IMRT

Radiotherapy of head and neck cancer is commonly accompanied by marked side-effects. Modern techniques have shown to significantly reduce long-term sequelae of the treatment [11-13] and have rapidly been integrated into routine clinical practice. Techniques such as intensity-modulated radiotherapy (IMRT) and image-guided radiotherapy (IGRT) facilitate application of higher doses due to stepp gradients and hence higher conformality and improved sparing of normal tissues. Despite relative dose escalation, acute and late toxicity can be reduced. A recent phase III trial comparing IMRT versus conventional RT could clearly demonstrate a significant advantage of IMRT in reducing the rate of xerostomia [14]. In order to reduce toxicity and therefore improve radiotherapy regimens, integration of modern radiotherapy techniques into potential new trial designs is of fundamental importance.