Intensity modulated radiotherapy for head-and-neck cancer: discussing safety of modern radiation techniques

Worldwide, head-and-neck cancer (HNC) accounts for more than 550,000 cases and 380,000 deaths annually. It is thereby the seventh most common cancer worldwide and also the seventh most common cause of death from cancer (1). Radiotherapy plays an important role in its treatment modalities. It can be recommended as definitive treatment with or without chemotherapy, adjuvant after surgery or in the treatment of local failure after surgery. Radiotherapy allows organ preservation and improved function preservation compared to surgery and can therefore be an elegant solution. The intensification of radiotherapy regimens and addition of concomitant chemotherapy has led to a decrease in local recurrences (LRs) and an improvement in overall survival, at the cost of increased toxicity (2,3). Despite these advances, however, loco-regional failure (LRF) remains an issue with up to 30% to 50% of patients relapsing loco-regionally within 5 years (4-6)