Proton Therapy for Head and Neck Cancer

Kim, Joseph K.; Leeman, Jonathan E.; Riaz, Nadeem; McBride, Sean; Tsai, C. Jillian; Lee, Nancy Y.

doi:10.1007/s11864-018-0546-9

Cited by 55 publications

(59 citation statements)

References 43 publications

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“…PBT has shown optimal tumor conformality, thereby providing a significant merit in dosimetry in the desired tumor volume and minimal or no exit radiation to surrounding normal and/or critical structures. PBT therapy may also function as an alternative RT modality to improve survival outcomes with fewer adverse effects in patients with recurrence of their HNC and who were being previously treated with IMRT 8,128 …”

Section: Discussionmentioning

confidence: 99%

“…The intensity, progression, and subsequent permanency of the side effects are influenced by RT planning (radical RT with or without chemotherapy, accelerated hyperfraction, IMRT, and proton beam therapy), cumulative radiation dose, volume, degree of vascularity, repair potential, and cellularity of the tissue being irradiated, age of patient, and concurrent use of drugs for chemotherapy 2,6‐8 …”

Section: Introductionmentioning

confidence: 99%

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Radiotherapy‐induced oral morbidities in head and neck cancer patients

Bhandari

Soni

Bahl

et al. 2020

Special Care in Dentistry

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The cumulative effect of radiation and the extent of related morbidities on oral tissues are enormous and increase over time. The numerous radiation-related side effects have a strong, negative influence on the oral functions and are responsible for a drastic reduction in the oral-health-related quality of life of the cancer survivors. In a significant deviation to the earlier approach of advising extraction of all remaining teeth before RT, the concept of preserving a maximum number of teeth in a state of health and for better oral functions postcancer cure has been globally accepted and is adhered to. The effects of radiation and their impact on the general well-being of the patients underscore the relevance of understanding the sequelae of radiation therapy on healthy oral tissues, preexisting oral diseases and their progression, impact on oral treatment needs, limitations in performing the indicated treatment, and shortcoming in treatment outcomes. It is vital for the professionals involved in head and neck cancer care to follow a well-devised referral system for oral care before and after RT and educate patients for a life-long follow-up K E Y W O R D S head and neck cancer, oral health, osteoradionecrosis, radiation caries, radiotherapy, trismus 238 wileyonlinelibrary.com/journal/scd Spec Care Dentist. 2020;40:238-250.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Radiotherapy‐induced oral morbidities in head and neck cancer patients

Bhandari

Soni

Bahl

et al. 2020

Special Care in Dentistry

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“…All the patients received photon-beam intensity-modulated radiation therapy (IMRT). IMRT is inherently limited by the physical properties of the photon beam, resulting in unavoidable irradiation of normal tissues at low to moderate doses even at substantial distances from the tumor [15]. In the present study, a minimum distance of 5 mm around the clinical target volume was required to de ne each planning target volume.…”

Section: Cancer and Rt Datamentioning

confidence: 94%

Hypothyroidism and Risks of Cerebrovascular Complications Among Patients with Head and Neck Cancer After Radiotherapy

Liu

Chang

Lee

et al. 2020

Preprint

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Background: Hypothyroidism (HT) and carotid artery stenosis (CAS) are complications of radiotherapy (RT) in patients with head and neck cancer (HNC). The impact of post-RT HT on CAS progression remains unclear.Methods: Between 2013 and 2014, HNC patients who had ever received RT and were under regular follow-up in our hospital were initially screened. Patients were categorized into euthyroid (EU) and HT groups. Details of RT and HNC were recorded. Total plaque scores and degrees of CAS were measured during annual extracranial duplex follow-up. Patients were monitored for CAS progression to >50% stenosis or ischemic stroke (IS). Cumulative time to CAS progression and IS between the 2 groups were compared. Data were further analyzed based on the use or nonuse of thyroxine of the HT group.Results: 333 HNC patients with RT history were screened. Finally, 216 patients were recruited (94 and 122 patients in the EU and HT groups). Patients of the HT group received higher mean RT doses (HT vs. EU; 7021.55 ± 401.67 vs. 6869.69 ± 425.32 centi-grays, p = 0.02). Multivariate Cox models showed comparable CAS progression (p = 0.24) and IS occurrence (p = 0.51) between the 2 groups. Moreover, no significant difference was observed in time to CAS progression (p = 0.49) or IS (p = 0.31) among patients with EU and HT using and not using thyroxine supplement.Conclusion: Our results did not demonstrate significant effects of HT and thyroxine supplementation on CAS progression and IS incidence in patients with HNC after RT.

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“…The use of intensity modulated radiotherapy (IMRT), which adjusts the dose to the tumor's size, has significantly reduced but not completely eliminated the risk of late toxicity including xerostomia, cariës, trismus, and osteoradionecrosis (21). The evolution of upcoming radiation modalities such as proton-based radiotherapy with better selectivity of the tissue to be irradiated might help reducing further these toxicities (22,23).…”

Section: Dental Care For Hnc Patientsmentioning

confidence: 99%

The Multidisciplinary Team (MDT) Approach and Quality of Care

et al. 2020

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The core function of a multidisciplinary team (MDT) is to bring together a group of healthcare professionals from different fields in order to determine patients' treatment plan. Most of head and neck cancer (HNC) units are currently led by MDTs that at least include ENT and maxillofacial surgeons, radiation and medical oncologists. HNC often compromise relevant structures of the upper aerodigestive tract involving functions such as speech, swallowing and breathing, among others. The impairment of these functions can significantly impact patients' quality of life and psychosocial status, and highlights the crucial role of specialized nurses, dietitians, psycho-oncologists, social workers, and onco-geriatricians, among others. Hence, these professionals should be integrated in HNC MDTs. In addition, involving translational research teams should also be considered, as it will help reducing the existing gap between basic research and the daily clinical practice. The aim of this comprehensive review is to assess the role of the different supportive disciplines integrated in an MDT and how they help providing a better care to HNC patients during diagnosis, treatment and follow up.

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Proton Therapy for Head and Neck Cancer

Cited by 55 publications

References 43 publications

Radiotherapy‐induced oral morbidities in head and neck cancer patients

Radiotherapy‐induced oral morbidities in head and neck cancer patients

Hypothyroidism and Risks of Cerebrovascular Complications Among Patients with Head and Neck Cancer After Radiotherapy

The Multidisciplinary Team (MDT) Approach and Quality of Care

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