Squamous cell cancers of the head-and-neck: recent progress in radiotherapy

Radiotherapy of squamous cell cancer of the head-and-neck remains a challenge with the necessity to deliver high total dose of irradiation with tight proximity of tumour targets and normal tissue like salivary glands or spinal cord. These carcinomas are generally curable when diagnosed at an early stage disease, but many patients' present locally advanced tumours. Despite aggressive local therapy with chemoradiation or/and surgery, the prognosis of these lesions remains relatively poor with overall survivals rates between 30 to 40% at 5 years, and new therapeutic approaches are needed. In this direction, several axes are under investigations with the aim of improving local control and reducing toxicity. Recent progresses concern dose distribution with high precision radiotherapy and radiobiology (combinations with radiosensitizers or protectors, altered fractionation, combination with molecular targeted therapies).