatment of head and neck tumors and one of the most effective methods to kill tumor cells. Modern radiotherapy techniques permit an improved dose distribution and higher dose conformity in tumors (increased TCP), and therefore allows a better protection of healthy normal tissues in the beam direction (reduced NTCP). The cumulative work describes clinical and experimental results which were acquired within the last
more » ... within the last few years on the improvement of radiation treatment of head and neck tumors. Objective: New methods of radiochemo- and molecular targeted therapies as well as strategies to avoid long-term treatment-related side effects of curative radiotherapy in the head and neck region are shown. Moreover, an introduction of first results of cellular biological experiments of the metabolic and respiratory disturbances of squamous cell carcinoma with relevance for the future treatment of tumors in the head and neck region is presented. Material and methods: All investigations were done exclusively of patients with locally advanced squamous cell carcinoma in the head and neck. Two prospective clinical studies as phase I/II trials were designed, on the one hand a study of intensified radiochemotherapy (RCXT) and on the other hand of radiochemoimmunotherapy (RCXIT). The dose-limiting toxicities (DLT) as well as the maximum tolerable dose (MTD) were determined. In the phase II study the 5-year event-free and overall survival rates were estimated. During and after RT the quantity of saliva was measured. The method of stimulated saliva measurment was used [ml/5 min]. The data were collected in patients who were irradiated with older 2D-RT or newer 3D-RT. The averaged mean dose value of both parotid glands [Dmean-parotis (Gy)] was calculated from the dose-volume histograms (DVHs) of the parotid glands and correlated with the saliva flow rate. At first the NTCP of the parotid glands was calculated with the "Mean dose model" with the [...]
doi:10.25673/2309 fatcat:34sgjf5ng5e73cmzptoaqurptm