Oral Complications of Head and Neck Cancer Therapy

Abstract

Current therapies for Head and Neck cancer treatment are extremely advanced. Though, they cause oral complications which have deleterious effects on basic life functions, affect oral and overall health, may lead to significant morbidity and treatment discontinuation and have an impact on survivorship and quality of life. As new therapies are introduced, a new spectrum of oral complications is rising, compromising the mucosal integrity and the salivary function, that may not be recognized, reported and treated properly. Oral complications, often permanent and extremely painful, may include mucositis, xerostomia, dysgeusia, infections, trismus and fibrosis, risk of dental disease and necrosis of the jaw, neurosensory disorders and when targeted therapies and immunotherapy are involved, aphthoid and lichenoid lesions can also be reported. Increased awareness is required for the prevention and management of these complications, which can be best provided by a multidisciplinary team.

Pharmacological Management of Neuropathic Pain after Radiotherapy in Head and Neck Cancer Patients: A Systematic Review

“…In HNC patients, pain may be nociceptive, but more frequently, it has one or more neuropathic components [ 4 , 5 , 6 ]. In most of the cases, it is caused by cancer therapy and may develop following radiotherapy (RT), targeted therapy, and/or immunotherapy [ 7 , 8 , 9 ].…”

“…In most of the cases, it is caused by cancer therapy and may develop following radiotherapy (RT), targeted therapy, and/or immunotherapy [ 7 , 8 , 9 ]. Oral mucositis (OM) is a frequent complication of these therapies, typically manifesting as erythema or ulcerations [ 4 ]. Oral mucositis-induced pain (OMP) is described by HNC patients as one of the most devastating side effects of RT.…”

“…It results in patient distress and suffering and may be responsible for the necessity to use feeding tubes, the administration of opioid medication, treatment interruptions, hospitalizations, and increased medical costs [ 10 , 11 ]. Even though the severity of OMP is often related to OM, due to mucosal atrophy and ulceration [ 11 , 12 ], some studies have not found such a relationship [ 4 , 13 , 14 ].…”

“…NP is a well-recognized problem in HNC patients [ 4 , 5 ]; treatment-induced polyneuropathy [ 15 ] and OMP are associated with NP [ 4 , 5 , 10 , 16 ]. Around 20% of HNC patients under RT develop NP [ 4 , 6 ].…”

“…NP is a well-recognized problem in HNC patients [ 4 , 5 ]; treatment-induced polyneuropathy [ 15 ] and OMP are associated with NP [ 4 , 5 , 10 , 16 ]. Around 20% of HNC patients under RT develop NP [ 4 , 6 ]. The actual therapy-related neuron damage as well as persistent unrelieved pain induced by the ulcers of OM can exacerbate the dysfunction in the nervous system, producing NP.…”