Radiotherapy for head and neck cancer: latest developments and future perspectives.
OBJECTIVE
Despite recent advances in multimodality management the prognosis of patients with stage III-IV squamous cell head and neck cancer remains disappointing. The objective of this review is to identify how, within the main axes of the current translational and clinical research and in an attempt to improve treatment outcome, a number of institutions and cooperative groups have embarked on systematic investigations of novel strategies for radiotherapy delivery and for combining radiation with systemic treatments.


RESULTS
Four domains of translational and clinical researches can be identified in head and neck radio-oncology: altered fractionation, concurrent delivery of chemotherapy and radiotherapy, combination of targeted therapies with radiation, and high-conformality radiotherapy.


CONCLUSIONS
Here we provide a critical appraisal of recent strategies allowing an increase in dose intensity for treatments based on radiotherapy and drug-radiation interactions, and revisit the potential opportunities they offer as well as the possible caveats they may present in patients with locally advanced head and neck cancers.
Bernier
Jacques
J
Department of Radio-Oncology, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland. Jacques.bernier@hcuge.ch
Bentzen
Soeren M
SM
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000532:radiotherapy*; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D019583:Dose Fractionation, Radiation; D016503:Drug Delivery Systems / Q000379:methods; D005544:Forecasting; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D006801:Humans; D011878:Radiotherapy / Q000379:methods / Q000639:trends; D011880:Radiotherapy Planning, Computer-Assisted; D050397:Radiotherapy, Intensity-Modulated