IMRT for head-and-neck tumor

Head-and-Neck is a suitable site for IMRT. Organ motion can be more easily controlled with immobilization devices as compared to other sites such as lung and abdomen. There are various critical organs, for which tolerance doses are different (i.e., 40Gy for the spinal cord, 25-30Gy for the parotid glands, etc. etc.). Recent reports on IMRT are impressive in that salivary function is preserved without compromising tumor control. With rapidly developing technology, this new treatment could be available in many hospitals in the near future. However, we must proceed to do IMRT with caution; the technique requires high-level quality assurance (ideally with experienced medical physicists), which requirement is not necessarily met here in Japan. Thus, deep understanding of both physical and biological aspects of IMRT, and perhaps sound judgment also, will promise good-quality radiotherapy leading to the well-being for suffering patients.