Recent advances in the oncological management of head and neck cancer and implications for oral toxicity

Radiotherapy is a key treatment modality for cancers of the head and neck, being used for curative intent either alone or in combination with surgery and chemotherapy. The treatment-related toxicities of these treatments can be significant in both the short and longer term. Many of these toxicities manifest orally, even in patients whose primary malignancy was outside the oral cavity, as radiotherapy often involves elective treatment of high-risk areas, such as locally draining lymph nodes in the neck. Reducing the burden of treatment is an area of intense focus in head and neck oncology. New technology and imaging techniques, such as proton therapy and magnetic resonance imaging, are being integrated into radiotherapy treatment to minimise radiation dose outside of the target areas. In parallel, tumour biology is being explored as a means of identifying patients who might be suitable for de-escalated therapy. This review will cover the latest advances in the oncology treatment available for patients with head and neck cancers, with a focus on how these might help reduce oral toxicity.