Radiation‐induced nausea and vomiting in head and neck cancer: Is it something worth considering in the intensity modulated radiotherapy era? “A narrative review”

Abstract

Radiation therapy is one of the cornerstones in the treatment of head and neck squamous cell carcinomas (HNSCC), alone or in combination with chemotherapy or surgery. Technological advances which occurred over the last few decades have increased the efficacy of radiotherapy (RT), particularly, intensity-modulated RT (IMRT). IMRT can deliver treatments on complex tumoral targets with dose escalation while sparing organs at risk; anyway IMRT deposits dose in unpredictable patterns outside of the target volume with the purpose of improving conformality.Radiation-induced nausea and vomiting (RINV) is a frequent albeit neglected side effect of RT that can lead to delays in treatment with serious consequences on cure rates. According to several guidelines (MASCC 2016, NCCN 2018, RT for HNSCC has traditionally been regarded as a low emetic risk treatment. Nevertheless, several works suggest that IMRT could increase RINV. Further studies are needed to define the exact incidence and the detailed pathophysiology of RINV in patients with HNSCC treated with state of art IMRT techniques, with and without concurrent chemotherapy. K E Y W O R D Shead and neck cancer, intensity modulated Radiation therapy, organ at risk, predictor factors, radiation induced nausea and vomiting

A Systematic Review and Meta-Analysis on the Efficacy of Curcumin/Turmeric for the Prevention and Amelioration of Radiotherapy/Radiochemotherapy Induced Oral Mucositis in Head and Neck Cancer Patients

“…Systemic chemotherapy, radiotherapy or both have become more effective for managing head and neck carcinoma, but they are related with short and long term side-effects (Paiar et al, 2020). Oral mucositis is a common short term side effect that are painful inflammation and ulceration of oral-pharyngeal mucosa (Sonis et al, 2004).…”

Impact of honey on radiotherapy-induced oral mucositis in patients with head and neck cancer: a systematic review and meta-analysis

“…Head and neck cancers (HNC) are the sixth most common cancer around the world (1), with estimated new cases of 710,000 in 2018 (2). Radiotherapy (RT) alone or in combination with chemotherapy or surgery remains a cornerstone in treating HNC (3). Unfortunately, RT also damages epithelium and submucosal connective tissue and then causes inflammation (4).…”

Predictive Factors of Crucial Nutrition Impact Symptom Clusters in Patients With Head and Neck Cancer Undergoing Radiotherapy

“…Xiao et al [17] also found that women were more likely to get severe gastrointestinal symptom clusters. RT and chemotherapy drugs could both conduct an impact on the central nervous system (dorsal vagal complex) and elevate levels of 5-hydroxytryptamine that involves in the generation of nausea and vomiting [41,42], so participants accepted concurrent chemoradiotherapy experienced severe upper gastrointestinal symptom clusters. As a result, clinical practitioners could identify patients at risk of severe upper gastrointestinal symptom cluster, and then provide early prevention measures for nausea and vomiting.…”