Intensity-modulated radiation therapy (IMRT) is one of the most reported techniques for head and neck cancer treatment, as it allows a good coverage of the planning target volume (PTV) while sparing the surrounding organs at risk (OAR) better than conventional conformal radiotherapy. The objective of this work is to optimise an IMRT technique for the simultaneously integrated boost (SIB) treatment of larynx cancer delivering a total dose of 69·96 Gy to the boost volume and 54·45 Gy to the elective volume in 33 fractions.

Three IMRT techniques, each using seven equally spaced beams, were planned for a sample of 10 patients. The first two techniques (IMRT-0 and IMRT-26) differ only for the starting angle of the seven beams, whereas the third (IMRT-CT) combines both these techniques by delivering IMRT-0 in the first half of treatment, and IMRT-26 in the second half, thus taking advantage of using 14 beams in total while using seven at a time only. The planning results were compared according to the dose coverage, homogeneity and conformity of the two PTVs, as well as to the dose to OARs, that is, spinal cord, parotids, mandible, brainstem and healthy tissue (defined as the body volume minus the sum of PTVs).

Basically the PTV coverage resulted acceptable and comparable with all the three techniques. Concerning OARs, statistically better results are obtained in IMRT-CT when compared with IMRT-26 and IMRT-0.

The IMRT-CT technique, combining two different seven-beam setups, delivered in two treatment phases, improves dose distribution without increasing delivery time.

Nasopharyngeal carcinoma with local extension to the external auditory meatus is rarely reported.

We present two cases of nasopharyngeal carcinoma with invasion to the external auditory meatus. First case at initial presentation; and the second at disease recurrence. Both patients presented with unilateral otologic symptoms corresponding to the affected site; as well as being heavily node positive. Otoscopic examination and 18F-fluorodeoxyglucose positron-emission topography demonstrated the involvement of external auditory meatus.

These two cases highlight the need of careful otoscopic examination and functional imaging to diagnose such cases.

18Fluorodeoxyglucose-positron emission tomography (FDG-PET) can indicate the presence or absence of non-small-cell lung cancer (NSCLC) after treatment. We present a description of the FDG-PET results following the contemporary management of locally advanced NSCLC including long-term outcomes.

The study participants were eight long-term survivors with metabolic tumour response (MTR) shown on FDG-PET following chemoradiotherapy for locally advanced stage NSCLC between June 2005 and April 2009.

After therapy, MTR was complete in five patients; four subjects were free of cancer, and one patient experienced progression of disease at the time of last follow-up. Of the three individuals with incomplete MTRs, distant metastases developed in two patients, and one subject remained disease-free. Long-term survival ranged from 37 to 75 months.

Although the number of cases is small, our observations confirm the diagnostic role of FDG-PET as well as its value for predicting prognosis in the clinical practice of oncology.