In contrast to conventional radiotherapy, intensity modulated radiotherapy (IMRT) enables individually adjusted dose and intensity depending on tumor size and organs at risk, thus enabling radiotherapy of complex volumes in the head and neck area using high doses. Despite new data presented at the annual congress of the American Society of Clinical Oncology (ASCO), questions remain unanswered in two basic categories: (a) How do we use IMRT with other important advances in head and neck cancer treatment, such as altered fractionation, chemotherapy, and novel agents? (b) Does IMRT in its current form produce sufficient risk:benefit improvements in salivary gland sparing/less xerostomia, better targeting/local control and less late toxicity? Whether IMRT with its complex target volume definition and dose distribution leads to improved local control needs to be further investigated in relevant studies.
