Radiation treatment of soft palate squamous cell carcinoma

Rapp, Cooper T.; Chera, Bhishamjit S.; Morris, Christopher G.; Amdur, Robert J.; Kirwan, Jessica; Mendenhall, William M.

doi:10.1002/hed.26035

Cited by 6 publications

(5 citation statements)

References 22 publications

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“…Most patients with head and neck carcinomas treated with curative intent receive a dose of 2 Gy per fraction delivered five times per week, up to a total dose of 64–70 Gy (Bourhis et al, 2005 ). Although there are no guidelines on the dental management of patients with planned radiotherapy of the head and neck region, it is generally acknowledged that dental management should consider the region and radiation dose planned, as the severity of oral complications is related to the daily and total cumulative dose of radiation (Haussmann et al, 2019 ; Rapp et al, 2020 ; Sciubba & Goldenberg, 2006 ). Moreover, the prevention of dental complications should include oral hygiene instruction, scaling, cleaning, and intensive fluoridation.…”

Section: Discussionmentioning

confidence: 99%

Dental management before radiotherapy of the head and neck region: 4‐year single‐center experience

Hoffmann

Marschner

Kakoschke

et al. 2022

Clinical & Exp Dental Res

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Objective: To review our experience with a standardized dental management approach in patients with planned radiotherapy of the head and neck region based on preradiation and follow-up data.Material and Methods: Records of patients who underwent radiotherapy between June 2016 and November 2020 were reviewed. Data on dental findings and therapeutic recommendations were extracted from a prospectively managed database. Hospital records were used to obtain follow-up data.Results: Two hundred eighty-one patient records were identified. After the exclusion of 81 patients because of incomplete data, 200 patients were included in the study. Dental findings relevant to radiotherapy were found in 144 cases (72.0%). Teeth extractions were recommended in 112 (56.0%) patients. Follow-up data were available for 172 (86.0%) patients (mean follow-up: 16.8 ± 10.7 months).Radiodermatitis was the most frequently observed sequela of radiotherapy (42.4%), followed by dysphagia (38.4%) and stomatitis (36.6%). Osteoradionecrosis was observed in only 2.3% of the patients. Conclusion:Dental findings relevant to planned radiotherapy were frequent and in many cases resulted in recommendations for teeth extraction. Based on our standardized dental management protocol, we observed low rates of late oral complications after radiotherapy of the head and neck region.dental management, follow-up, oral cancer, radiotherapy | INTRODUCTIONRadiotherapy is a standard form of treatment for many head and neck tumors. Depending on the tumor entity, size, stage, localization, grade, resection status, and patient comorbidities, radiotherapy can be applied as an adjuvant or alternative to surgery. Where indicated, it can be combined with chemotherapy (Koga et al., 2008). Radiotherapy leads to a decreased proliferation rate or even apoptosis: the tumor stops growing or decays. Nevertheless, the cell-damaging effects of radiation therapy are nonspecific, and the tumorsurrounding tissue (i.e., oral mucosa, salivary glands, maxillary and mandibular bone, teeth, and masticatory muscles) is affected as well

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Section: Discussionmentioning

confidence: 99%

Dental management before radiotherapy of the head and neck region: 4‐year single‐center experience

Hoffmann

Marschner

Kakoschke

et al. 2022

Clinical & Exp Dental Res

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“…Soft palate tumors represent fewer than 15% of such cancers [2,3]. Malignant soft palate tumors are commonly squamous cell carcinomas and are treated via chemoradiotherapy, radiotherapy, and/or surgery [4,5]. Soft palate defects trigger velopharyngeal insufficiency associated with airflow escape, affecting swallowing (thus creating dysphagia) and speech (the vocal quality becomes hypernasal and intelligibility is compromised) [6][7][8].…”

Section: Background and Rationale {6a}mentioning

confidence: 99%

Efficacy of a new membrane obturator prosthesis in terms of speech, swallowing, and the quality of life of patients with acquired soft palate defects: study protocol of the VELOMEMBRANE randomized crossover trial

Naveau

Krêt

Plaire

et al. 2022

Trials

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Background Soft palate defects created during oral cancer surgery may prevent complete palatal closure and trigger palatopharyngeal insufficiency. One current treatment employs a rigid obturator prosthesis; an extension of acrylic resin at the level of the hard palate ensures surface contact with the remaining musculature. Unfortunately, airflow escape often causes hypernasality, compromises speech intelligibility, and creates swallowing problems (including leakage of food and fluid into the nasal airway). We plan to test a new removable denture featuring a thick dental dam that serves as a membrane obturator. The principal objective of the clinical trial is a comparison of speech handicap levels after 1 month in patients with acquired velar insufficiencies who wear either the new device or a conventional, rigid obturator. The secondary objectives are between-device comparisons of the swallowing handicaps and the health-related qualities of life. Methods The VELOMEMBRANE trial is a superiority, open-labeled, two-way, random crossover clinical trial. Adult patients exhibiting velar or palatovelar substance loss after tumor excision and who are indicated for rigid obturator-mediated prosthetic rehabilitation will be recruited in two teaching hospitals in France. Fourteen participants will be randomly allocated to wear both prostheses for 1-month periods in either order. The new membrane obturator is a removable resin prosthesis incorporating a rigid extension that holds a dental dam to restore the soft palate. The primary outcome will be the extent of phonation-related disability (the overall score on the Voice Handicap Index [VHI]). The secondary outcomes will be the Deglutition Handicap Index and health-related quality of life scores of the European Organization for Research and Treatment of Cancer (EORTC). Discussion High-quality evidence will be provided to document the utility of a new medical device that may greatly improve the management and quality of life of patients with acquired velar insufficiency. Trial registration ClinicalTrials.govNCT04009811. Registered on 4 July 2019

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“…Sin embargo, siendo el paladar blando una sublocalización de la orofaringe, los carcinomas suelen ser VPH negativos [3]. Se desconoce la razón por la que esto es así y algunos autores suponen que se debe a la ausencia de tejido linfoide en el paladar blando [10]. En nuestra serie, los tumores de paladar blando representaban el 35% de los tumores de orofaringe.…”

Section: Descripciónunclassified

Carcinoma de paladar blando. Descripción de una serie de casos

Zabaleta-López

Ramos-Casademont

Gómez-Tomé

et al. 2020

ORL

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Conflicto de intereses: Los autores declaran no tener conflictos de intereses Imágenes: Los autores declaran haber obtenido las imágenes con el permiso de los pacientes Política de derechos y autoarchivo: se permite el autoarchivo de la versión post-print (SHERPA/RoMEO) Licencia CC BY-NC-ND. Licencia Creative Commons Atribución-NoComercial-SinDerivar 4.0 Internacional Universidad de Salamanca. Su comercialización está sujeta al permiso del editor RESUMEN Introducción y objetivo: Describir las características clínicas, anatómicas y el tratamiento quirúrgico, incluyendo las distintas opciones de reconstrucción de los tumores de paladar blando. Descripción: Estudio retrospectivo de 6 pacientes diagnosticados y tratados en el servicio de Otorrinolaringología del hospital San Pedro de Logroño entre los años 2018 y 2019. Discusión: Exponemos los resultados de nuestros pacientes y realizamos una revisión de los tumores de orofaringe localizados en el paladar blando, los detalles anatómicos y técnicas quirúrgicas reconstructivas más utilizadas en el tratamiento quirúrgico de los tumores de paladar blando. Conclusiones: La prevalencia de los tumores de orofaringe ha aumentado en los últimos años a expensas de la infección por el virus del papiloma humano (VPH). Sin embargo, los carcinomas de paladar blando son mayoritariamente P16 negativos. Estos tumores son poco sintomáticos en fases iniciales y es necesario un alto índice de sospecha para evitar diagnósticos tardíos. El desarrollo de la cirugía transoral ha impulsado el tratamiento quirúrgico de los tumores de paladar blando y puede reducir la necesidad de tratamientos complementarios hasta en un 40% de los casos. La reconstrucción se hace necesaria en resecciones mayores del 50%. PALABRAS CLAVE Anatomía; carcinoma; orofaringe; paladar blando; procedimientos quirúrgicos reconstructivos SUMMARY Introduction and objective: To describe clinical and anatomical features, and surgical treatment including several techniques of reconstructive surgery of soft palate carcinomas. Description: We conducted a retrospective study with 5 patients. All of them were diagnosed and treated in our department during 2018 and 2019. Discussion: We present our results and make a review on soft palate tumors pointing out anatomical details and most employed reconstructive surgical techniques for soft palate carcinoma´s removal. Conclusions: The incidence of oropharyngeal carcinoma is increasing worldwide essentially due to increasing prevalence of human

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Radiation treatment of soft palate squamous cell carcinoma

Cited by 6 publications

References 22 publications

Dental management before radiotherapy of the head and neck region: 4‐year single‐center experience

Dental management before radiotherapy of the head and neck region: 4‐year single‐center experience

Efficacy of a new membrane obturator prosthesis in terms of speech, swallowing, and the quality of life of patients with acquired soft palate defects: study protocol of the VELOMEMBRANE randomized crossover trial

Carcinoma de paladar blando. Descripción de una serie de casos

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