Elderly patients affected by head and neck squamous cell carcinoma unfit for standard curative treatment: Is de-intensified, hypofractionated radiotherapy a feasible strategy?

Head and neck squamous cell carcinoma (HNSCC) represents the sixth most common malignant tumor worldwide, with over 600.000 new cases diagnosed per year [1]. In last 15 years, human papilloma virus (HPV) infection has been recognized to account for a distinct epidemiologic trend occurring mainly in western countries, leading to a rising incidence of oropharyngeal cancer (OPC) particularly in male patients in their 5 th decade of life [2,3]. Next to the pathogenesis of HPV-driven OPC [4], the development of HNSCC is still largely the result of a chronic exposure to tobacco and alcohol – induced field cancerization [5] of the upper aerodigestive mucosal tract.

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