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Comparative Effectiveness and Safety of Radiotherapy Treatments for Head and Neck Cancer

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Gaps in Knowledge: Radiotherapy Treatments for Head and Neck Cancer

The available literature to assess the relative effectiveness of different techniques of radiotherapy in head and neck cancer on the whole consisted of poor-quality studies and, with the exception of late xerostomia and quality of life, a low or insufficient level of evidence. The challenges of conducting research in head and neck cancer need to be acknowledged. Head and neck cancer is not common, so the pace of patient accrual may be slow; this may be accompanied by changes in practices, both for the technology of radiotherapy itself and other aspects of management and treatment. Also, patients with head and neck cancer are likely to be clinically diverse in terms of tumor site, histology, stage, prior and cointerventions, and other factors. On the other hand, the length of followup needed to study head and neck cancer treatments is relatively short when compared to some common types of cancer, such as breast or colon cancer. A further challenge to evaluating radiotherapy techniques for head and neck cancer concerns the rapid pace at which these technologies are evolving.