Oral Sequelae of Head and Neck Radiotherapy

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.

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NMR-Based Metabolomics in Investigation of the Radiation Induced Changes in Blood Serum of Head and Neck Cancer Patients and Its Correlation with the Tissue Volumes Exposed to the Particulate Doses

International Journal of Molecular Sciences ◽

10.3390/ijms22126310 ◽

2021 ◽

Vol 22 (12) ◽

pp. 6310

Author(s):

Łukasz Boguszewicz ◽

Agata Bieleń ◽

Mateusz Ciszek ◽

Jacek Wendykier ◽

Krzysztof Szczepanik ◽

...

Keyword(s):

Blood Serum ◽

Head And Neck ◽

Tumor Location ◽

Multivariate Methods ◽

Optimal Planning ◽

Normal Tissues ◽

Radiation Induced ◽

Branched Chain ◽

Induced Changes ◽

Radio Chemotherapy

In the present study, we analyze the nuclear magnetic resonance (NMR) blood serum metabolic profiles of 106 head and neck squamous cell carcinoma (HNSCC) patients during radio (RT) and concurrent radio-chemotherapy (CHRT). Four different fractionation schemes were compared. The blood samples were collected weekly, from the day before the treatment until the last week of CHRT/RT. The NMR spectra were acquired on A Bruker 400 MHz spectrometer at 310 K and analyzed using multivariate methods. Seven metabolites were found significantly to be altered solely by radiotherapy: N-acetyl-glycoprotein (NAG), N-acetylcysteine, glycerol, glycolate and the lipids at 0.9, 1.3 and 3.2 ppm. The NMR results were correlated with the tissue volumes receiving a particular dose of radiation. The influence of the irradiated volume on the metabolic profile is weak and mainly limited to sparse correlations with the inflammatory markers, creatinine and the lymphocyte count in RT and the branched-chain amino-acids in CHRT. This is probably due to the optimal planning and delivery of radiotherapy improving sparing of the surrounding normal tissues and minimizing the differences between the patients (caused by the tumor location and size).

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Prevention and Treatment of the Consequences of Head and Neck Radiotherapy

Critical Reviews in Oral Biology & Medicine ◽

10.1177/154411130301400306 ◽

2003 ◽

Vol 14 (3) ◽

pp. 213-225 ◽

Cited By ~ 239

Author(s):

A. Vissink ◽

F.R. Burlage ◽

F.K.L. Spijkervet ◽

J. Jansma ◽

R.P. Coppes

Keyword(s):

Head And Neck ◽

Radiation Treatment ◽

Treatment Protocols ◽

Radiation Caries ◽

Prevention And Treatment ◽

Radiation Induced ◽

Node Metastases ◽

Induced Changes ◽

Head And Neck Radiotherapy

The location of the primary tumor or lymph node metastases dictates the inclusion of the oral cavity, salivary glands, and jaws in the radiation treatment portals for patients who have head and neck cancer. The clinical sequelae of the radiation treatment include mucositis, hyposalivation, loss of taste, osteoradionecrosis, radiation caries, and trismus. These sequelae may be dose-limiting and have a tremendous effect on the patient’s quality of life. Most treatment protocols to prevent these sequelae are still based on clinical experience, but alternatives based on fundamental basic and clinical research are becoming more and more available. Many of these alternatives either need further study before they can be incorporated into the protocols commonly used to prevent and treat the radiation-related oral sequelae or await implementation of these protocols. In this review, the various possibilities for prevention and/or treatment of radiation-induced changes in healthy oral tissues and their consequences are discussed.

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Mechanism, Prevention, and Treatment of Radiation-Induced Salivary Gland Injury Related to Oxidative Stress

Antioxidants ◽

10.3390/antiox10111666 ◽

2021 ◽

Vol 10 (11) ◽

pp. 1666

Author(s):

Zijing Liu ◽

Lihua Dong ◽

Zhuangzhuang Zheng ◽

Shiyu Liu ◽

Shouliang Gong ◽

...

Keyword(s):

Oxidative Stress ◽

Head And Neck ◽

Clinical Symptoms ◽

Clinical Manifestations ◽

Serious Adverse Event ◽

Oral Infections ◽

Normal Tissues ◽

Radiation Induced ◽

Swallowing Muscles

Radiation therapy is a common treatment for head and neck cancers. However, because of the presence of nerve structures (brain stem, spinal cord, and brachial plexus), salivary glands (SGs), mucous membranes, and swallowing muscles in the head and neck regions, radiotherapy inevitably causes damage to these normal tissues. Among them, SG injury is a serious adverse event, and its clinical manifestations include changes in taste, difficulty chewing and swallowing, oral infections, and dental caries. These clinical symptoms seriously reduce a patient’s quality of life. Therefore, it is important to clarify the mechanism of SG injury caused by radiotherapy. Although the mechanism of radiation-induced SG injury has not yet been determined, recent studies have shown that the mechanisms of calcium signaling, microvascular injury, cellular senescence, and apoptosis are closely related to oxidative stress. In this article, we review the mechanism by which radiotherapy causes oxidative stress and damages the SGs. In addition, we discuss effective methods to prevent and treat radiation-induced SG damage.

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Pharmacological Interventions for the Prevention and Treatment of Kidney Injury Induced by Radiotherapy: Molecular Mechanisms and Clinical Perspectives

Current Molecular Pharmacology ◽

10.2174/1874467214666210824123212 ◽

2021 ◽

Vol 14 ◽

Author(s):

Adeleh Sahebnasagh ◽

Fatemeh Saghafi ◽

Saeed Azimi ◽

Ebrahim Salehifar ◽

Seyed Jalal Hosseinimehr

Keyword(s):

Oxidative Stress ◽

Molecular Mechanisms ◽

Cell Injury ◽

Kidney Injury ◽

Pharmacological Interventions ◽

Normal Tissues ◽

Radiation Induced ◽

Effects Of Radiation ◽

Preclinical And Clinical Studies ◽

Radiation Beams

: More than half of cancer patients need radiotherapy during the course of their treatment. Despite the beneficial aspects, the destructive effects of radiation beams on normal tissues lead to oxidative stress, inflammation, and cell injury. Kidneys are affected during radiotherapy of abdominal malignancies. Radiation nephropathy eventually leads to the release of factors triggering systemic inflammation. Currently, there is no proven prophylactic or therapeutic intervention for the management of radiation-induced nephropathy. This article reviews the biomarkers involved in the pathophysiology of radiation-induced nephropathy and its underlying molecular mechanisms. The efficacy of compounds with potential radio-protective properties on amelioration of inﬂammation and oxidative stress is also discussed. By outlining the approaches for preventing and treating this critical side effect, we evaluate the potential treatment of radiation-induced nephropathy. Available preclinical and clinical studies on these compounds are also scrutinized.

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