The effect of customized beam shaping on normal tissue complications in radiation therapy of parotid gland tumors

Keus, Ronald B.; Noach, P.; Boer, Renate de; Lebesque, Joos V.

doi:10.1016/0167-8140(91)90039-j

Cited by 18 publications

(12 citation statements)

References 8 publications

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“…Modification of radiation portals may lead to sufficient reduction in the dose delivered to the EAC that the incidence of EAC stenosis may be attenuated without compromising therapeutic effect on the target tissues. 25 The accessible nature of the EAC may also allow for treatment (i.e., ototopical preparations) directed at the underlying inflammatory response. The relatively high rate of EAC stenosis complicating combined EBRT and periauricular surgery suggests that consideration should be given to possible prophylactic measures.…”

Section: Discussionmentioning

confidence: 99%

External Auditory Canal Stenosis After Radiation Therapy

et al. 2002

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Section: Discussionmentioning

confidence: 99%

External Auditory Canal Stenosis After Radiation Therapy

et al. 2002

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“…Radiation shields (intraoral devices), midline mucosa-sparing blocks, 3-D and RT field design, intensity-modulated radiation therapy (IMRT), and removal of separable prosthetics are shown in preclinical studies to reduce the radiation scatter and the RIOM injury (66–69). …”

Section: Prevention Of Riommentioning

confidence: 99%

Radiation-Induced Oral Mucositis

2017

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Radiation-induced oral mucositis (RIOM) is a major dose-limiting toxicity in head and neck cancer patients. It is a normal tissue injury caused by radiation/radiotherapy (RT), which has marked adverse effects on patient quality of life and cancer therapy continuity. It is a challenge for radiation oncologists since it leads to cancer therapy interruption, poor local tumor control, and changes in dose fractionation. RIOM occurs in 100% of altered fractionation radiotherapy head and neck cancer patients. In the United Sates, its economic cost was estimated to reach 17,000.00 USD per patient with head and neck cancers. This review will discuss RIOM definition, epidemiology, impact and side effects, pathogenesis, scoring scales, diagnosis, differential diagnosis, prevention, and treatment.

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“…Patients should refrain from smoking. yes/yes/no P instructions on oral care significant reduction Rugg et al 32 no/no/no P smoking during RT higher mucositis incidence in smokers CT Greenberg et al 44 no/yes/no P dental treatment prior to CT significant reduction of septicemia CT+RT Sonis et al 36 no/no/no P early and aggressive reduced frequency of oral complications dental intervention BMT Peters et al 52 no/no/no P treatment of asymptomatic no difference in infectious complications periapical radiolucencies BMT Borowski et al 35 yes/yes/no P intensive vs. regular oral care significant reduction of mucositis but not septicemia b) Radiation shields RT Perch et al 106 no/no/no P midline mucosa sparing blocks decreased mucositis without affecting tumor control Keus et al 104 no/yes/no P customized beam shaping lower incidence of mucositis c) Soft lasers BMT Barasch et al 109 yes/yes/no P laser on one buccal side, significant reduction placebo light to the other Cowen et al 110 yes/yes/no P laser vs. no treatment significant reduction of incidence CT Ciais et al 107 no/yes/no P+T soft laser treatment lowers incidence and alleviates course of mucositis d) Cryotherapy CT Mahood et al 67 yes/yes/no P oral cryotherapy vs. no significant lower incidence prophylaxis Rocke et al 65 yes/yes/no P 30 vs. 60 minutes of equivalent cryotherapy during Cascinu et al 66 yes/yes/no P oral cryotherapy vs. no significant lower incidence prophylaxis Edelman et al 68 no/yes/no P ice chips during dose escalation lower incidence of mucositis of edatrexate Gandara et al 69 no/yes/no P ice chips during edatrexatelower incidence of severe mucositis based CT 2. Locally applied pharmacotherapeutics e) Mouth-coating agents Sucralfate CT Loprinzi et al 130 yes/yes/yes T sucralfate vs. placebo after no difference cryoprophylaxis RT Scherlacher et al 120 yes/yes/no P sucralfate vs. standard oral significant reduction of incidence and hygiene severity of mucositis Throughout treatment, elimination of apparent infectious foci, mostly through extraction of teeth with infected pulp, has to be emphasized-even in myelosuppressed patients.…”

Section: Oral Mucositis Complicating Chemotherapy And/or Radiotherapymentioning

confidence: 99%

Oral Mucositis Complicating Chemotherapy and/or Radiotherapy: Options for Prevention and Treatment

Köstler

Hejna

Wenzel

et al. 2001

CA: A Cancer Journal for Clinicians

289

252

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The incidence and severity of oral mucositis is influenced by the type of antineoplastic treatment administered and by patient-related factors. Severe courses of oral mucositis are observed during simultaneous radiochemotherapy, which Oral Mucositis Complicating Chemotherapy and/or Radiotherapy: Options for Prevention and TreatmentWolfgang J. Köstler, MD; Michael Hejna, MD; Catharina Wenzel, MD; and Christoph C. Zielinski, MD 290 CA A Cancer Journal for Clinicians ABSTRACT Chemotherapy-and radiotherapy-induced oral mucositis represents a therapeutic challenge frequently encountered in cancer patients. This side effect causes significant morbidity and may delay the treatment plan, as well as increase therapeutic expenses.The pathogenesis of this debilitating side effect can be attributed to the direct mucosal toxicity of cytotoxic agents and ionizing radiation and to indirect mucosal damage caused by a concomitant inflammatory reaction exacerbated in the presence of neutropenia, and the emergence of bacterial, mycotic, and viral infections. affects virtually all patients with head and neck cancer who receive this therapeutic modality. 8 However, up to 40% of patients treated with conventional chemotherapy and the more than 70% of patients undergoing conditioning therapy for bone marrow transplantation also experience oral treatment-related complications. 9,10The pathogenesis of oral mucositis is not fully understood, yet it is thought to involve direct and indirect mechanisms. Direct mucosal injury by radiation and chemotherapy interfere with the average 5-to 14-day turnover time of the oral epithelium 11 and induce apoptosis. Indirect stomatotoxic effects that result from the release of inflammatory mediators, loss of protective salivary constituents, and therapyinduced neutropenia have been postulated to contribute to the development of oral mucositis and also promote the emergence of bacteria, fungi, and viruses on damaged mucosa.12 Although a linear relationship among the occurrence of oral mucositis, oral and systemic granulocyte counts, and a coincidence of resolution of mucositis with neutrophil recovery, has been demonstrated, 10,[13][14][15] significant mucositis can occur in the absence of myelotoxicity. 16,17 In addition, the prophylactic or therapeutic elimination of the pathogenic mucosal flora frequently observed in patients developing oral mucositis by various antiseptic and antimicrobial agents can at most alleviate the course of oral mucositis (see Antimicrobal Agents p. 302).Based upon these considerations, newer pathophysiologic concepts have emerged characterizing oral mucositis as having an initial inflammatory/vascular phase, an epithelial phase, a (pseudomembraneous) ulcerative/bacteriological phase and a healing phase.18 During the inflammatory phase, tissue injury induces release of free radicals, modified proteins and proinflammatory cytokines including interleukin-1β, prostaglandins and tumor necrosis factor-α (TNF-α) by epithelial, endothelial, and connective tissue cells. These ...

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The effect of customized beam shaping on normal tissue complications in radiation therapy of parotid gland tumors

Cited by 18 publications

References 8 publications

External Auditory Canal Stenosis After Radiation Therapy

External Auditory Canal Stenosis After Radiation Therapy

Radiation-Induced Oral Mucositis

Oral Mucositis Complicating Chemotherapy and/or Radiotherapy: Options for Prevention and Treatment

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