Manifestations or oral manifestations resulting from head and neck radiotherapy




Radiotherapy; Oral Complications; Head and neck cancer.


Head and neck cancer (CPP) corresponds to assumed tumors in the skin, oral cavity, lips, salivary glands, larynx, pharynx, nasal cavity, paranasal sinuses, external auditory canal and middle ear. It affects people of both sexes, but with greater predilection for males and over 40 years of age. The risk factors associated with this malignancy are smoking, alcohol consumption, overweight, exposure to ultraviolet rays, sedentary lifestyle, among others. Radiotherapy (RT) is the most used treatment for CPP, and consists of different forms of ionizing radiation that act on the DNA of malignant cells in order to cause their death and/or prevent their reproduction. However, although it is in a smaller proportion, due to the greater capacity for regeneration, an RT affects healthy tissues and cells, causing adverse effects that can affect cancer treatment and lead to the patient's health well-being. Given the above, this study aimed to review the literature on oral manifestations resulting from head and neck radiotherapy and address oral management strategies for head and neck radiotherapy. For the construction of this article, a bibliographic survey was carried out in the SciVerse Scopus, Scientific Electronic Library Online (Scielo), National Library of Medicine of the United States (PUBMED) and ScienceDirect databases, using the Mendeley reference manager. The articles were collected from May to August 2021 and covered between 2015 and 2021. From the narrative review of the literature, it was observed that the oral manifestations resulting from radiotherapy of the head and neck xerostomia, oral mucositis, osteoradionecrosis , trismus and dysgeusia. Taking into account the high incidence of PPC, it is extremely important that health professionals are familiarized with the complications arising from cancer treatments.


Agarwal, P., Shiva Kumar, H. R., & Rai, K. K. (2016). Trismus in oral cancer patients undergoing surgery and radiotherapy. Journal of Oral Biology and Craniofacial Research, 6, S9–S13.

Campos, L., Carvalho, D. L. C., Castro, J. R., & Simões, A. (2013). Laserterapia no tratamento da mucosite oral induzida por quimioterapia: relato de caso. Revista Da Associacao Paulista de Cirurgioes Dentistas, 67(2), 102–106.

Chiu, Y.-H., Tseng, W.-H., Ko, J.-Y., & Wang, T.-G. (2021). Radiation-induced swallowing dysfunction in patients with head and neck cancer: A literature review. Journal of the Formosan Medical Association.

Davies, A. N., & Thompson, J. (2015). Parasympathomimetic drugs for the treatment of salivary gland dysfunction due to radiotherapy. Cochrane Database of Systematic Reviews, 2015(10).

Djordjevic, V., Djokic, G., Domic, D., Zivkovic, N., Jankovic, L., Milicic, B., & Dejanovic, S. D. (2016). P.3.d.013 - Hyposalivation and xerostomia in schizophrenic patients on psychotropic medications. European Neuropsychopharmacology, 26, S537.

Frankart, A. J., Frankart, M. J., Cervenka, B., Tang, A. L., Krishnan, D. G., & Takiar, V. (2021). Osteoradionecrosis: Exposing the Evidence Not the Bone. International Journal of Radiation Oncology*Biology*Physics, 109(5), 1206–1218.

Gómez, G. J. Á., Camacho, R. V. L., Torres, J. E. B., Gómez, S. M. B., Álzate, D. P. C., Ross, P. A. C., & Arévalo, J. E. H. (2017). Alterations found in the mouth of patients treated with head and neck radiotherapy. Medellin, Colombia. Revista Odontológica Mexicana, 21(2), e86–e96.

Jafari, A., Alaee, A., & Ghods, K. (2021). The etiologies and considerations of dysgeusia: A review of literature. Journal of Oral Biosciences.

Kawashita, Y., Soutome, S., Umeda, M., & Saito, T. (2020). Oral management strategies for radiotherapy of head and neck cancer. Japanese Dental Science Review, 56(1), 62–67.

Kim, S. Y., Beer, M., & Tshering Vogel, D. W. (2021). Imaging in head and neck cancers: Update for non-radiologist. Oral Oncology, 120, 105434.

Kovarik, J. P., Voborna, I., Barclay, S., Iqbal, M. S., Cunnell, M., Kelly, C., Willis, N., Kennedy, M., & Kovarik, J. (2021). Osteoradionecrosis after treatment of head and neck cancer: A comprehensive analysis of risk factors with a particular focus on role of dental extractions. British Journal of Oral and Maxillofacial Surgery.

Mody, M. D., Rocco, J. W., Yom, S. S., Haddad, R. I., & Saba, N. F. (2021). Head and neck cancer. The Lancet.

Musha, A., Shimada, H., Kubo, N., Kawamura, H., Okano, N., Sato, H., Kaminuma, T., Okada, K., Anakura, M., Adachi, A., Shirai, K., Saitoh, J., Yokoo, S., Chikamatsu, K., & Ohno, T. (2021). Clinical features and dosimetric evaluation of carbon ion radiation-induced osteoradionecrosis of mandible in head and neck tumors. Radiotherapy and Oncology, 161, 205–210.

OLADEGA, A., MOJDAMI, D., HOPE, A., WATSON, E., & GLOGAUER, M. (2021). The process of developing consensus guidelines by Dental Oncologists for pre-radiotherapy dental care in head and neck cancer patients using the modified Delphi technique. Journal of Evidence Based Dental Practice, 101620.

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Ribeiro, G. H., Chrun, E. S., Dutra, K. L., Daniel, F. I., & Grando, L. J. (2018). Osteonecrosis of the jaws: a review and update in etiology and treatment. Brazilian Journal of Otorhinolaryngology, 84(1), 102–108.

Scherpenhuizen, A., van Waes, A. M. A., Janssen, L. M., Van Cann, E. M., & Stegeman, I. (2015). The effect of exercise therapy in head and neck cancer patients in the treatment of radiotherapy-induced trismus: A systematic review. Oral Oncology, 51(8), 745–750.

Shao, C.-H., Chiang, C.-C., & Huang, T.-W. (2020). Exercise therapy for cancer treatment-induced trismus in patients with head and neck cancer: A systematic review and meta-analysis of randomized controlled trials. Radiotherapy and Oncology, 151, 249–255.

Silva, I. M. V, Donaduzzi, L. C., Perini, C. C., Couto, S. A. B., Werneck, R. I., de Araújo, M. R., Kurahashi, M., Johann, A. C. B. R., Azevedo-Alanis, L. R., Vieira, A. R., & Couto-Souza, P. H. (2021). Association of xerostomia and taste alterations of patients receiving antineoplastic chemotherapy: A cause for nutritional concern. Clinical Nutrition ESPEN, 43, 532–535.

Soutome, S., Yanamoto, S., Nishii, M., Kojima, Y., Hasegawa, T., Funahara, M., Akashi, M., Saito, T., & Umeda, M. (2021). Risk factors for severe radiation-induced oral mucositis in patients with oral cancer. Journal of Dental Sciences, 16(4), 1241–1246.

Tawfik, G. M., Mostafa, E. M., Alshareef, A., Hmeda, A. Ben, Khaled, S., Abdelwahed, K. A., Mahran, S. A., Agage, H. S., Amer, A. E., Emara, N. S., El-Qushayri, A. E., Ebied, A., & Huy, N. T. (2021). Association between radiotherapy and obstructive sleep apnea in head and neck cancer patients: A systematic review and meta-analysis. Auris Nasus Larynx, 48(6), 1126–1134.

Weng, C.-T., Huang, S.-L., Yang, H.-W., Kao, C.-C., Wei, C.-C., & Huang, Y.-F. (2021). Oral microbiota in xerostomia patients - A preliminary study. Journal of Dental Sciences.

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How to Cite

BINDA, N. C. .; BINDA , A. L. C. .; RODRIGUES , S. de A.; LOURES, L. L. da S. .; SÁ, A. C. S. F. de .; SILVA, J. V. L.; FRANCO, A. G. .; BORBA, T. O. da S.; MAGALHÃES, P. Ícaro B. M. de A. .; ARAÚJO, E. L. da S. F. de .; SOUZA, H. Y. M. S. de .; BARBOSA, R. L. S. .; SAVI, F. da R. .; REIS, J. L. .; RAMALHO, M. A.; FERNANDES, C. da S. . .; SÁTIRO, V. D. de S. . Manifestations or oral manifestations resulting from head and neck radiotherapy. Research, Society and Development, [S. l.], v. 10, n. 12, p. e411101220519, 2021. DOI: 10.33448/rsd-v10i12.20519. Disponível em: Acesso em: 24 feb. 2024.



Health Sciences