Conclusion

Cancer is still a major global public health challenge, with its burden predicted to rise substantially due to population growth and aging. Current estimates suggest that by 2050, global incidence will reach 35 million, with Asia accounting for nearly half of this burden. In this scenario, HNC emerges as a particularly serious type of cancer. A comparative analysis shows that India’s HNC profile is notably different from the region’s; for instance, the ASIR for lip and OCC in India is 9.8, more than three times the Asian average of 3.2 and exceeding the global average of 4.1.

This review highlights that India has one of the highest HNC burdens in the world, characterized by a stark gender disparity. Indian men are facing a critical public health crisis with an ASIR of 14.7 for OCC. This rate is nearly double the 4.9 ASIR observed in women. The ASMR is also high at 8.1 for men and 2.9 for women across the country. These figures, along with a much lower burden of nasopharyngeal cancer in India (ASIR 0.4) compared to the rest of Asia (ASIR 1.9), highlight the region’s specific health challenge. Such high MIR across all sub-sites indicate many cases are diagnosed at an advanced stage. This situation emphasizes the urgent need for focused prevention and early detection programs.

Radiotherapy has changed significantly and is still a remains a cornerstone of managing HNC. The transition from conventional 2DRT to 3DCRT, IMRT, IGRT, VMAT and advanced modalities like SRS, SRT, SBRT, tomotherapy, proton therapy and adaptive therapy has substantially improved dose conformity and sparing of organs at risk. Despite these advances, precise and reproducible patient positioning is crucial to the clinical efficacy of radiation therapy, especially in addressing the high mortality rates noted above.

In conclusion, a comprehensive strategy that integrates prevention, early diagnosis, and technologically advanced treatment delivery is needed to address the rising burden of HNC. Continued research focused on optimizing radiotherapy techniques and improving positioning accuracy with 6DOF systems will be essential to improve survival outcomes and quality of life for HNC patients in the years ahead.