30-Second Takeaway
- HPV-driven oropharyngeal cancer now dominates new HNSCC in high-income settings and shapes prognosis and treatment goals.
- Head and neck radiotherapy modestly increases ischemic stroke risk versus surgery and the general population.
- Standardized AECRS definitions and microbiome data in CRS and COME argue against reflexive antibiotic and steroid use.
Week ending December 20, 2025
Head & neck updates: cancer care, treatment toxicity, sinus/ear microbiome, and emerging diagnostics
Contemporary head and neck cancer review highlights HPV, staging, and multimodal therapy
This review outlines current epidemiology, risk factors, staging, and management of head and neck squamous cell carcinoma (HNSCC). Tobacco and alcohol remain the primary global risk factors, while HPV causes 60%–70% of new oropharyngeal cancers in the US and Europe. Only 30% of patients present with localized disease; 60% present with locoregionally advanced disease and 10% with metastases. Localized HNSCC treated with surgery or radiotherapy alone achieves 5-year overall survival of approximately 70%–90%.
Head and neck radiotherapy increases long-term ischemic stroke risk
This systematic review and meta-analysis evaluated cerebrovascular events after head and neck radiotherapy for cancer. Across 50 studies, carotid stenosis incidence after radiotherapy ranged from 0% to 40% over variable follow-up periods. Pooled ischemic stroke incidence was 8.98 events per 1,000 person-years after head and neck radiotherapy. Stroke risk was higher after radiotherapy than after surgery alone (HR 1.33; 95% CI 1.21–1.45) and versus the general population (HR 1.29; 95% CI 1.13–1.47).
Defining and managing acute exacerbations of chronic rhinosinusitis
This narrative review synthesizes emerging data on acute exacerbations of chronic rhinosinusitis (AECRS). A recent regulatory definition requires more than 3 days of worsened symptoms plus escalation of treatment to qualify as AECRS. Patient-reported rescue medication use substantially underestimates AECRS burden, capturing only about one-third of reported episodes. The authors emphasize viral insults and microbiome dysbiosis as triggers that facilitate secondary bacterial infection in AECRS.
Multidisciplinary supportive care during RT cuts interruptions in head and neck cancer
This randomized trial tested a structured multidisciplinary support program (SHINE-MDT) versus usual care during radiotherapy for head and neck cancer. SHINE-MDT coordinated nutritional, psychological, and rehabilitation services delivered by specialist nurses and a multidisciplinary team. Radiotherapy interruption rates were significantly lower with SHINE-MDT, with a 13.9 percentage-point absolute reduction versus usual care. SHINE-MDT also improved quality of life, nutritional status, and psychological distress scores through 6 months posttreatment.
References
Numbered in order of appearance. Click any reference to view details.
Additional Reads
Optional additional studies from this edition.