Organ-Sparing in Radiotherapy for Head-and-Neck Cancer: Improving Quality of Life

This is an overview of select studies characterizing the effect of radiation on normal tissues in the treatment of head-and-neck cancer. Recommendations for organ-at-risk dose constraints aiming to reduce risks of xerostomia and dysphagia, the factors which have the highest effect on patient quality of life, are discussed, along with their supporting evidence. Recent advances in technology and biology, and their implications for reducing toxicity are explored. Considerations related to organ-sparing in the setting of treatment deintensification for good-prognosis head-and-neck cancer are also discussed.
Source: Seminars in Radiation Oncology - Category: Cancer & Oncology Authors: Source Type: research

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AbstractObjectivesTo evaluate cancer treatment –related toxicities in young head and neck cancer (HNC) patients.Material and methodsA total of 44 patients were included in the present retrospective cohort study, which was designed to access oral toxicities of cancer treatment in young (  58 years of age, Group II,n = 22) HNC patients with similar tumor stage and treatment protocols. Oral mucositis (OM), xerostomia, dysphagia, dysgeusia, trismus, and radiodermatitis were assessed during days 7th, 21st, and 35th of head and neck radiotherapy (HNRT) according to previously validated scales (Wor...
Source: Supportive Care in Cancer - Category: Cancer & Oncology Source Type: research
Abstract Salivary gland function is severely disrupted by radiation therapy used to treat patients diagnosed with head and neck cancer and by Sjögren's syndrome. The resulting condition, which results in xerostomia or dry mouth, is due to irreversible loss of the secretory acinar cells within the major salivary glands. There are presently no treatments for the resolution of xerostomia. Cell-based approaches could be employed to repopulate acinar cells in the salivary gland but investigations into potential therapeutic strategies are limited by the challenges of maintaining and expanding acinar cells in vitro....
Source: Cell Research - Category: Cytology Authors: Tags: Cell Tissue Res Source Type: research
AbstractSalivary gland function is severely disrupted by radiation therapy used to treat patients diagnosed with head and neck cancer and by Sj ögren’s syndrome. The resulting condition, which results in xerostomia or dry mouth, is due to irreversible loss of the secretory acinar cells within the major salivary glands. There are presently no treatments for the resolution of xerostomia. Cell-based approaches could be employed to repopulat e acinar cells in the salivary gland but investigations into potential therapeutic strategies are limited by the challenges of maintaining and expanding acinar cells in vitro. W...
Source: Cell and Tissue Research - Category: Cytology Source Type: research
The aim of this study was to evaluate the clinical risk factors (RF) for acute (mucositis and candidiasis) and chronic (radiation caries and xerostomia) complications of the treatment in patients undergoing intensity modulated radiotherapy (IMRT) for head and neck cancer.
Source: Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics - Category: ENT & OMF Authors: Source Type: research
True acupuncture resulted in fewer and less severe radiation-induced xerostomia symptoms in this phase III study.
Source: CancerNetwork - Category: Cancer & Oncology Authors: Source Type: news
AbstractTo explore the parotid normal tissue complication probability (NTCP) modeling with percolation-based dose clusters for head-and-neck patients receiving concomitant chemotherapy and radiation therapy. Cluster models incorporating the spatial dose distribution in the parotid gland were developed to evaluate the radiation induced complication. Cluster metrics including the mean cluster size (NMCS) and the largest cluster size both normalized by the gland volume (NSLC) were evaluated and scrutinized against the benchmark NTCP. Two fitting strategies to the Lyman –Kutcher–Burman (LKB) model using the maximum...
Source: Australasian Physical and Engineering Sciences in Medicine - Category: Biomedical Engineering Source Type: research
Conclusions/Implications for Practice: Primary HNCs and their treatment significantly deteriorate oral function. A holistic and interdisciplinary approach may maximize oral function.
Source: Journal of Nursing Research - Category: Nursing Tags: SYSTEMATIC REVIEW Source Type: research
ConclusionsThis study suggests that the outcome after initial treatment of MALT lymphomas in the oromaxillofacial head and neck region is satisfactory and that this disease progresses slowly. The CR rate and PFS of localized lymphoma patients are better than those of disseminated lymphoma patients. Systemic treatment (chemotherapy or rituximab) may improve PFS in disseminated disease patients. MALT ‐IPI and Ann Arbor staging are independent prognostic factors.
Source: Cancer Medicine - Category: Cancer & Oncology Authors: Tags: ORIGINAL RESEARCH Source Type: research
Publication date: November–December 2019Source: Reports of Practical Oncology &Radiotherapy, Volume 24, Issue 6Author(s): Ram Abhinav Kannan, TR Arul PonniAbstractAimTo analyse the long term swallowing function in head and neck cancer patients and correlate with the dose to midline swallowing structures.BackgroundThe use of concurrent chemo radiation (CRT) as the present standard of care resulted in high rates of early and late toxicities. Dysphagia, aspiration, and xerostomia are early as well as late effects of radiation. Not many studies on the dysphagia scores during radiation and follow-up period have correl...
Source: Reports of Practical Oncology and Radiotherapy - Category: Cancer & Oncology Source Type: research
Publication date: Available online 29 October 2019Source: British Journal of Oral and Maxillofacial SurgeryAuthor(s): C. Paterson, M.C. Thomson, B. Caldwell, R. Young, A. McLean, S. Porteous, S. Clark, C.M. Messow, S. Kean, D. Grose, C. Lamb, M. Rizwannullah, A. James, S. Schipani, C. Wilson, R. Rulach, R. JonesAbstractRadiotherapy-induced xerostomia (RIX) is a common and untreatable side effect of radiotherapy to the head and neck. Visco-ease™ mouth spray (Lamellar Biomedical Ltd), a new product that is made from lamellar body mimetics, reduces the viscosity of saliva ex vivo. The purpose of this study was to evalua...
Source: British Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Source Type: research
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