Treatment of late sequelae after radiotherapy for head and neck cancer

Primož Strojan, Katherine A Hutcheson, Avraham Eisbruch, Jonathan J Beitler, Johannes A Langendijk, Anne W M Lee, June Corry, William M Mendenhall, Robert Smee, Alessandra Rinaldo, Alfio Ferlito

Research output: Contribution to journalReview articleAcademicpeer-review

88 Citations (Scopus)

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. (C) 2017 Elsevier Ltd. All rights reserved.

Original languageEnglish
Pages (from-to)79-92
Number of pages14
JournalCANCER TREATMENT REVIEWS
Volume59
Early online date18-Jul-2017
DOIs
Publication statusPublished - Sep-2017

Keywords

  • Head and neck cancer
  • Radiotherapy
  • Toxicity
  • Late sequelae
  • Treatment
  • QUALITY-OF-LIFE
  • RADIATION-INDUCED XEROSTOMIA
  • HYPERBARIC-OXYGEN THERAPY
  • INTENSITY-MODULATED RADIOTHERAPY
  • LOCALLY ADVANCED HEAD
  • IRRADIATION-INDUCED HYPOSALIVATION
  • INDUCED SALIVARY HYPOFUNCTION
  • ADENOVIRAL-MEDIATED TRANSFER
  • SENSORINEURAL HEARING-LOSS
  • FREE-FLAP RECONSTRUCTION

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