Long-term oral effects in patients treated with radiochemotherapy for head and neck cancer

Deboni, Aline Lima da Silva; Giordani, Adelmo José; Lopes, Nilza Nelly Fontana; Dias, Rodrigo Souza; Segreto, Roberto Araújo; Jensen, Siri Beier; Segreto, Helena Regina Cômodo

doi:10.1007/s00520-012-1418-7

Cited by 39 publications

(31 citation statements)

References 41 publications

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“…These include both acute toxicities, such as mucositis, nausea, pain, hematologic changes, and stomatitis, among numerous other acute side effects, and late toxicities, such as chronic xerostomia, fibrosis, edema, trismus, and dysphagia [67]. Low risk HPV+ patients that are known to have significantly better survival rates would benefit from treatment de-intensification in order to minimize short and long-term treatment sequelae [72], while maintaining high rates of loco-regional control [73]. As such, a recent publication by our group described the need to refine the current recursive partitioning analysis (RPA) based TMN stage and prognostic groups for classification of HPV+ OPC, as defined by the AJCC/UICC classification system.…”

Section: Therapeutic Perspectives: Treatment Of Hpv+ Hnc As a Distmentioning

confidence: 99%

HPV Associated Head and Neck Cancer

Spence

Bruce

Yip

et al. 2016

Cancers

112

108

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Head and neck cancers (HNCs) are a highly heterogeneous group of tumours that are associated with diverse clinical outcomes. Recent evidence has demonstrated that human papillomavirus (HPV) is involved in up to 25% of HNCs; particularly in the oropharyngeal carcinoma (OPC) subtype where it can account for up to 60% of such cases. HPVs are double-stranded DNA viruses that infect epithelial cells; numerous HPV subtypes, including 16, 18, 31, 33, and 35, drive epithelial cell transformation and tumourigenesis. HPV positive (HPV+) HNC represents a distinct molecular and clinical entity from HPV negative (HPV−) disease; the biological basis for which remains to be fully elucidated. HPV positivity is strongly correlated with a significantly superior outcome; indicating that such tumours should have a distinct management approach. This review focuses on the recent scientific and clinical investigation of HPV+ HNC. In particular, we discuss the importance of molecular and clinical evidence for defining the role of HPV in HNC, and the clinical impact of HPV status as a biomarker for HNC.

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Section: Therapeutic Perspectives: Treatment Of Hpv+ Hnc As a Distmentioning

confidence: 99%

HPV Associated Head and Neck Cancer

Spence

Bruce

Yip

et al. 2016

Cancers

112

108

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“…Initially, prostate cancer was treated with IMRT to prevent adverse effects on the rectum [5]. Many patients treated with radiotherapy for head and neck malignancies suffer from xerostomia, which causes reductions of patient quality of life, including difficulty of speaking and swallowing, as well as taste loss and oral infections [2]. There have been several attempts to reduce radiation damage to the major salivary glands in radiotherapy [3, 4].…”

Section: Discussionmentioning

confidence: 99%

“…Despite advances in radiotherapy equipment and irradiation technology, morbidity related to radiotherapy is not completely avoidable [1]. Xerostomia is a common adverse effect of radiotherapy for head and neck tumors, and results in reduced patient quality of life by inducing dysphagia, dysgeusia, caries, and periodontitis [2]. In recent years, our hospital has used intensity-modulated radiotherapy (IMRT) for patients with head and neck tumors to enable preservation of the major salivary glands.…”

Section: Introductionmentioning

confidence: 99%

Changes in parotid gland morphology and function in patients treated with intensity-modulated radiotherapy for nasopharyngeal and oropharyngeal tumors

Obinata

Nakamura²,

Carrozzo

et al. 2013

Oral Radiol

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ObjectiveTo evaluate the morphological changes of the parotid glands in patients treated with intensity-modulated radiotherapy (IMRT) for nasopharyngeal and oropharyngeal tumors and the correlations with parotid function.MethodsTen patients with nasopharyngeal and oropharyngeal tumors treated with IMRT between May 2009 and January 2010 at Hokkaido University Hospital were included in this study. In the morphological assessment of the parotid glands, the sizes and computed tomography (CT) numbers of the bilateral parotid glands before and after IMRT with CT were calculated. For functional assessment of the parotid glands, we conducted the Saxon test and used a visual analog scale (VAS) for xerostomia evaluation.ResultsReductions in saliva secretion were observed in the patients treated with IMRT for nasopharyngeal and oropharyngeal tumors, and there was a significant correlation between the reduction in saliva secretion and the VAS. The reductions in the parotid gland size and CT number were larger on the ipsilateral side than on the contralateral side. The reduction in saliva secretion was not significantly correlated with the reduction in parotid gland size, but was significantly correlated with the reduction in CT number.ConclusionsMorphological and functional changes of the parotid glands were observed after IMRT for nasopharyngeal and oropharyngeal tumors, and preservation of the contralateral parotid glands was only partly achieved. Among the morphological changes of the parotid glands, the CT number may be considered a predictor of parotid function after radiotherapy.

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“…If the conditions of low pH are repeated on a regular basis, then the balance of the microbiota can be significantly disrupted, resulting in increased numbers and proportions of acid-producing bacteria, thereby increasing the risk of caries still further. Similar effects would result if saliva flow was impaired or its composition was altered, for example, as a result of medical interventions or as a side-effect of a number of medications [37,38].…”

Section: Reduce Microbial Acid Productionmentioning

confidence: 94%