Clinical evaluation of the effects of radiotherapy on oral mucosa and gingiva

2008 ◽  
Vol 7 (4) ◽  
pp. 195-204 ◽  
Author(s):  
M. Taheri ◽  
K. Sohrabi ◽  
M.H. Salehi ◽  
M.H. Najafi
Keyword(s):  
Head And Neck ◽  
Oral Mucosa ◽  
Radiation Dosage ◽  
Gingival Recession ◽  
Medical File ◽  
Normal Tissues ◽  
Periodontal Index ◽  
Assessment And Treatment ◽  
Effects Of Radiation ◽  
The Impact

AbstractIntroduction:The use of radiotherapy, alone or in conjunction with surgical resection, is common in treating head and neck tumours. However, ionising radiation induces unavoidable changes in the surrounding normal tissues, causing severe complications. Therefore, we decided to study different effects of radiotherapy on gingiva and oral mucosa.Methods and Materials:This prospective analytical study was performed on 30 patients with head and neck cancers referred to the radiotherapy department of Ghaem Hospital from March to October 2006. Data were collected by means of interviews, clinical examinations and patients’ medical file investigation. The impact of different dosages of radiation on gingiva and oral mucosa was investigated. Data analysis was performed using general linear model (GLM), Cochran and multivariate analysis of variance (MANOVA) tests via SPSS V. 11.5 software.Results:A direct relationship between increase in radiation dosage, irritation of oral mucosa, ulcer development and mucositis was observed. But there was no significant relationship between NUG (necrotising ulcerative gingivitis) and perlèche and radiation dosage. Periodontal index (PI), gingival index (GI) and papillary bleeding index (PBI) were increased, but due to limited time of study (6–7 weeks), no change in gingival recession was observed. Plaque index (PLI) decreased during treatment process because of oral hygiene instructions.Conclusion:The oral and periodontal health status of head and neck cancer patients before and during radiotherapy has been described in this article. The authors believe that prevention or reduction of side-effects of radiation should be an integral part of treatment as they may have tremendous effect on the patient's quality of life. This study supports the need for dental assessment and treatment planning before radiation therapy.

Oral Sequelae of Head and Neck Radiotherapy

2003 ◽  
Vol 14 (3) ◽  
pp. 199-212 ◽  
Author(s):  
A. Vissink ◽  
J. Jansma ◽  
F.K.L. Spijkervet ◽  
F.R. Burlage ◽  
R.P. Coppes
Keyword(s):  
Head And Neck ◽  
Neck Region ◽  
Normal Tissues ◽  
Radiation Caries ◽  
Temporomandibular Joints ◽  
Clinical Consequences ◽  
Radiation Induced ◽  
Heavy Burden ◽  
Effects Of Radiation ◽  
Induced Changes

In addition to anti-tumor effects, ionizing radiation causes damage in normal tissues located in the radiation portals. Oral complications of radiotherapy in the head and neck region are the result of the deleterious effects of radiation on, e.g., salivary glands, oral mucosa, bone, dentition, masticatory musculature, and temporomandibular joints. The clinical consequences of radiotherapy include mucositis, hyposalivation, taste loss, osteoradionecrosis, radiation caries, and trismus. Mucositis and taste loss are reversible consequences that usually subside early post-irradiation, while hyposalivation is normally irreversible. Furthermore, the risk of developing radiation caries and osteoradionecrosis is a life-long threat. All these consequences form a heavy burden for the patients and have a tremendous impact on their quality of life during and after radiotherapy. In this review, the radiation-induced changes in healthy oral tissues and the resulting clinical consequences are discussed.

scholarly journals Oral Complications and Its Management during Radiotherapy

2011 ◽  
Vol 2 (2) ◽  
pp. 109-113 ◽  
Author(s):  
Dheeraj Kumar ◽  
Namrata Rastogi
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Oral Mucosa ◽  
Neck Cancer ◽  
Intensity Modulated Radiation Therapy ◽  
Upper Aerodigestive Tract ◽  
Conformal Radiation Therapy ◽  
Normal Tissues ◽  
Oral Complications

ABSTRACT Cancer is a class of diseases in which a cell or a group of cells display uncontrolled growth, invasion, and sometimes metastasis. The term head and neck cancer refers to a group of biologically similar cancers originating from the upper aerodigestive tract, including the lip, oral cavity, nasal cavity, paranasal sinuses, pharynx and larynx. About 90% of head and neck cancers are squamous cell carcinomas, originating from the mucosal lining (epithelium) of these regions. Radiation therapy is the most common form of treatment along with surgery and chemotherapy. There are different forms of radiation therapy, including 3D conformal radiation therapy, intensity-modulated radiation therapy and brachytherapy, which are commonly used in the treatment of cancers of the head and neck. There are both acute and long-term sequelae of radiation therapy (RT) for head and neck cancer (HNC) that occur because of effects on normal tissues. Radiotherapy-induced oral complications are complex, dynamic pathobiological processes that lower the quality of life and predispose patients to serious clinical disorders. Radiotherapy-induced damage in the oral mucosa is the result of the deleterious effects of radiation, not only on the oral mucosa itself but also on the adjacent salivary glands, bone, dentition, and masticatory musculature and apparatus. Dental surgeons should organize and implement preventive and therapeutic strategies in the management of various complications due to radiotherapy. The clinical features, diagnosis and management of various complications are discussed here. This article mainly presents a brief overview of the whole program of oral evaluation and proper care before, during and after the radiotherapy, managing all the common problems involved.

EFFECTS OF RADIATION THERAPY ON NORMAL TISSUES IN HEAD AND NECK CANCER

Toukeibu Gan ◽  
2004 ◽  
Vol 30 (3) ◽  
pp. 445-449 ◽  
Author(s):  
Katsumasa NAKAMURA ◽  
Yoshiyuki SHIOYAMA ◽  
Tomonari SASAKI ◽  
Saiji OHGA ◽  
Madoka SAKU ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
Normal Tissues ◽  
Effects Of Radiation

scholarly journals The Impact of Radiation on the Tumor Microenvironment: Effect of Dose and Fractionation Schedules

2018 ◽  
Vol 11 ◽  
pp. 117906441876163 ◽  
Author(s):  
Kimberly M Arnold ◽  
Nicole J Flynn ◽  
Adam Raben ◽  
Lindsay Romak ◽  
Yan Yu ◽  
...  
Keyword(s):  
Tumor Microenvironment ◽  
External Beam Radiotherapy ◽  
Tumor Stroma ◽  
Therapeutic Benefit ◽  
Normal Tissues ◽  
Technological Advances ◽  
Fractionation Schedule ◽  
Effects Of Radiation ◽  
Hypofractionated Radiation ◽  
The Impact

In addition to inducing lethal DNA damage in tumor and stromal cells, radiation can alter the interactions of tumor cells with their microenvironment. Recent technological advances in planning and delivery of external beam radiotherapy have allowed delivery of larger doses per fraction (hypofractionation) while minimizing dose to normal tissues with higher precision. The effects of radiation on the tumor microenvironment vary with dose and fractionation schedule. In this review, we summarize the effects of conventional and hypofractionated radiation regimens on the immune system and tumor stroma. We discuss how these interactions may provide therapeutic benefit in combination with targeted therapies. Understanding the differential effects of radiation dose and fractionation can have implications for choice of combination therapies.

scholarly journals Diagnosis and treatment delay of head and neck cancers during COVID-19 era in a tertiary care academic hospital: what should we expect?

2021 ◽  
Author(s):  
Pietro De Luca ◽  
Antonella Bisogno ◽  
Vito Colacurcio ◽  
Pasquale Marra ◽  
Claudia Cassandro ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Head And Neck ◽  
Retrospective Analysis ◽  
Tertiary Care ◽  
Diagnostic Delay ◽  
Treatment Delay ◽  
Head And Neck Cancers ◽  
Control Measures ◽  
Academic Hospital ◽  
The Impact

Abstract Background Since the spreading of SARS-CoV-2 from China, all deferrable medical activities have been suspended, to redirect resources for the management of COVID patients. The goal of this retrospective study was to investigate the impact of COVID-19 on head and neck cancers’ diagnosis in our Academic Hospital. Methods A retrospective analysis of patients treated for head and neck cancers between March 12 and November 1, 2020 was carried out, and we compared these data with the diagnoses of the same periods of the 5 previous years. Results 47 patients were included in this study. We observed a significative reduction in comparison with the same period of the previous 5 years. Conclusions Our findings suggest that the COVID-19 pandemic is associated with a decrease in the number of new H&N cancers diagnoses, and a substantial diagnostic delay can be attributable to COVID-19 control measures.

scholarly journals Randomized Trial Assessing the Impact of Routine Assessment of Health-Related Quality of Life in Patients with Head and Neck Cancer

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3826
Author(s):  
Oumar Billa ◽  
Franck Bonnetain ◽  
Jérôme Chamois ◽  
Angeline Ligey ◽  
Valérie Ganansia ◽  
...  
Keyword(s):  
Head And Neck ◽  
Satisfaction With Care ◽  
Related Quality ◽  
Eortc Qlq C30 ◽  
Health Related ◽  
Eortc Qlq ◽  
The Impact ◽  
Routine Assessment ◽  
Eq Vas

The impact of routine assessment of health-related quality of life (HRQoL) on satisfaction with care and the HRQoL of patients with head and neck cancer (HNC) treated with radiotherapy was assessed. Patients with HNC were randomly assigned to two arms, with stratification on sex, cancer localization, and stage of the disease. In the intervention arm, the patients completed the EORTC QLQ-C30 and EORTC QLQ-H&N35 questionnaires first before randomization, then before each medical appointment during radiotherapy (7 weeks), and then every 3 months until 1 year and at 2 years thereafter. In the control arm, the EORTC QLQ-C30 and EORTC QLQ-H&N35 questionnaires were completed before randomization and at 1 year and 2 years thereafter. The primary endpoint was mean change in HRQoL at score at 2 years from baseline assessed by EQ VAS from the EuroQol questionnaire. The secondary endpoint was mean change in satisfaction with care at 2 years from baseline assessed by QLQ-SAT32. Two hundred patients with head and neck cancers were involved in this study (mean age, 58.83 years (range, 36.56–87.89)), of whom 100 were assigned to the intervention arm and 100 to the control arm. Patients in the intervention arm were reported to have a statistically significant increase in EQ VAS at 2 years (p < 0.0001) and exceeded the minimal clinically important difference (mean change at 2 years from baseline = 10.46). In the two arms, mean differences between arms were not statistically significant, but minimal clinically important differences in favor of the intervention arm were found for EQ VAS (mean change difference (MD) = 5.84), satisfaction with care, in particular waiting times (MD = 10.85) and satisfaction with accessibility (MD = 6.52). Routine assessment of HRQoL improves HRQoL and satisfaction with care for patients with HNC treated with radiotherapy.

The impact of coronavirus disease 2019 on suspected head and neck cancer two-week-wait referrals

2021 ◽  
pp. 1-10
Author(s):  
N Bhamra ◽  
B Gorman ◽  
W Arnold ◽  
A Rajah ◽  
K Jolly ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Cancer ◽  
The Impact

Impact of anti-cancer drugs shortages in oncology and hematology departments in a Moroccan hospital

2021 ◽  
pp. 107815522110082
Author(s):  
Ali Cherif Chefchaouni ◽  
Youssef Moutaouakkil ◽  
Badr Adouani ◽  
Yasmina Tadlaoui ◽  
Jamal Lamsaouri ◽  
...  
Keyword(s):  
Management Plan ◽  
Essential Elements ◽  
Cancer Drugs ◽  
Drug Shortage ◽  
Medical File ◽  
Short Supply ◽  
Drug Shortages ◽  
Non Hodgkin Lymphoma ◽  
Anti Cancer ◽  
The Impact

Introduction Drug shortages have been a growing global problem in recent years. Some of them are of vital necessity and importance for the patient, such as those used to treat pathologies in clinical hematology and oncology departments. The objectives of this study are to determine the impact of anti-cancer drugs shortages on both: treatment and patient in the hematology and oncology departments, to describe the actions that have been put in place to manage the shortages and to survey patients about their perspectives and experiences. Materials and methods It was a prospective, observational study, it took place in the oncology and hematology departments. It was carried out with the help of an operating sheet, which contained two parts: patient and treatment data. This sheet was filled out after the interview with the patient and on the basis of the medical file. Results Of the 101 patients interviewed, 67.3% were impacted by the shortage of drugs. The treated pathology that was most impacted by the rupture was Non-Hodgkin lymphoma (55.8%), vincristine was the drug most responsible for the shortages (34%). Most patients (51.4%) went to a non-local pharmacy to buy the medicine that was in short supply in the hospital. Delayed care was the main impact of the drug shortage (42.6%). As a result of these shortages, the majority of patients (45.6%) were frustrated and anxious about the situation. Conclusion Drug shortages have a profound impact on patient safety, clinical outcomes, quality of treatment, hospital management and other important factors. In-depth collaboration between different health actors and timely communication strategies are essential elements of an effective drug shortage management plan.

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