Xerostomia remains one of the most common and impactful side effects associated with radiotherapy for head and neck malignancies. With improvements in oncologic therapy and an improved prognosis for patients with head and neck squamous cell carcinoma (HNSCC) overall, the long-standing effects of therapy have become even more significant. Recent efforts have primarily focused on prevention of this morbidity through technological advances, reductions in radiotherapy fields, and radioprotectants. The promises of de-intensified strategies and proton radiation warrant ongoing investigation. However, palliative care for and active management of xerostomia before, during, and after treatment deserve further attention and research to define optimal approaches.
Keywords: Radiation; de-intensification; palliative care; proton therapy; supportive care; xerostomia.