The study focuses on the impact of sarcopenia on acute and late toxicities in head and neck tumor affected patients treated with particle therapy.

To evaluate in HNC patients treated with particle therapy the impact of SP (measured by low skeletal muscle mass at the C3 vertebral body) on toxicity profile assessed according to NCI's Common Terminology Criteria for Adverse Events CTCAE (version 5.0), defined as:

• Acute toxicity: within 3 months from the beginning of particle RT
• Late toxicity: more than 6 months after the end of particle RT. To investigate possible association between SP and nutritional

Inclusion Criteria:

• All HNC histologies and stages
• Histological and/or radiological diagnosis of head and neck tumors
• The patient is able to give consent
• Definitive/postoperative treatment with curative intent
• Age >18 years
• KPS> 80

Exclusion Criteria:

• Plurimetastiatic disease
• Palliative intent and re-irradiation treatments
• Known cases of any psychiatric and neurological diseases leading to disability (eg, manic disorder, schizophrenia etc..), which could impair compilation of questionnaires

A sample of 70 patients of which 40% showing baseline sarcopenia will be recruited. The population is composed by head and neck patients treated with particle therapy, both carbon ions and protons.