Patients with head and neck cancer (HNC) frequently endure multiple distressing symptoms that can substantially compromise their quality of life. This study aimed to assess the use of nurse-led consultations (NLCs) and examine whether these interventions influenced symptom burden. We performed a retrospective review of clinical data collected in routine practice to evaluate the delivery of NLCs and monitor symptom progression using the M.D. Anderson Symptom Inventory (MDASI). The analysis included patients receiving standard care (n = 72) and those who participated in NLCs (n = 62) at a radiation oncology unit from 2017 to 2019. Symptom assessments were conducted at three intervals: T0 (pre-treatment), T1 (mid-treatment, weeks 3–4), and T2 (late treatment, weeks 5–6). In the NLC group, over 80% of patients underwent assessments for nutrition, smoking, oral health, and swallowing/chewing function, whereas pain evaluation was less consistently performed. Interventions related to patient education (16%) and coordination of care (7%) were comparatively limited. Symptom severity increased over the treatment course, with no statistically significant differences between patients receiving NLCs and those receiving standard care. The findings indicate that nurse-led consultations did not significantly alter symptom burden during radiotherapy. Further research with larger patient populations, systematic process evaluation, and long-term follow-up is warranted to better understand the potential role of NLCs in managing symptoms for HNC patients.