A total of 117 patients with inoperable, histologically diagnosed locally recurrent head and neck cancer were treated with BNCT at the FiR 1, a 250-kW Triga Mark II research reactor located in Espoo, Finland, between February 2003 and January 2012. Seventy-nine (68%) out of these patients had locally recurrent head and neck squamous cell carcinoma (HNSCC) and were evaluable for tumor response and/or survival outcomes. All patients were treated using L-boronophenylalanine as the boron carrier compound. The patients were treated with BNCT either once or twice, and the median time interval between the two BNCT treatments was about 6 weeks. Forty-seven (68%) of the 69 patients evaluable for response achieved either complete response or partial response with BNCT, despite earlier photon radiotherapy to the same site, 17 (25%) had stable disease lasting for a median of about 4 months, and 5 (7%) had progressive disease. The patients treated twice with BNCT for locally recurrent head and neck cancer responded more often than those who were treated only once. The median follow-up time after BNCT was 7.8 years. About a quarter of the patients were free from locoregional progression 2 years after BNCT. A high minimum tumor dose and a small tumor volume were independently associated with overall survival in a multivariable survival analysis. In addition, a few patients with newly diagnosed large inoperable head and neck cancer were treated by integrating BNCT with conventional cancer therapy consisting of IMRT, cetuximab, and cisplatin administered concomitantly with photon radiotherapy. This combination treatment yielded promising results, but the evidence remains anecdotal. Yet, studies aiming at integration of BNCT with other cancer treatments are planned to be an important topic to be formally studied at the accelerator-based BNCT facility now undergoing commissioning at the Helsinki University Hospital.