Multiple dental issues can arise for patients with cancer throughout the continuum of cancer therapy. Clinicians must be familiar with the potential complications that can arise in the oral cavity from cancer treatment modalities in order to assist in the prevention and treatment of dental toxicities.

Managing and preventing sequelae following surgery, radiation therapy (RT), and systemic therapy (e.g., trismus, pain, lymphedema and muscle spasm of the neck, xerostomia, dysphagia, speech and swallowing problems, dental and jaw decay, depression, peripheral neuropathy, hearing loss, renal failure) requires professionals familiar with head and neck cancers. Limited data are available comparing the efficacy of different chemoradiotherapy regimens for squamous cell carcinoma of the head and neck (SCCHN). Immunotherapy options for recurrent/metastatic nasopharyngeal cancer is a rapidly evolving area of research.

These NCCN Guidelines Insights summarize the panel’s most recent recommendations regarding management of nasopharynx cancer and ongoing research in this area.

Despite advances in radiation therapy (RT) techniques for the treatment of head and neck cancers, patients with head and neck cancers continue to be at risk of oral and dental complications after surgery or RT because of treatment-induced xerostomia and salivary gland dysfunction, which are associated with increased dental caries.

Despite advances in radiation therapy (RT) techniques for the treatment of head and neck cancers, patients with head and neck cancers continue to be at risk of oral and dental complications after surgery or RT because of treatment-induced xerostomia and salivary gland dysfunction, which are associated with increased dental caries.

For patients with widely metastatic head and neck cancer, the goal is palliation or prolongation of life. Recent studies show that immunotherapy provides a reasonable treatment option for patients with recurrent or metastatic squamous cell carcinoma of the head and neck. This presentation will discuss new and emerging treatment options to optimize outcomes for these patients.

Clinical trials are continuing to investigate the role of induction chemotherapy prior to systemic therapy/radiation therapy for patients with locoregionally advanced nasopharyngeal carcinoma. New evidence regarding the addition of a PD-1 inhibitor to gemcitabine/cisplatin provides an emerging avenue of treatment for patients with recurrent or metastatic disease. It is important for clinicians to remain current on emerging treatment options for patients with nasopharyngeal carcinoma.

Clinical trials are continuing to investigate the role of induction chemotherapy prior to systemic therapy/radiation therapy for patients with locoregionally advanced nasopharyngeal carcinoma. New evidence regarding the addition of a PD-1 inhibitor to gemcitabine/cisplatin provides an emerging avenue of treatment for patients with recurrent or metastatic disease. It is important for clinicians to remain current on emerging treatment options for patients with nasopharyngeal carcinoma.

The overall incidence of HPV-positive oropharynx cancers is increasing in the United States. Deintensification treatment protocols for HPV-associated locally advanced oropharyngeal cancer are being investigated in ongoing clinical trials. Strategies under active investigation include reducing or using response-stratified radiation therapy (RT) dose, using RT alone versus chemoradiation, using less invasive surgical procedures such as TORS, using sequential systemic therapy/RT, and using immunotherapy and targeted therapy agents.

These NCCN Guidelines Insights summarize the panel’s most recent recommendations regarding management of HPV-positive oropharynx cancer and ongoing research in this area.