ABSTRACT
The treatment of head and neck cancer (HNC) is a complex topic due to the large palette of available modalities revolving around radiotherapy. The selection of the treatment, therefore, depends on the type, stage, and location of the tumour; the clinical condition of the patient at the time of diagnosis; and the possible side effects. In addition, the definition of the target for head and neck radiotherapy is also a complex step in the management of this disease. The available radiotherapy techniques are external beam radiotherapy (EBRT) with photons, protons, and heavier ions and brachytherapy delivered with low or high dose rate (HDR) and also in a pulsed manner. Radiotherapy is very rarely delivered as stand-alone therapy in the management of HNC and; therefore, combined treatment involving chemo- and radiation therapy is one of the most common choices. The evolution of chemoradiotherapy shows that cisplatin-based chemotherapy remains the most potent treatment when combined with radiation, despite the dose-limiting toxicities exhibited by the drug. Recent progress in imaging techniques allows the monitoring of the response to the treatment and the subsequent adaptation in case of lack of response based on functional magnetic resonance imaging (MRI) and positron emission tomography (PET). Close follow-up of the evolution post-treatment is also needed.
