Oral complications in the head and neck radiation patient. Introduction and scope of the problem

Head and neck cancer arises in the upper aerodigestive tract, most commonly in the oral cavity, pharynx, and larynx. The anatomy and physiology of this region are uniquely complex, and the function and appearance are critical to patients' self-image and quality of life. Head and neck cancer is related to tobacco and alcohol exposure, and is hence found more frequently in males in lower socio-economic classes. These patients therefore tend to be less health conscious and to have less social support than most other groups of cancer patients. Most head and neck cancer patients are treated with high-dose radiotherapy to large irradiation fields encompassing sensitive structures, including the oral cavity and surrounding structures. Significant side effects occur in both the acute and the chronic phase, and dealing with these is a complex issue. Increasing intensity of treatment has improved survival but has also increased treatment side effects. A dedicated multidisciplinary team of oncologist, head and neck surgeon, dentist, nurse, dietician, physical therapist, social worker and in some instances plastic surgeon, prosthodontist, and psychologist is needed to provide the optimal supportive care for these patients. New developments in radiotherapy techniques are expected to lead to even higher cure rates and fewer side effects in patients with head and neck cancer.