**1. Introduction**

Oral cancers are one of the most well described & clearly detailed cancers in history, since the times of ancient Egyptian and Ayurveda (Sushrutha) systems. Globally, as per the data released from International Agency for research on cancer (IARC), oral cancer occurs most commonly in middle- & low-income countries with worldwide incidence of 377,713 cases with 177,757 deaths seen in 2020 [1]. The worldwide incidence rate is 4.1 cases per 100,000.

Since the evolution of modern contemporary management for oral cavity cancers, radiotherapy has played a pivotal role along with surgery and recently with chemotherapy in improving patient outcomes. After the milestone discovery of x-rays by Wilhem Roentgen in 1898, utility of radiation in various cancers was established. The role of radiotherapy in oral cancers specifically, developed between the two world wars, as the morbidity was less troublesome and was easier to deliver in community hospitals [2]. However, as surgical processes got more flexible and easier to execute and the survival rates of patients receiving radiation alone were not very encouraging, radical surgery resurfaced as the primary modality for oral cancers mid-century. Also, concerns of long-term radiation morbidity affecting patient's quality of life, in those receiving conventional radiation as a sole modality came to the fore. Keeping this in mind, towards the end of the 20th century, development of newer technology was directed towards minimising these particular issues. Also, optimum and effective combinations between surgery & radiotherapy with or without the addition of chemotherapy, were slowly established as standards of care which have been thoroughly reviewed in this chapter.

In order to keep the options simple and to make the life of an oncologist simpler, one can divide oral cancers as early, locally advanced and metastatic disease. In this chapter, we will give an overview of the current understanding for the choice of treatment in these different categories with insight into the specific therapeutic aspects of both external & internal radiation therapy. We will also dwell upon the advances in recent research related to oral cancer management as well as the possible future directions from the prism of the new age radiation oncologist.
