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We review parametric decay instabilities (PDIs) expected in connection with electron cyclotron resonance heating (ECRH) of magnetically confined fusion plasmas, with a specific focus on conditions relevant for the ITER tokamak. PDIs involving upper hybrid (UH) waves are likely to occur in O-mode ECRH scenarios at ITER if electron density profiles allowing trapping of UH waves near the ECRH frequency are present. Such PDIs may occur near the plasma center in ITER full-field scenarios heated by 170 GHz O-mode ECRH and on the high-field side of half-field ITER plasmas heated by 110 GHz or 104 GHz O-mode ECRH. Additionally, 110 GHz O-mode ECRH of half-field ITER scenarios may have low ECRH absorption, due to the electron cyclotron resonance being located on the high-field side of the main plasma. This potentially allows PDIs driven by a significant amount of ECRH radiation reaching the UH resonance in X-mode to occur, as X-mode radiation can be generated by reflection of unabsorbed O-mode radiation from the high-field side wall. The occurrence of PDIs during ECRH may damage microwave diagnostics, such as the electron cyclotron emission and low-field side reflectometer systems at ITER, as well as complicate the calculation of heating and current drive characteristics. However, if PDIs are induced in a controlled manner, they may provide novel diagnostic tools and allow the generation of a moderate fast ion population in plasmas heated only by ECRH. [ABSTRACT FROM AUTHOR]