Abstract
Over the last decade, major progress has been made in radiation therapy of head and neck squamous cell carcinoma (HNSCC). The most important developments include the use of altered fractionation schedules [ [1] Bourhis J. Overgaard J. Audry H. et al. Meta-Analysis of Radiotherapy in Carcinomas of Head and neck (MARCH) Collaborative Group. Hyperfractionated or accelerated radiotherapy in head and neck cancer: a meta-analysis. Lancet. 2006; 368: 843-854 Abstract Full Text Full Text PDF PubMed Scopus (833) Google Scholar ] and technological improvements that have led to the use of more advanced radiation delivery techniques, such as CT-based 3-dimensional conformal radiotherapy (3D-CRT) and intensity modulated radiotherapy (IMRT), and possibly protons, aiming at better tumour dose coverage and/or reduction of radiation-induced side effects [ 2 Paelinck L. Smedt B.D. Reynaert N. et al. Comparison of dose-volume histograms of IMRT treatment plans for ethmoid sinus cancer computed by advanced treatment planning systems including Monte Carlo. Radiother Oncol. 2006; 81: 250-256 Abstract Full Text Full Text PDF Scopus (20) Google Scholar , 3 Krayenbuehl J. Davis J.B. Ciernik I.F. Dynamic intensity-modulated non-coplanar arc radiotherapy (INCA) for head and neck cancer. Radiother Oncol. 2006; 81: 151-157 Abstract Full Text Full Text PDF PubMed Scopus (30) Google Scholar , 4 Steneker M. Lomax A. Schneider U. Intensity modulated photon and proton therapy for the treatment of head and neck tumors. Radiother Oncol. 2006; 80: 263-267 Abstract Full Text Full Text PDF PubMed Scopus (127) Google Scholar , 5 Saibishkumar E.P. Jha N. Sparing submandibular gland by IMRT. Radiother Oncol. 2006; 80: 106 Abstract Full Text Full Text PDF Scopus (3) Google Scholar ]. Other important developments include the addition of concomitant chemotherapy [ [6] Pignon J.P. Bourhis J. Domenge C. Designe L. Chemotherapy added to locoregional treatment for head and neck squamous-cell carcinoma: three meta-analyses of updated individual data. MACH-NC Collaborative Group. Meta-Analysis of Chemotherapy on Head and Neck Cancer. Lancet. 2000; 355: 949-955 Abstract Full Text Full Text PDF PubMed Scopus (2202) Google Scholar ], and more recently, the addition of targeted therapy to radiation [ [7] Bonner J.A. Harari P.M. Giralt J. et al. Radiotherapy plus cetuximab for squamous-cell carcinoma of the head and neck. N Engl J Med. 2006; 354: 567-578 Crossref PubMed Scopus (4120) Google Scholar ], that resulted in a significant improvement of loco-regional tumour control and overall survival.
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