Implementation of the 2024 ASCO guidelines for the prevention and management of osteoradionecrosis in patients with head & neck cancer treated with radiation therapy

Purpose of review Osteoradionecrosis may often be prevented in context of interprofessional healthcare that includes dental specialists prior to and following completion of the patient's head and neck radiation therapy. Important factors, however, compromise delivery of guideline-concordant management of osteoradionecrosis (ORN), including patient access to this interprofessional care. This review is directed to these and related issues, in order to foster enhanced approaches for ORN management. Recent findings The review is centered in the 2024 Journal of Clinical Oncology publication 'Prevention and Management of Osteoradionecrosis in Patients With Head and Neck Cancer Treated With Radiation Therapy: ISOO-MASCC-ASCO Guideline', and the companion 2024 JCO Oncology Practice publication in which clinical insights for the guideline are addressed. Key recent literature is cited in order to provide contemporary context to clinical decision-making for prevention and early diagnosis and treatment of ORN. Although a relatively infrequent complication in head and neck radiation patients, ORN can have profound clinical and financial impact when it occurs. Summary Interprofessional oncology care is essential for ORN management. Future research is needed in order to enhance this management, including studies directed to predicting risk of development of ORN based on patient-centered risk factors.