Radiotherapy for head and neck cancer

Although radiation therapy plays a significant role in the treatment of head and neck malignancy, the clinical outcome of this single modality remains insufficient. Radiation therapy has the advantage of organ and functional preservation compared with surgery, but is at a disadvantage in curing locally advanced lesions. In this decade, several factors such as combinations of anti-cancer drugs, technological developments in radiation techniques, and the clinical application of particle therapy, have markedly improved the clinical results of radiation therapy. Chemoradiotherapy is thought to be promising because of its enhancement of the radiation effect in advanced lesions, and meta-analysis has indicated its usefulness. When the method of combining the anti-cancer agent and radiation is used, both concurrent and alternating settings should be recommended. These two methods can provide significant improvement of both local control and survival; however, this improvement is accompanied with increasingly significant acute toxicity. New agents including molecular target agents are under now active investigation to refine treatment outcome. Recent technological revolutions have led to the clinical utilization of intensity modulated radiation therapy (IMRT), which makes it possible to escalate radiation dose while reducing radiation exposure to normal tissue. With the aid of IMRT, more refined radiation results will be achieved in the future. (author). 121 rets