Treatment of late sequelae after radiotherapy for head and neck cancer

• Type of Material: Article
• Authors: Primož Strojan, Institute of Oncology; Katherine A. Hutcheson, MD Anderson Cancer Center; Avraham Eisbruch, University of Michigan; Jonathan J Beitler, Emory University; Johannes A. Langendijk, University of Groningen; Anne W. M. Lee, University of Hong Kong; June Corry, Peter MacCallum Cancer Centre; William M. Mendenhall, University of Florida; Robert Smee, The Prince of Wales Cancer Centre; Alessandra Rinaldo, University of Udine; Alfio Ferlito, International Head and Neck Scientific Group
• Language: English
• Date: 2017-09-01
• Publisher: Elsevier: 12 months
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 Elsevier Ltd
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.ctrv.2017.07.003
• Title of Journal or Parent Work: Cancer Treatment Reviews
• ISSN: 0305-7372
• Volume: 59
• Start Page: 79
• End Page: 92
• Grant/Funding Information: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
• Keywords: Late sequelae; HYPERBARIC-OXYGEN THERAPY; ADENOVIRAL-MEDIATED TRANSFER; Science & Technology; SENSORINEURAL HEARING-LOSS; Radiotherapy; QUALITY-OF-LIFE; Treatment; IRRADIATION-INDUCED HYPOSALIVATION; LOCALLY ADVANCED HEAD; RADIATION-INDUCED XEROSTOMIA; INDUCED SALIVARY HYPOFUNCTION; Head and neck cancer; FREE-FLAP RECONSTRUCTION; Oncology; INTENSITY-MODULATED RADIOTHERAPY; Toxicity; Life Sciences & Biomedicine
• Research Categories: Biology, Radiation; Health Sciences, Oncology

Abstract

Radiotherapy (RT) is used to treat approximately 80% of patients with cancer of the head and neck. Despite enormous advances in RT planning and delivery, a significant number of patients will experience radiation-associated toxicities, especially those treated with concurrent systemic agents. Many effective management options are available for acute RT-associated toxicities, but treatment options are much more limited and of variable benefit among patients who develop late sequelae after RT. The adverse impact of developing late tissue damage in irradiated patients may range from bothersome symptoms that negatively affect their quality of life to severe life-threatening complications. In the region of the head and neck, among the most problematic late effects are impaired function of the salivary glands and swallowing apparatus. Other tissues and structures in the region may be at risk, depending mainly on the location of the irradiated tumor relative to the mandible and hearing apparatus. Here, we review the available evidence on the use of different therapeutic strategies to alleviate common late sequelae of RT in head and neck cancer patients, with a focus on the critical assessment of the treatment options for xerostomia, dysphagia, mandibular osteoradionecrosis, trismus, and hearing loss.