Long-term toxicities in 10-year survivors of radiation treatment for head and neck cancer.

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Abstrakt

Tytuł:: Long-term toxicities in 10-year survivors of radiation treatment for head and neck cancer.
Autorzy:: Dong Y; Departments of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA, United States.
Ridge JA; Departments of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, United States.
Li T; Departments of Biostatistics, Fox Chase Cancer Center, Philadelphia, PA, United States.
Lango MN; Departments of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, United States.
Churilla TM; Departments of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA, United States.
Bauman JR; Departments of Medical Oncology, Fox Chase Cancer Center, Philadelphia, PA, United States.
Galloway TJ; Departments of Radiation Oncology, Fox Chase Cancer Center, Philadelphia, PA, United States. Electronic address: .
Źródło:: Oral oncology [Oral Oncol] 2017 Aug; Vol. 71, pp. 122-128. Date of Electronic Publication: 2017 Jun 23.
Typ publikacji:: Journal Article; Research Support, N.I.H., Extramural
Język:: English
Imprint Name(s):: Publication: Amsterdam : Elsevier
Original Publication: Oxford ; New York : Pergamon, c1997-
MeSH Terms:: Survivors*
Head and Neck Neoplasms/*radiotherapy
Radiotherapy/*adverse effects
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Chemoradiotherapy ; Female ; Head and Neck Neoplasms/drug therapy ; Humans ; Male ; Middle Aged ; Young Adult
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Grant Information:: P30 CA006927 United States CA NCI NIH HHS
Contributed Indexing:: Keywords: 10-Year survivorship; Chemoradiation; HNC; Long-term toxicity; Radiation
Entry Date(s):: Date Created: 20170710 Date Completed: 20180502 Latest Revision: 20201020
Update Code:: 20240104
PubMed Central ID:: PMC7570432
DOI:: 10.1016/j.oraloncology.2017.05.009
PMID:: 28688679
: Czasopismo naukowe

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Objectives: To characterize the recognized but poorly understood long-term toxicities of radiation therapy (RT) for head and neck cancer (HNC).
Materials and Methods: We retrospectively evaluated patients treated with curative-intent RT for HNC between 1990 and 2005 at a single institution with systematic multidisciplinary follow-up ≥10years. Long-term toxicities of the upper aerodigestive tract were recorded and assigned to two broad categories: pharyngeal-laryngeal and oral cavity toxicity. Kaplan-Meier estimates and Chi-square tests were used for univariable analysis (UVA). Cox model and logistic regression were used for multivariable analysis (MVA).
Results: We identified 112 patients with follow-up ≥10years (median 12.2). The primary tumor sites were pharynx (42%), oral cavity (34%), larynx (13%), and other (11%). Forty-four percent received postoperative RT, 24% had post-RT neck dissection, and 47% received chemotherapy. Twenty-eight (25%) patients developed pharyngeal-laryngeal toxicity, including 23 (21%) requiring permanent G-tube placed at median of 5.6years (0-20.3) post-RT. Fifty-three (47%) developed oral cavity toxicity, including osteoradionecrosis in 25 (22%) at a median of 7.2years (0.5-15.3) post-RT. On MVA, pharyngeal-laryngeal toxicity was significantly associated with chemotherapy (HR 3.24, CI 1.10-9.49) and age (HR 1.04, CI 1.00-1.08); oral cavity toxicity was significantly associated with chemotherapy (OR 4.40, CI 1.51-12.9), oral cavity primary (OR 5.03, CI 1.57-16.1), and age (OR 0.96, CI 0.92-1.00).
Conclusion: Among irradiated HNC patients, pharyngeal-laryngeal and oral cavity toxicity commonly occur years after radiation, especially in those treated with chemotherapy. Follow-up for more than five years is essential because these significant problems afflict patients who have been cured.
(Copyright © 2017 Elsevier Ltd. All rights reserved.)

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