Early side effects of radiation treatment for head and neck cancer

Brook, Itzhak

doi:10.1016/j.canrad.2021.02.001

Cited by 47 publications

(29 citation statements)

References 35 publications

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“…In a retrospective analysis, Brook et al. demonstrated a positive correlation between the frequency and severity of mucositis and the total radiation dosage ( 7 , 8 ). The laryngeal mucosa undergoes repeated stimulation of inflammation, which results in hyperplasia and even scarring ( 15 ), narrowing the pharyngeal cavity.…”

Section: Discussionmentioning

confidence: 99%

“…It has been shown by later research that radiotherapy may cause local tissue hypoxia, which can result in tissue fibrosis, endarteritis, vascular blockage, and decreased blood flow. The physiological function of the larynx is impacted, and the anatomical structure of the larynx is destroyed when microcracks in the perichondrium expose the deep surface cartilage to the air, resulting in infection and ultimately radionecrosis of cartilage ( 7 , 17 – 19 ).…”

Section: Discussionmentioning

confidence: 99%

“…④ patients with obvious laryngeal stridor, dyspnea and other respiratory obstruction symptoms. All patients received systemic treatment in the radiotherapy department of our hospital; (3) Age ≥18 years; (4) clear consciousness and stable condition; (5) Sign the informed consent; (6) No cognitive or communication disorders; (7) No serious chronic underlying diseases of heart, lung, liver or kidney or organ dysfunction. Exclusion criteria: (1) the patient refused to continue treatment if the treatment course was not completed; (2) patients who are intolerant to treatment; (3) patients who were lost to follow-up during treatment; (4) severe mental cognitive impairment;…”

Section: Study Samplementioning

confidence: 99%

“…(5) hearing impairment; (6) severe cardiopulmonary dysfunction; (7) severe infection; (8) combined with organic diseases of the digestive tract affecting swallowing function; (9) complicated with neuromuscular diseases; (10) combined with other malignant tumors; (11) unable to cooperate with complete researchers. (12) patients with radiotherapy as a primary treatment; (13) patients not receiving radiotherapy; (14) patients with total laryngectomy.…”

Section: Study Samplementioning

confidence: 99%

“…According to particular research, the severity of toxicity is significantly impacted by the increase in radiation dose (2). For instance, the radiation dose is positively connected with the larynx's ability to swallow, the larynx's muscle strength, and the frequency and intensity of mucositis (6)(7)(8). According to List et al observed in one study, aspiration pneumonia may develop due to laryngeal swallowing function problems (9,10).…”

Section: Introductionmentioning

confidence: 99%

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Higher radiation doses after partial laryngectomy may raise the incidence of pneumonia: A retrospective cohort study

Wang

et al. 2022

Front. Oncol.

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BackgroundCurrently, studies have shown that a high dose of radiotherapy to the throat have various harmful and adverse effects on the patients’ laryngeal function, resulting in the development of pneumonia. This study aimed to explore how radiotherapy dose affected the probability of pneumonia following laryngeal cancer surgery.Materials and methodsA retrospective analysis was done on patients diagnosed with laryngeal cancer between 2010 and 2020 and were treated surgically and with postoperative radiotherapy in the same institution. This study included 108 patients in total, 51 of who were in the low-dose group and 57 of whom were in the high-dose group. Age, gender, the location of laryngeal cancer, the presence or absence of lymph node metastasis, and other demographic and clinical characteristics were collected, and the prevalence of postoperative pneumonia was compared between the two groups.ResultsThe total prevalence of postoperative pneumonia was 59.3%, but there was a significant difference between the two groups(high-dose group 71.9% VS low-dose group 45.1%; p=0.005). A total of 9.3% (10/108) of the patients had readmission due to severe pneumonia, and the rate of readmission due to pneumonia was significantly different between the two groups (high-dose group 15.8% VS low-dose group 2.0%, p=0.032). Additionally, the high-dose group’s prevalence of Dysphagia was significantly higher than the low-dose group’s. According to multivariate logistic modeling, high-dose radiation was a risk factor for pneumonia (OR=4.224, 95%CI =1.603-11.131, p=0.004).ConclusionPneumonia risk could increase with radiotherapy doses > 50 Gy in the treatment of laryngeal cancer. Therefore, we recommend that when the radiation dose surpasses 50Gy, doctors should pay particular attention to the lung health of patients with laryngeal cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Study Samplementioning

confidence: 99%

Section: Study Samplementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Higher radiation doses after partial laryngectomy may raise the incidence of pneumonia: A retrospective cohort study

Wang

et al. 2022

Front. Oncol.

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SNOT‐22 subdomain outcomes following treatment for sinonasal malignancy: A prospective, multicenter study

Grimm,

Beswick,

Maoz

et al. 2024

Int Forum Allergy Rhinol

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BackgroundPatients with sinonasal malignancy (SNM) present with significant sinonasal quality of life (QOL) impairment. Global sinonasal QOL as measured by the 22‐item Sinonasal Outcomes Test (SNOT‐22) has been shown to improve with treatment. This study aims to characterize SNOT‐22 subdomain outcomes in SNM.MethodsPatients diagnosed with SNM were prospectively enrolled in a multi‐center patient registry. SNOT‐22 scores were collected at the time of diagnosis and through the post‐treatment period for up to 5 years. Multivariable regression analysis was used to identify drivers of variation in SNOT‐22 subdomains.ResultsNote that 234 patients were reviewed, with a mean follow‐up of 22 months (3 months–64 months). Rhinologic, psychological, and sleep subdomains significantly improved versus baseline (all p < 0.05). Subanalysis of 40 patients with follow‐up at all timepoints showed statistically significant improvement in rhinologic, extra‐nasal, psychological, and sleep subdomains, with minimal clinically important difference met between 2 and 5 years in sleep and psychological subdomains. Adjuvant chemoradiation was associated with worse outcomes in rhinologic (adjusted odds ratio (5.22 [1.69–8.66])), extra‐nasal (2.21 [0.22–4.17]) and ear/facial (5.53 [2.10–8.91]) subdomains. Pterygopalatine fossa involvement was associated with worse outcomes in rhinologic (3.22 [0.54–5.93]) and ear/facial (2.97 [0.32–5.65]) subdomains. Positive margins (5.74 [2.17–9.29]) and surgical approach—combined versus endoscopic (3.41 [0.78–6.05])—were associated with worse psychological outcomes. Adjuvant radiation (2.28 [0.18–4.40]) was associated with worse sleep outcomes.ConclusionsSinonasal QOL improvements associated with treatment of SNM are driven by rhinologic, extra‐nasal, psychological, and sleep subdomains.

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Early Improved Functional Outcomes in Head and Neck Cancer Patients with Primary Tumor Detection

et al. 2023

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ObjectivesWe characterize functional outcomes in head and neck cancer of unknown primary (CUP) based on primary site identification.MethodsIn this retrospective study, CUP cases were categorized as known primaries (KP) if a tumor was localized after diagnostic workup or persisting unknown primaries (UP). Age, sex, HPV status, diagnostic methods, and treatments regimens were collected. Pretreatment and short‐term posttreatment (3–6 months after completion of treatment) weights, PHQ‐9, Eating Assessment Tool (EAT‐10), and Voice Handicap Index (VHI‐10) scores were compared between UP and KP.ResultsAmong 67 CUP patients, 35 (52.2%) had identified primaries (91.4% oropharyngeal and 8.6% nasopharyngeal). KP patients were younger (58 vs. 64, p = 0.04) and more likely to be HPV‐positive (88.6% vs. 50%, p = 0.002). Overall detection rates were 16.7% for PET/CT, 34.7% for direct laryngoscopy, and 46.6% for transoral robotic oropharyngectomy. Diagnostic workup was not significantly different between groups. Patients with KP received smaller intermediate radiation dose volumes (436.5 vs. 278.9 cc, p = 0.03) and lower doses to the cricopharyngeal muscle (41.6 vs. 24.6 Gy, p = 0.03).Pretreatment weights, PHQ‐9, EAT‐10, and VHI‐10 scores did not differ between groups. However, posttreatment, UP had greater relative weight loss (−14.1% vs. −7.6%, p = 0.032), higher EAT‐10 scores (12.5 vs. 3, p = 0.004), and higher PHQ‐9 scores (6 vs. 1.4, p = 0.017). Specifically, UP reported more stressful swallowing, difficulty swallowing solids and pills, and swallowing affecting public eating.ConclusionKP patients experienced less weight loss, depression, and reduced swallowing dysfunction, highlighting an early functional benefit of primary tumor identification likely driven by reduced radiation treatment volumes.Level of Evidence4 Laryngoscope, 2023

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Early side effects of radiation treatment for head and neck cancer

Cited by 47 publications

References 35 publications

Higher radiation doses after partial laryngectomy may raise the incidence of pneumonia: A retrospective cohort study

Higher radiation doses after partial laryngectomy may raise the incidence of pneumonia: A retrospective cohort study

SNOT‐22 subdomain outcomes following treatment for sinonasal malignancy: A prospective, multicenter study

Early Improved Functional Outcomes in Head and Neck Cancer Patients with Primary Tumor Detection

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