BACKGROUND: Cisplatin-based chemoradiation (CRT) offers head and neck squamous cell carcinoma (HNSCC) patients better overall survival when compared to radiation alone. However, it also increases acute and late toxicity (LT). Here we aimed to review the main aspects of diagnosis and treatment of long-term toxicities in HNSCC patients after CRT. METHODS: We crossed-searched PubMed MeshTerms: Survivors, Deglutition Disorders, Xerostomia, Hypothyroidism, Cisplatin, Kidney, Hearing, and Osteoradionecrosis, with keywords: "Head and Neck Neoplasms" and "Chemoradiotherapy." A total of 5,541 publications were retrieved and 48 were selected for this systematic review. RESULTS: Dysphagia (25%), xerostomia (40-80%, depending on the technique used), hypothyroidism (42%), ototoxicity (27%), and osteoradionecrosis (4%) were the most commonly reported LT and were related to compromised quality of life aspects in HNSCC patients. Concurrent cisplatin and higher radiation doses, especially to normal tissue, increased the rates of LT. CONCLUSIONS: Late CRT toxicities were reported mostly in retrospective studies. Addressing these adverse effects as endpoints in future clinical trials is necessary to provide tools to prevent and treat them adequately, allowing better quality of life and survival results.
BACKGROUND:Cisplatin-based chemoradiation (CRT) offers head and neck squamous cell carcinoma (HNSCC) patients better overall survival when compared to radiation alone. However, it also increases acute and late toxicity (LT). Here we aimed to review the main aspects of diagnosis and treatment of long-term toxicities in HNSCCpatients after CRT. METHODS: We crossed-searched PubMed MeshTerms: Survivors, Deglutition Disorders, Xerostomia, Hypothyroidism, Cisplatin, Kidney, Hearing, and Osteoradionecrosis, with keywords: "Head and Neck Neoplasms" and "Chemoradiotherapy." A total of 5,541 publications were retrieved and 48 were selected for this systematic review. RESULTS:Dysphagia (25%), xerostomia (40-80%, depending on the technique used), hypothyroidism (42%), ototoxicity (27%), and osteoradionecrosis (4%) were the most commonly reported LT and were related to compromised quality of life aspects in HNSCCpatients. Concurrent cisplatin and higher radiation doses, especially to normal tissue, increased the rates of LT. CONCLUSIONS: Late CRT toxicities were reported mostly in retrospective studies. Addressing these adverse effects as endpoints in future clinical trials is necessary to provide tools to prevent and treat them adequately, allowing better quality of life and survival results.
Authors: Elise M Gane; Steven M McPhail; Anna L Hatton; Benedict J Panizza; Shaun P O'Leary Journal: J Cancer Surviv Date: 2018-05-16 Impact factor: 4.442
Authors: Muhammad Shahid Iqbal; Cheng Chaw; Josef Kovarik; Shahzeena Aslam; Aaron Jackson; John Kelly; Werner Dobrowsky; Charles Kelly Journal: Int Arch Otorhinolaryngol Date: 2016-12-19
Authors: Virginie Achim; Rachel K Bolognone; Andrew D Palmer; Donna J Graville; Tyler J Light; Ryan Li; Neil Gross; Peter E Andersen; Daniel Clayburgh Journal: JAMA Otolaryngol Head Neck Surg Date: 2018-01-01 Impact factor: 6.223