Phase II Study of Whole or Partial Parotid Sparing Intensity Modulated Radiotherapy in Patients With Head and Neck Cancers

Inclusion Criteria: * Histologically confirmed squamous cell cancer or undifferentiated cancer of nasopharynx, oropharynx, larynx and hypopharynx and squamous cell carcinoma unknown primary. * TNM Stage: T1-4, N0-3 M0 * Patients requiring primary or postoperative radiotherapy to the primary site and bilateral neck irradiation requiring IMRT * Parotid sparing IMRT feasible (parotids clear of malignant disease) * WHO Performance status 0-1 (Karnofsky \>80) * Aged 18 or older * Induction chemotherapy and concomitant platinum based chemotherapy is permitted * Concomitant cetuximab is permitted where platinum chemotherapy is contraindicated * All patients must be suitable to attend regular follow-up and salivary flow measurements and be available for long term follow up. * All patients must be able to complete self-assessed quality of life questionnaire * Be able to provide written informed consent Exclusion Criteria: * Previous radiotherapy to the parotid gland/s * Pre-existing salivary gland pathology interfering with saliva production * Previous or concurrent illness which in the investigator's opinion which will interfere with either completion of therapy or follow up * Brachytherapy is not allowed as part of the treatment * Presence of lymphadenopathy adjacent to or involving both parotid glands making whole parotid sparing or superficial parotid sparing impossible * Prophylactic use of amifostine or pilocarpine is not allowed