Radiation Therapy for Head and Neck Cancer

Radiation oncologist Nancy Lee

Radiation therapy is a cancer treatment that involves sending high-energy beams of particles through the skin toward the tumor. When the beams reach the tumor, they destroy the cancer cells by damaging their DNA. Radiation therapy is known for its particular effectiveness against head and neck tumors.

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Radiation therapy can be used in one of several ways to treat head and neck cancer. It may be recommended after head and neck surgery to prevent the cancer from coming back. Radiation may also be used as the sole treatment. Some people may receive radiation in combination with chemotherapy or other drug therapies.

Why choose Memorial Sloan Kettering for head and neck cancer radiation therapy?

  • We take a personalized approach to treating head and neck cancer. Our head and neck radiation team understands that one size doesn’t fit all. That’s why we tailor treatment to each individual. Our goal is to maximize the chances of curing the cancer while minimizing the side effects of treatment.
  • MSK’s radiation therapy team has special training in caring for people with head and neck cancer. We work closely with the care teams.
  • MSK is the only center in the world to offer weekly MRI imaging at no cost to people having treatment for head and neck cancer. This mapping allows our radiation oncologists to optimize radiation plans in real time. Our patients may be eligible to participate in promising cutting-edge clinical trials. These studies explore new ways to boost the effectiveness of treatments.

Types of Head and Neck Cancer Radiation

There are many ways to treat head and neck cancer with radiation. The MSK radiation oncologists who care for people with head and neck cancer specialize in the disease. We have extensive knowledge in knowing which approach will provide the most benefit.

MSK’s radiation therapy team has access to every modern form of radiation available. We will customize a treatment plan so precise that it factors in the size and shape of the tumor to the millimeter. Your team’s goal is twofold: to eliminate tumor cells and to prevent the side effects of treatment by keeping the healthy cells around the tumor safe.

Here you will find more in-depth information about the different approaches to head and neck cancer radiation therapy.

Proton Therapy

Proton therapy is a form of radiation that uses proton beams instead of photon beams. Unlike photons, protons do not penetrate beyond the tumor. That’s why proton therapy reduces the likelihood of side effects caused by damage to normal tissue. Because there could be fewer side effects, proton therapy allows us to use a higher radiation dose on the tumor, maximizing the chance of destroying it.

Proton therapy is extremely helpful for many people. At present, it is most commonly used for head and neck cancer that has come back after prior treatment.

Memorial Sloan Kettering is one of a limited number of centers nationwide that offer proton therapy.

Intensity-Modulated Radiation Therapy (IMRT)

Intensity-modulated radiation therapy (IMRT) combines the use of a highly advanced computer program with a metal device called a collimator. These tools allow your care team to shape the radiation beams to the exact dimensions of the treatment area.

Prior to the start of radiation therapy, a team of experts collects detailed information about the treatment area. This group includes radiation oncologists and experienced medical physicists. You will have:

  • a CT scan to map the tumor in 3-D
  • PET, CT, and MRI scans to generate an outline of the tumor

Your team uses this information along with sophisticated treatment-planning software to calculate the best number of radiation beams and the exact angles of those beams. During treatment, the collimator is adjusted to produce the beams at the angles specified by the computer program.

This approach allows us to deliver more-precise doses of radiation to the tumor while reducing the risk that healthy tissue is exposed.

Image-Guided Intensity-Modulated Radiation Therapy (IG-IMRT)

Image-guided intensity-modulated radiation therapy (IG-IMRT) uses imaging tests such CT, MRI, or PET. These are combined with special computer software to optimize the real-time delivery of radiation to the treatment area.

In this approach, daily imaging scans are performed to ensure an accurate position when the dose of radiation is delivered. The imaging scans are processed by special software to map changes in the tumor’s size or location. Your radiation therapy team can use this information to improve the accuracy of the radiation treatments while you are receiving them.

Adaptive Radiotherapy

In conventional radiation therapy, your care team works together to formulate the best approach for your treatment plan. This group includes radiation oncologists, radiation therapists, medical physicists, and treatment planners. Your team then carries out that plan during your course of treatment, which typically lasts six to seven weeks. Adaptive radiotherapy simply means that we repeat the planning process throughout your treatment. Every time we detect certain changes that could affect the precision of the radiation, we review your treatment plan. Changes we look for could be anything from weight loss to the tumor shrinking.

This personalized approach allows us to continually optimize your care while sparing healthy tissue. It is particularly beneficial for people who did not have surgery to remove a tumor.

Stereotactic Body Radiotherapy (SBRT)

Stereotactic body radiotherapy (SBRT) combines IGRT with even more-advanced techniques. It can deliver extremely high doses of radiation to a tumor while minimizing the dose to nearby healthy tissue. It usually involves fewer treatments than other forms of radiation therapy. SBRT can result in better outcomes and fewer side effects than conventional radiation therapy.

Our radiation oncologists are highly skilled in SBRT. We know when such an approach might be right for you. The key consideration is always which technique is best for curing the cancer and giving you a normal life afterward. Although SBRT can be a good option for some people, it’s not right for everyone.

Brachytherapy

Brachytherapy involves the placement of radioactive material in the body. The material is sealed inside a seed, pellet, wire, or capsule using a needle or catheter. The radiation given off by this source damages the DNA of nearby cancer cells. Brachytherapy is most commonly used for head and neck cancer that has come back after prior treatment. Your doctors will discuss with you whether you are a candidate for brachytherapy.

Chemoradiation

Sometimes chemotherapy is recommended as part of a head and neck cancer treatment plan. Chemotherapy can increase the sensitivity of the tumor to radiation treatment. The combination of radiation plus chemotherapy is called chemoradiation.

Cisplatin (Platinol®) is the standard chemotherapy drug that doctors use for head and neck cancer chemoradiation. Your doctor may recommend a different drug therapy that is equally effective based on which side effects are easier for you to tolerate. Our researchers are studying other drugs that may be used in combination with radiation to further reduce the risk of the cancer returning.

Clinical Trials

Clinical trials are research studies that test new treatments to see how well they work. People who choose to participate in a trial at MSK receive the most-advanced cancer treatment available. Sometimes these therapies are available through MSK’s trials years before being offered anywhere else.

Our researchers are experts in studying immunotherapy, targeted therapies, and other approaches to boost the effectiveness of radiation therapy.

View our clinical trials for head and neck cancer.

Side Effects of Radiation Therapy

MSK’s radiation oncologists work hard to minimize the side effects of head and neck cancer treatment. We explain in detail what you can expect and when side effects are likely to occur.

The most common side effects of radiation to the head and neck include:

  • changes in your skin that look like a sunburn
  • hoarseness
  • changes in taste
  • dryness of the mouth
  • weakening of the teeth
  • pain, sores, or redness in the mouth

Our dental oncology team is available to support you with any problems that may arise with your teeth. We may also fit you with a custom mouth guard to protect your teeth during treatment.

Our rehabilitation team has extensive experience in helping people address the side effects of radiation therapy. A speech and swallowing specialist will meet with you before treatment to discuss any possible changes in your speech, voice, or swallowing. During and after treatment, we will provide you with exercises to prevent side effects. We will look out for any problems you are having with swallowing and make sure you are maintaining the range of motion in your tongue, jaw, and neck.