Navigate Up

UPMC/University of Pittsburgh Schools of the Health Sciences
Patients and medical professionals may call 1-800-533-UPMC (8762) for more information.

Dwight E. Heron, M.D.

Dwight E. Heron, M.D.

Researchers Define Ideal Doses Of Intensity Modulated Radiation Therapy To Reduce Side Effects From Treatment For Head And Neck Cancer​

DENVER, October 18, 2005 — Results from a University of Pittsburgh study evaluating intensity modulated radiation therapy (IMRT) for head and neck cancer determined the ideal doses for lessening treatment side effects. The findings were presented today at the 47th Annual Meeting of the American Society for Therapeutic Radiology and Oncology (ASTRO) in Denver.

“Despite major advances in chemotherapy and radiation for the treatment of head and neck cancers, many patients continue to suffer debilitating side effects that greatly impact their quality of life,” said Dwight E. Heron, M.D., study co-author and associate professor of radiation oncology, University of Pittsburgh School of Medicine and director of radiation oncology, University of Pittsburgh Medical Center.

“While these high-energy beams are targeted to the tumor site as precisely as possible, they often inadvertently injure healthy tissue that surrounds the tumor site, limiting the doses of radiation that can be used to effectively destroy cancer cells. With this study, we sought to discover whether tightly focused radiation beams, such as those provided by IMRT, would make a difference in the severity of side effects associated with treatment and found a distinct dose-response relationship in the oral cavity of patients treated with IMRT in addition to chemotherapy.”

In the study, 70 patients with head and neck cancer were treated with IMRT using the Eclipse Planning System, Varian Medical Systems and chemotherapy. Patients were treated from April 2002 through September 2004 and were evaluated for grade level of oral mucositis, or inflammation, based on the volume of IMRT dose administered. Oral mucositis not only causes pain, but also can affect speech, the ability to eat or drink and to take oral medication. Patients with severe cases may require tube feeding.

Results indicated that the severity of side effects, or the grade of oral mucositis, was directly correlated with the volume of the radiation dose administered to the oral cavity, and the researchers defined an ideal dose volume of IMRT at which the incidence of acute oral mucositis was lessened.

“We found that if we constrain the dose of IMRT, we reduce the toxic effects of treatment,” said Dr. Heron. “These results are encouraging evidence that head and neck cancer patients can benefit from IMRT at specific doses. With more homogenous and conformal treatment, head and neck cancer patients may be spared side effects from standard radiotherapy that can be significant.”

During radiation therapy, high-energy beams are aimed at cancer cells to destroy them by permanently damaging their underlying genetic material. Unlike standard radiation therapy, IMRT administers a radiation field that consists of several hundred small beams of varying intensities that pass through normal tissue without doing significant damage, but converge to give a precise dose of radiation at the tumor site. IMRT can potentially limit the adverse side effects from radiation while increasing the intensity of doses that can be given to effectively destroy cancer cells.

IMRT is combined with a process called inverse treatment planning to determine the best way to treat a patient. It relies on CT (computed tomography) data from patients that is processed and analyzed by a complex computer system to produce the ideal radiation dose distribution for that patient.

Co-authors of the study include Jeffrey Shogan, M.D.; Ajay Bhatnagar, M.D.; Ryan Smith, M.D.; Regiane Andrade, M.D.; Gregory Ross, M.B.A.; and Chyongchiou J. Lin, Ph.D., all with the department of radiation oncology at the University of Pittsburgh School of Medicine; and Mark Sontag, Ph.D., and Ron Lalonde, Ph.D., with D3 Advanced Radiation Treatment Planning in Pittsburgh.

UPMC | Affiliated with the University of Pittsburgh Schools of the Health Sciences Supplemental content provided by Healthwise, Incorporated. To learn more, visit

For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1.

UPMC is an equal opportunity employer. UPMC policy prohibits discrimination or harassment on the basis of race, color, religion, ancestry, national origin, age, sex, genetics, sexual orientation, gender identity, marital status, familial status, disability, veteran status, or any other legally protected group status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations.

Medical information made available on is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have. Further, is not a tool to be used in the case of an emergency. If an emergency arises, you should seek appropriate emergency medical services.

Pittsburgh, PA, USA |