Head and neck tumors: Viewpoint—fractionated radiation therapy and chemotherapy

Abstract

Head and neck cancers are common malignancies that present considerable treatment challenges in terms of disease control and patient morbidity. Over several decades, the management of head and neck malignancies has moved from single modality to multimodality treatment, with an emphasis on disease control and organ preservation. The combination of chemotherapy and radiotherapy forms the cornerstone of current treatment paradigms for locally advanced head and neck cancers. Advances in altered fractionation and delivery techniques, effective chemotherapy combinations, novel biologic treatments, and risk stratification have led to improved disease control, decreased treatment-related morbidity, and improved patient quality of life. The role of stereotactic radiotherapy in head and neck cancers has made considerable advances in the past decade. These advances stem from progress in tumor identification and delineation, image guidance, patient immobilization, and treatment planning and delivery. Stereotactic radiosurgery and stereotactic body radiotherapy are becoming more widely used in the setting of reirradiation for head and neck malignancies. Ongoing research aims to improve the safety and efficacy of stereotactic radiotherapy for head and neck cancers.​