Introduction: Head & Neck cancers accounts more than 644,000 cases and 320,000 deaths annually worldwide. The majority of cases are reported from South – East Asia region, where India is a major contributor. For Locally advanced Head and neck cancers, multimodal treatment is the standard of care. The fractionated doses of radiotherapy are important because of the differences in the response of the tumor and normal tissue. Acute adverse effects continue to be an important concern in head and neck cancer patients which may be intense and debilitating but resolve over time. Material and Methods: Observational Prospective Study, from2015 to 2017.100 patients enrolled. Three arms, 30 patients in each arm. ARM A. ICT f/b CTRT ARM B. ICT f/b RT ARM C. RT alone RESULT: Among 90 cases, male: female ratio was 1.6:1 with 62% were of age more than 40 years. Acute toxicities i.e. Nausea, vomiting, mucositis and myelo–suppression were significantly more in ARM–A than ARM –B and C, and radiation dermatitis was significantly more in ARM–C. CONCLUSION: Treatment related toxicities and protracted treatment protocols are associated with high attrition rate but with good symptomatic, nutritional support and proper counseling it can be avoided successfully. Treatment related toxicities can be minimized by using more conformal techniques of radiotherapy like 3D CRT, IMRT.