الفهرس 
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Abstract
In our study, RT dose escalation and OTT acceleration using SIB-IMRT technique in both definitive and postoperative setting in patients with stage III-IV HNC, could achieve a very good dose distribution and sparing of normal tissue and hence good results regarding outcome and pattern of toxicity.
• SIB-IMRT as an altered fractionation schedule is safe in combination with systemic chemotherapy and/or Targeting therapy in treatment patients with stage III-IV HNC.
• No statistically significant differences between patients who were treated with surgery followed by postoperative radiochemotherapy and those who received definitive radiochemotherapy, regarding PFS, LRFS, DMFS, and OS rates at 2 years.
• The mean dose > 26 Gy to the contralateral parotid gland was predictor for persistent grade II xerostomia.
• Oral cavity primary tumor site, advanced T3-T4 stage, advanced N2c-N3 disease, and RT interruption were associated with LRF.
• The role of neoadjuvant chemotherapy in patients with stage III-IV HNC needs further investigation.