Head and Neck

Head and neck radiation therapy requires meticulous planning due to the region’s anatomical complexity and the proximity of tumors to critical structures. This chapter provides a comprehensive framework for evaluating plan quality, covering clinical intent, simulation setup, imaging review, contouring accuracy, and optimization strategies. Key topics include the use of simultaneous integrated boost (SIB), multi-modal image registration, margin verification, dose calculation accuracy, and robust plan evaluation. Special considerations such as re-irradiation, artifact management, immobilization challenges, and adaptive planning are also addressed. Practical guidance is provided for balancing tumor coverage with organ-at-risk sparing, reviewing dose distribution beyond DVH metrics, and ensuring clear communication across the multidisciplinary team. Emphasis is placed on maintaining plan robustness, ensuring safe delivery, and promoting a culture of continuous improvement.