TY - JOUR
T1 - Treatment of late sequelae after radiotherapy for head and neck cancer
AU - Strojan, Primož
AU - Hutcheson, Katherine A.
AU - Eisbruch, Avraham
AU - Beitler, Jonathan J.
AU - Langendijk, Johannes A.
AU - Lee, Anne W.M.
AU - Corry, June
AU - Mendenhall, William M.
AU - Smee, Robert
AU - Rinaldo, Alessandra
AU - Ferlito, Alfio
N1 - Publisher Copyright:
© 2017 Elsevier Ltd
PY - 2017/9
Y1 - 2017/9
N2 - 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.
AB - 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.
KW - Head and neck cancer
KW - Late sequelae
KW - Radiotherapy
KW - Toxicity
KW - Treatment
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U2 - 10.1016/j.ctrv.2017.07.003
DO - 10.1016/j.ctrv.2017.07.003
M3 - Review article
C2 - 28759822
AN - SCOPUS:85026430562
SN - 0305-7372
VL - 59
SP - 79
EP - 92
JO - Cancer treatment reviews
JF - Cancer treatment reviews
ER -