PDF herunterladen
CC BY-NC-ND 4.0 · South Asian J Cancer 2019; 08(02): 120-123
DOI: 10.4103/sajc.sajc_264_17
ORIGINAL ARTICLE: Head and Neck Cancers

Burden of acute toxicities in head-and-neck radiation therapy: A single-institutional experience

Sandeep Muzumder
Department of Radiation Oncology, St. John's Medical College and Hospital, Bengaluru, Karnataka
,
Nirmala Srikantia
Department of Radiation Oncology, St. John's Medical College and Hospital, Bengaluru, Karnataka
,
Avinash H. Udayashankar
Department of Radiation Oncology, St. John's Medical College and Hospital, Bengaluru, Karnataka
,
Prashanth Bhat Kainthaje
Department of Radiation Oncology, St. John's Medical College and Hospital, Bengaluru, Karnataka
,
M. G. John Sebastian
Department of Radiation Oncology, St. John's Medical College and Hospital, Bengaluru, Karnataka
› Institutsangaben Financial support and sponsorship: This study was financially supported by the Department of Radiation Oncology, St John’s Medical College and Hospital, Bengaluru, India.
› Weitere Informationen
Auch verfügbar auf
  als PDF herunterladen Lizenzen und Reprints

Abstract

Introduction: Combined modality therapy is the standard of care in locally advanced head-and-neck cancer (HNC). The incidence of acute toxicities increases with additional therapy. The present study investigated the incidence and patterns of mucositis, dysphagia, aspiration, feeding tube use, admission for supportive care, and treatment compliance in patients with HNC treated curatively with radiation therapy (RT) with or without chemotherapy. Methods and Material: A retrospective review of 164 consecutive HNC patients treated with RT at St. John's Medical College Hospital, Bengaluru, from January 2013 to June 2017 was done. Results: A total of 148 HNC patients were treated with a curative intent and 122 (82.4%) were locally advanced HNC. Combined Modality treatment was received by 119 (80.4%) patients. Eighty-four (56.7%) patients were treated by concurrent chemo-radiation. IMRT technique was used in 125 (84.5%) patients. The incidence of grade 3-4 mucositis, dysphagia and aspiration was 25%, 46%, and 10%, respectively. Nasogastric tube feeding was necessitated in 18.9% (n=28) and 27% (n = 40) required inpatient admission for supportive care. Twenty-nine (19.6%) patients did not complete planned RT dose and 46 (31%) patients had unscheduled RT break (>2days). Fifty-six (66.7%) patients did not receive planned chemotherapy. Conclusions: Acute toxicity due to RT in HNC remains a challenge despite using modern techniques. A significant proportion of patients require supportive therapy for more than 12 weeks and did not complete the scheduled treatment.

Key words

Acute toxicity - dysphagia - head-and-neck cancer - mucositis - radiation therapy


Publikationsverlauf

Artikel online veröffentlicht:
21. Dezember 2020

© 2019. MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Kaur J, Mohanti BK, Muzumder S. Clinical audit in radiation oncology: Results from one academic centre in Delhi, India. Asian Pac J Cancer Prev 2013;14:2829-34.
  • 2 Pignon JP, le Maître A, Maillard E, Bourhis J, MACH-NC Collaborative Group. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): An update on 93 randomised trials and 17,346 patients. Radiother Oncol 2009;92:4-14.
  • 3 Bernier J, Domenge C, Ozsahin M, Matuszewska K, Lefèbvre JL, Greiner RH, et al. Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 2004;350:1945-52.
  • 4 Cooper JS, Pajak TF, Forastiere AA, Jacobs J, Campbell BH, Saxman SB, et al. Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 2004;350:1937-44.
  • 5 Madan R, Kairo AK, Sharma A, Roy S, Singh S, Singh L, et al. Aspiration pneumonia related deaths in head and neck cancer patients: A retrospective analysis of risk factors from a tertiary care centre in North India. J Laryngol Otol 2015;129:710-4.
  • 6 Gupta T, Agarwal J, Jain S, Phurailatpam R, Kannan S, Ghosh-Laskar S, et al. Three-dimensional conformal radiotherapy (3D-CRT) versus intensity modulated radiation therapy (IMRT) in squamous cell carcinoma of the head and neck: A randomized controlled trial. Radiother Oncol 2012;104:343-8.
  • 7 Marta GN, Silva V, de Andrade Carvalho H, de Arruda FF, Hanna SA, Gadia R, et al. Intensity-modulated radiation therapy for head and neck cancer: Systematic review and meta-analysis. Radiother Oncol 2014;110:9-15.
  • 8 Trotti A, Bellm LA, Epstein JB, Frame D, Fuchs HJ, Gwede CK, et al. Mucositis incidence, severity and associated outcomes in patients with head and neck cancer receiving radiotherapy with or without chemotherapy: A systematic literature review. Radiother Oncol 2003;66:253-62.
  • 9 Moroney LB, Helios J, Ward EC, Crombie J, Wockner LF, Burns CL, et al. Patterns of dysphagia and acute toxicities in patients with head and neck cancer undergoing helical IMRT±concurrent chemotherapy. Oral Oncol 2017;64:1-8.
  • 10 Alam MS, Siddiqui SA, Perween R. Epidemiological profile of head and neck cancer patients in Western Uttar Pradesh and analysis of distributions of risk factors in relation to site of tumor. J Cancer Res Ther 2017;13:430-5.
  • 11 Mohanti BK, Mukhopadhyay A, Das S, Sharma K, Dash S. The economic burden of cancer. Econ Polit Wkly 2011;43:112-8.
  • 12 Nair KS, Raj S, Tiwari VK, Piang LK. Cost of treatment for cancer: Experiences of patients in public hospitals in India. Asian Pac J Cancer Prev 2013;14:5049-54.