Precision adiotherapy to Treat head and neck cancers

Cancer treatment took a significant step forward in 1896 with the discovery of radiation therapy. This groundbreaking approach harnessed the power of ionizing radiation to combat cancer by destroying cancer cells and restraining their growth. However, there was a downside to this pioneering method: it also affected the healthy tissue surrounding the tumour, resulting in a range of distressing side effects including nausea, difficulty swallowing, dry mouth, fatigue, and hair loss. In response to this challenge, the field of precision radiotherapy emerged, aiming to make radiation treatment more focused and less damaging to healthy tissues, ultimately improving patient outcomes.

In recent years, precision radiotherapy has proven particularly valuable in treating patients with head and neck cancers. These encompass cancers affecting the throat, larynx, nose, sinuses, and mouth. This advanced approach leverages cutting-edge imaging techniques, such as MRIs, CT scans, and PET scans, to tailor the radiation dose to individual patients. Factors like age, tumour location, and its spread are meticulously considered. Precision radiotherapy has several compelling advantages for head and neck cancer patients, notably a reduction in the severity of side effects like dry mouth, hoarseness, changes in taste, weakened teeth, mouth soreness, and redness. Furthermore, it can serve as a standalone treatment or be combined with chemotherapy and surgery for comprehensive care.

Several types of precision radiotherapy have emerged to address the specific needs of head and neck cancer patients:

• Intensity-Modulated Radiation Therapy (IMRT): This technique employs a multi-leaf collimator and advanced computer software to precisely shape radiation beams according to the treatment area's dimensions. IMRT optimization allows patients to maintain vital functions like swallowing, breathing, and eating comfortably. Special attention is given to avoiding radiation deposition in the salivary glands.
• Image-guided Intensity-Modulated Radiation Therapy (IG-IMRT): IG-IMRT enhances precision by integrating in-room imaging using X-ray volume imaging, real CT scans (Helical Tomotherapy), or digital reconstruction (Cyberknife) with specialized software.
• Stereotactic Body Radiotherapy (SBRT): Building on IG-IMRT, SBRT employs advanced techniques to deliver higher radiation doses per fraction with a sharp dose gradient. This approach is increasingly used for recurrent or second primary head-neck cancers.
• Brachytherapy: This method involves placing radioactive material within the body, sealed within a seed, pellet, wire, or capsule using a needle or catheter. It's primarily used for visible head and neck cancers within the mouth or on the lips, or for cancers that have reappeared after previous treatment.
• Proton Therapy: Proton therapy employs proton beams that stop at the tumour site, minimizing collateral damage to healthy tissue. This enables the administration of higher radiation doses to the tumour, increasing the likelihood of effective eradication. However, it can cause more skin reactions compared to IG-IMRT. Proton therapy is primarily used for recurrent head and neck cancers.

Precision radiotherapy tailors treatment to target the tumour site, significantly reducing the risk of side effects and improving treatment outcomes. Patients can recover more swiftly, returning to their normal lives sooner. In India, where head and neck cancer rates are rising, there's an urgent need to educate the public about precision radiotherapy's benefits. In India, head and neck cancers account for 30% of all cancer cases, with a higher percentage of advanced disease at presentation compared to developed countries. Equipping patients with accurate information empowers them to make informed decisions about their treatment. Precision therapy represents a holistic approach to treating head and neck cancers, and as technology and innovation continue to advance, it will only become more efficient and effective in targeting and eliminating cancer cells.