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Advisor(s)
Abstract(s)
Introdução e Objetivos – Ao longo do tratamento de cancro de cabeça e pescoço (CCP) com radioterapia externa (RTE) é possível ocorrer várias alterações anatómicas. A Adaptive Radiotherapy (ART), consiste numa técnica emergente que contraria as alterações na anatomia do doente e do volume alvo (VA) durante o decurso de tratamentos de RTE através da criação de planos dosimétricos adaptados. Porém, não existem protocolos para a sua implementação. É objetivo estudar o papel/benefício da ART, quais os doentes que podem beneficiar desta técnica e o momento ideal para a sua realização. Método – Revisão da literatura foi baseada na metodologia Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA). Foi realizada uma pesquisa nas bases de dados MEDLINE, Scopus e na B-on, no intervalo de tempo de janeiro de 2016 a janeiro de 2021. Foram identificados 252 artigos. Após exclusão dos duplicados e a adaptação aos critérios de exclusão e inclusão, são incluídos no estudo 10 artigos. Resultados e Discussão – Através da ART, foi possível diminuir a xerostomia na maioria dos estudos. Outros efeitos secundários foram referidos, mas com conclusões mais heterogéneas. Relativamente ao controlo da doença não existiram diferenças significativas. Em geral, o protocolo quimio-radioterapia (QRT) mostrou ser um preditor para a necessidade de ART, tal como tumor primário da nasofaringe e estádio avançado. Conclusão – Apesar de não se observar diferenças no controlo da doença, alguns efeitos secundários diminuíram devido à ART. Não foi possível identificar o momento ideal para ART, devido à heterogeneidade dos resultados.
ABSTRACT - Introduction and Objectives – During the treatment of head and neck cancer (HNC) with external radiotherapy (ERT) it is possible to occur several anatomical changes. Adaptive radiotherapy (ART) is an emerging technique that prevents changes in patient anatomy and target volume (TV) during ERT treatments by designing adapted dosimetric plans. However, there are no protocols for its implementation. This study aims to study the role/benefit of ART, which patients can benefit from this technique and the ideal time for ART. Methods – The literature review was based on the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) methodology. A search was conducted in MEDLINE, Scopus, and the B-on article aggregator website, in the time from January 2016 to January 2021. Two hundred and fifty-two articles were identified. After the exclusion of duplicates and fitting to the exclusion and inclusion criteria, 10 articles are included in the study. Results and Discussion – Through ART, it was possible to decrease xerostomia in most studies. Other side effects were mentioned but with more heterogeneous conclusions. Concerning disease control, there were no significant differences. In general, chemoradiotherapy (QRT) was a predictor of the need for ART, as were primary tumors of the nasopharynx and advanced stage. Conclusion – Although no differences in disease control were observed, some side effects decreased due to ART. It was not possible to identify the ideal time for ART due to the heterogeneity of results.
ABSTRACT - Introduction and Objectives – During the treatment of head and neck cancer (HNC) with external radiotherapy (ERT) it is possible to occur several anatomical changes. Adaptive radiotherapy (ART) is an emerging technique that prevents changes in patient anatomy and target volume (TV) during ERT treatments by designing adapted dosimetric plans. However, there are no protocols for its implementation. This study aims to study the role/benefit of ART, which patients can benefit from this technique and the ideal time for ART. Methods – The literature review was based on the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) methodology. A search was conducted in MEDLINE, Scopus, and the B-on article aggregator website, in the time from January 2016 to January 2021. Two hundred and fifty-two articles were identified. After the exclusion of duplicates and fitting to the exclusion and inclusion criteria, 10 articles are included in the study. Results and Discussion – Through ART, it was possible to decrease xerostomia in most studies. Other side effects were mentioned but with more heterogeneous conclusions. Concerning disease control, there were no significant differences. In general, chemoradiotherapy (QRT) was a predictor of the need for ART, as were primary tumors of the nasopharynx and advanced stage. Conclusion – Although no differences in disease control were observed, some side effects decreased due to ART. It was not possible to identify the ideal time for ART due to the heterogeneity of results.
Description
Keywords
Radioterapia Cancro de cabeça e pescoço Radioterapia adaptativa Preditores para ART Estratégias para ART Radiotherapy Head and neck cancer Adaptive radiotherapy Predictors for ART Strategies for ART
Pedagogical Context
Citation
Caetano M, Feliz C, Cavaquinho R. Radioterapia adaptativa no cancro de cabeça e pescoço: revisão sistemática. Saúde & Tecnologia. 2023;(28):21-7.
Publisher
Instituto Politécnico de Lisboa, Escola Superior de Tecnologia da Saúde de Lisboa