Hypothyroidism in patients treated with radiotherapy for head and neck carcinoma: standardised long-term follow-up study

AbstractObjective:Hypothyroidism is a common complication when radiotherapy is part of the treatment for head and neck tumours. This study aimed to show the incidence of hypothyroidism and possible risk factors in these patients.Methods:Factors related to the population, tumour, treatment and occurrence of hypothyroidism were analysed in 241 patients diagnosed with head and neck carcinoma.Results:Approximately 53 per cent of patients were diagnosed with radiation-induced hypothyroidism. Its occurrence was related to: tumour location, laryngeal surgery type, neck dissection type, post-operative complications, cervical radiotherapy and radiotherapy unit type (linear particle accelerator or telecobalt therapy technology).Conclusion:Control of thyroid function should be standardised for several years after treatment, particularly in patients with risk factors, such as those treated with telecobalt therapy, those with post-operative complications and for whom the thyroid parenchyma is included in the irradiated area (laryngeal or pharyngeal location and bilateral cervical radiation).

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Interstitial Lung Disease Associated With Cetuximab in Patients With Head and Neck Carcinoma: A Single-Institution Experience in Japan

International Surgery ◽

10.9738/intsurg-d-16-00256.1 ◽

2019 ◽

Vol 103 (11-12) ◽

pp. 528-533

Author(s):

Hiroki Sato ◽

Kiyoaki Tsukahara ◽

Isaku Okamoto ◽

Soichiro Takase ◽

Kunihiko Tokashiki ◽

...

Keyword(s):

Risk Factors ◽

Interstitial Lung Disease ◽

Lung Disease ◽

Head And Neck ◽

Performance Status ◽

Head And Neck Carcinoma ◽

Smoking History ◽

Advanced Squamous Cell Carcinoma ◽

Lung Disorder ◽

Neck Carcinoma

Objective: This study retrospectively analyzed the risk of interstitial lung disease with cetuximab using risk factors known to be associated with interstitial lung disease during administration of epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitor (TKI). Summary of background data: Cetuximab is an inhibitor of EGFR commonly used for advanced squamous cell carcinoma of the head and neck. Interstitial lung disease is a rare but serious adverse event of cetuximab. EGFR-TKIs are molecularly targeted drugs resembling cetuximab and show increased risk of interstitial lung disease associated with positive smoking history, age >55 years, preexisting lung disorder, and poor performance status. Methods: Among 44 patients treated with cetuximab for advanced squamous cell carcinoma of the head and neck between March 2013 and April 2015 at Tokyo Medical University, 6 patients developed interstitial lung disease. Smoking history, age, preexisting lung disorder, and performance status were examined for these 6 patients. Results: Two of these 6 patients died due to interstitial lung disease. All patients with interstitial lung disease were >55 years old and had a history of smoking. Three patients with interstitial lung disease had a preexisting lung disorder. Performance status was 0 in 4 patients and 1 in 2 patients. Conclusions: Age >55 years, smoking history, and preexisting lung disease may represent risk factors for interstitial lung disease during cetuximab treatment for head and neck carcinoma, whereas performance status may not.

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Sequential Evaluation of DNA Damage in Patients with Head and Neck Carcinoma Receiving Radiotherapy

10.21203/rs.3.rs-482544/v1 ◽

2021 ◽

Author(s):

Sivakumar M ◽

Ariyanachi K

Keyword(s):

Risk Factors ◽

Dna Damage ◽

High Risk ◽

Head And Neck ◽

Head And Neck Carcinoma ◽

Head And Neck Cancers ◽

Neck Carcinoma ◽

Secondary Carcinoma ◽

Baseline Sample ◽

Damaged Dna

Abstract Background:Head and neck cancers account for about 30% of all cancers in India. The incidence rates of HNSCC in India are30/1, 00,000 for males and 10/1, 00,000 for females. The commonly used treatment modalities include surgery, chemotherapy and radiotherapy. Studies conducted in different types of cancers showed that there is anincreased primary DNA damage even before the commencement of treatment in cancer patients.The treatment modality will further induce DNA damage in addition to the already existing DNA damage.In normal healthy people, DNA damage is effectively repaired. However, in patients with carcinoma, chemo-radiation induced DNA damage is not repaired so effectively. Consequently, there is a high risk of secondary carcinoma by unrepaired damaged DNA.Methodology:In this study, the degree of DNA damage is assessed by comet assay technique in patients with head and neck carcinoma receiving radiotherapy and had complete regression of tumor following radiotherapy. The degree of DNA damage is compared according to the age, gender and associated risk factors of the patients.Results:The comet length parameter of post-RT sample is increased when compared to baseline sample. The head diameter parameter of post-RT sample is increased when compared to baseline sample. The percentage of DNA in head parameter of post-RT sample is decreased when compared to baseline sample. The tail length parameter of post-RT sample is increased when compared to baseline sample. All these findings are indicative of DNA damage following radiotherapy. Consequently, there is a high risk of secondary carcinoma by unrepaired damaged DNA.Conclusion:Patients with locally advanced head and neck carcinoma with complete tumor response following radiotherapy showed a sequential increase in the DNA damage. The co-existing risk factors and old age may increase the baseline DNA damage in the patients with head and neck cancers.

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