An Updated Review on Head and Neck Cancer Treatment with Radiation Therapy

Abstract

The complexity of head and neck cancers (HNC) mandates a multidisciplinary approach and radiation therapy (RT) plays a critical role in the optimal management of patients with HNC, either as frontline or adjuvant treatment postoperatively. The advent of both definitive and post-operative RT has significantly improved the outcomes of patients with HNC. Herein, we discuss the role of postoperative RT in different subtypes of HNC, its side effects, and the importance of surveillance. The treatment regions discussed in this paper are the oral cavity, nasopharynx, paranasal sinus cavity, oropharynx, larynx and hypopharynx. Multiple studies that demonstrate the importance of definitive and/or postoperative RT, which led to an improved outlook of survival for HNC patients will be discussed.

Keywords: adjuvant radiation therapy; head and neck cancer; hypopharynx; larynx; oral cavity cancer; oropharynx; postoperative radiation therapy; squamous cell carcinoma.

Figure 1

Illustration of the head and neck. The oral cavity includes the mucosal surface of the lips, the anterior two-thirds of the tongue, buccal mucosa, retromolar trigone and the hard palate. The oropharynx just posterior to the oral cavity includes the soft palate, the palatine tonsils, and base of the tongue. The nasopharynx located superiorly is bordered by the nasal cavity, clivus, soft palate, and sphenoid. The larynx includes the supraglottis, glottis, and subglottis. The hypopharynx just posterior to the larynx includes the following subsites: piriform sinus, postcricoid space, and posterior pharyngeal wall. Additional sites of the head and neck including the nasal cavity and paranasal sinuses (not imaged). Copyright 2005-2011 American Society of Clinical Oncology. Robert Morreale/Visual Explanations, LLC.