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Lancet Oncol. 2017 May;18(5):e266-e273. doi: 10.1016/S1470-2045(17)30252-8. Epub 2017 Apr 26.

The future of personalised radiotherapy for head and neck cancer.

Author information

1
Department of Radiation Oncology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
2
Department of Cancer Imaging and Metabolism, Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
3
Department of Integrated Mathematical Oncology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
4
Department of Radiation Oncology, Moffitt Cancer Center and Research Institute, Tampa, FL, USA. Electronic address: louis.harrison@moffitt.org.

Abstract

Radiotherapy has long been the mainstay of treatment for patients with head and neck cancer and has traditionally involved a stage-dependent strategy whereby all patients with the same TNM stage receive the same therapy. We believe there is a substantial opportunity to improve radiotherapy delivery beyond just technological and anatomical precision. In this Series paper, we explore several new ideas that could improve understanding of the phenotypic and genotypic differences that exist between patients and their tumours. We discuss how exploiting these differences and taking advantage of precision medicine tools-such as genomics, radiomics, and mathematical modelling-could open new doors to personalised radiotherapy adaptation and treatment. We propose a new treatment shift that moves away from an era of empirical dosing and fractionation to an era focused on the development of evidence to guide personalisation and biological adaptation of radiotherapy. We believe these approaches offer the potential to improve outcomes and reduce toxicity.

PMID:
28456586
DOI:
10.1016/S1470-2045(17)30252-8
[Indexed for MEDLINE]

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