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Showing 8 results for Head and Neck Cancer

Dr. S.z. Gorgu, A.f. Ilknur, O. Sercan, H. Rahsan, A. Nalan,
Volume 11, Issue 2 (4-2013)
Abstract

Background: To investigate the effect of zinc sulphate for prophylaxis of radiation-induced oral mucositis in patients with head and neck cancer. Materials And Methods: In the department of Radiation Oncology, Ankara Numune Education and Research Hospital, 40 patients with head and neck cancer were selected randomly to receive either Zinco-C 25 mg, four tablets daily or control group who did not receive any drug. The patients were treated with Cobalt 60 teletherapy unit with conventional fractionation of 2 Gy/fraction. Oral mucositis were assessed by using the Radiation Therapy Oncology Group (RTOG) Acute Radiation Morbidity Scoring criteria, before treatment, once a week during treatment and after treatment. Statistical analyses were performed using the SPSS for Windows software package. Results: In all patients, rates of grade 0, 1, 2, 3 mucositis were found 37.5%, 32.5%, 27.5% ve 2.5% respectively. Grade 0, 1, 2, 3 esophagitis were found 20%, 40%, 32.5%, 7.5%, respectively. Grade 4 mucositis and esophagitis were not detected in any patients. Between two groups, no relation was found between giving zinc and mucositis/esophagitis. Before radiotherapy, plasma zinc levels were lower in 20 patients (%50). In control group patients, post treatment serum zinc levels were significantly lower than zinc sulphate group (p=0.05). Incidence of mucositis and esophagitis was decreased when serum zinc levels were normal before and after treatment, though this was not statistically significant (p=0.476, p= 0.351 respectively). Conclusion: We found that zinc sulphate prophylaxis does not reduce incidence of mucositis and esophagitis. This may be due to before radiotherapy serum zinc levels in the patients who were given zinc were generally lower than control group. In other hand we showed that in control group patients, post treatment serum zinc levels were significantly lower than zinc sulphate group (p=0.05).


M.d. G. Turkkan, M. Caloglu, V. Yurut-Caloglu, A.r. Karasalihoglu, M. Dogan, C. Uzal,
Volume 17, Issue 4 (10-2019)
Abstract

Background: This study aimed to evaluate the relationship between late dysphagia and dosimetric–clinical parameters in patients receiving radiotherapy for head and neck cancer (HNC). Materials and Methods: Twenty-six HNC patients treated with three-dimensional conformal radiotherapy were evaluated. A total dose of 66–70 Gy in 33–35 fractions was administered for curative purposes. Six swallowing organs at risk were contoured for each patient: the superior, middle and inferior pharyngeal constrictor muscles (SPCM, MPCM and IPCM); the cervical oesophagus (CE); the base of tongue (BOT); and the larynx. The mean dose in Gray [Dmean(Gy)], maximum dose in Gray [Dmax(Gy)] and percentages of organ volumes receiving ≥ 50 Gy, ≥ 60 Gy and ≥ 70 Gy [V50 (%), V60 (%) and V70 (%), respectively] were calculated from the dose–volume histograms for each structure. Dysphagia was evaluated using video laryngoscopy, the European Organization for Research and Treatment of Cancer quality of life module for HNC and the Leipzig scale. Results: Dmean, V60 and V70 for the BOT; Dmean and V60 for the SPCM; Dmean, Dmax, V60 and V70 for the IPCM; Dmean, Dmax, V60 and V70 for the larynx; and Dmean, Dmax, V50 and V70 for the CE were correlated with the presence of pharyngeal secretion. Only V50 for the CE was correlated with abnormal glottic closure. Dmean, Dmax, V60 and V70 for the BOT and the SPCM were correlated with liquid swallowing problems. Dmax for the MPCM; Dmean, Dmax, V60 and V70 for the IPCM; and Dmax, V60 and V70 for the CE were correlated with the Leipzig score. Conclusion: The dose–volume parameters of swallowing organs were found to be associated with different rates of late dysphagia in HNC patients receiving radiotherapy. The identification of dosimetric parameters that predict late dysphagia is not adequate yet. Well-designed multi-institutional studies are necessary to clarify the dose–volume constraints.

A.h. Rezaeyan, H. Ghaffari, S.r. Mahdavi, A.r. Nikoofar, M. Najafi, F. Koosha, Phd. S. Cheraghi Cheraghi,
Volume 17, Issue 4 (10-2019)
Abstract

Background: Hearing loss is a major concern in the patient with head and neck cancer (HNC) undergoing radiotherapy (RT) and/or chemotherapy (CHT). The present study aimed to assess the incidence of sensorineural hearing loss (SNHL) at 6 months follow-up after RT and/or concurrent Cisplatin-based CHT.  Materials and Methods: In this prospective study, 60 patients with histopathologically proven HNC underwent three-dimensional conformal radiotherapy (3DCRT) (35 patients) and concurrent Cisplatin-based CHT and RT (25 patients). The status of the hearing was assessed pre-treatment (baseline), one day, 1, 3 and 6 months after treatment by pure tone audiometry (PTA) and other audiometric tests such as tympanometry (TM), acoustic reflex (AR), and speech audiometry (SA). Results: In the RT group, SNHL was observed in 18 patients and hearing loss occurred in 47 % (33 of 70 ears) of ears. In the chemo-radiotherapy (CRT) group, SNHL was discerned in 20 patients and hearing loss appeared in 88 % (44 of 50 ears) of ears. Perforation of the tympanic membrane occurred in 2/35 patients in the RT group and 1/25 patients in the CRT group. The AR threshold (ART) of patients with CRT significantly increased compared to the RT group at the end of 6 months after treatment (P <0.05). Meanwhile, there was a significant difference in the speech discrimination score (SDS) and speech recognition threshold (SRT) between the CRT group and RT group at the 6 months after treatment (P <0.05). Conclusion: The incidence of hearing loss in patients that underwent CRT was higher. The auditory system should be considered as a critical organ at risk (OAR) in treatment planning.

C. Andaloro, F. Gigante, I. La Mantia,
Volume 19, Issue 1 (1-2021)
Abstract

This article is retracted based on authors request because of use of unauthorized unpublished data
Background: Salivary glands (SGs) are usually irradiated during radiotherapy for head and neck cancers, which may lead to radiation-induced changes. These changes could be evaluated safely by ultrasonography; however, there have been few studies in this regard. Thus, we aimed to investigate the changes in post-radiotherapy submandibular glands using ultrasonography in patients undergoing head-neck radiotherapy. Materials and Methods: We evaluated 46 submandibular glands of 23 patients ultrasonographically in terms of echogenicity, echotexture, margin, and dimensional (anteroposterior, superoinferior, mediolateral length and volume) changes before radiotherapy, and at the second and sixth months after radiotherapy. Results: About 93.5% of the submandibular glands were hyperechoic before RT. When the same submandibular glands were evaluated two months later, 39.1% were hyperechoic. Six months after the therapy, 56,5% were hyperechoic (p<0.001). There is also a similar trend for the echotexture (p<0.001) and the regularity margins before RT, two months after-, and at sixth month after RT (p<0.001). Also, there were statistically significant differences between anteroposterior, superoinferior, mediolateral lengths, and volumetric values measured before radiotherapy and at the end of two and six months after radiotherapy onset (p<0.001). Conclusion: We revealed that submandibular glands were isoechoic or hypoechoic, heterogeneous, and irregular after radiotherapy; however, as the time elapsed after radiotherapy, the parenchyma structure returned to normal in half of them. Indeed, defining radiotherapy-related changes in SGs may be helpful in better understanding the mechanism of common oral complications associated with RT, and in the differential diagnosis of other SG diseases.

H.j. Han, Ph.d., H. Jang,
Volume 19, Issue 4 (10-2021)
Abstract

Background: The whole neck is often included in the radiation therapy (RT) field of head and neck cancer (HNC), and carotid vessels of the neck may be affected by radiation in a manner that increases the risk of ischemic stroke (IS). In the present study, we analyzed the relationship between RT for HNC and subsequent IS using a database managed by the Health Insurance Review & Assessment Service. Materials and Methods: A public insurance system was used to identify a nationwide cohort of patients diagnosed with HNC that underwent RT. The incidence of IS after RT was determined up to the end of December 2018, and associated risks were analyzed. In addition, patients that underwent frequent elective neck irradiation as determined by disease classification or less frequent elective neck irradiation were allocated to groups A and B, respectively. Results: 12,079 HNC patients that received RT between 2010 and 2014 were identified. 472 (3.9%) of the subjects experienced IS and incidence rates were > 5% for hypopharyngeal cancer and supraglottic cancer. The incidence of IS was 5.4% in patients > 60 years and 2.2% in patients < 60 years (relative risk (RR) 2.59). In addition, the incidence of IS was greater in group A than in group B (RR 1.29), and in men than in women (RR 1.33). Conclusion: When performing extensive RT involving the whole neck in older men, close follow-up and prophylactic medication should be considered to prevent IS.

D.h. Kim, Ph.d., Y.k. Ki, W.t. Kim, D. Park, J.h. Joo, H.s. Jeon, J.h. Nam,
Volume 20, Issue 2 (4-2022)
Abstract

Background: The appropriate extent of the radiation field (primary site ± neck) in pathologically node-negative (pN0) head and neck cancer (HNC) with adverse features at the primary site remains controversial. We investigated the effect of adjuvant neck radiotherapy (RT) on regional control and survival in patients with pN0 HNC. Materials and Methods: A systematic search of databases (MEDLINE, EMBASE, and Cochrane library) was performed for literature published until January 2021. Studies of HNC patients with pN0 neck that reported on the regional recurrence (RR) rate and regional recurrence-free survival (RRFS) with respect to adjuvant neck RT were included. Results: Five studies comprising 553 patients, with a median follow-up of 50 months, were included. The overall RR rates were 2.0% (3/153) for patients treated with adjuvant neck RT and 6.5% (26/400) for patients treated with neck dissection (ND) only. Patients who received adjuvant neck RT had a 0.37-fold (95% confidence interval [CI]=0.13–1.04, P=0.06, I2=0%) lower risk of RR than did patients with ND only. The addition of adjuvant neck RT did not significantly improve RRFS (hazard ratio=0.58, 95% CI=0.16–2.08, P=0.41, I2=0%). Conclusions: Given the RR rate of 6.5% in the RT-negative group, ND alone appears to be sufficient for treating neck disease in pN0 HNC. However, the neck RT group had a lower RR rate than that of the non-RT group, suggesting that pN0 HNC patients with a high risk of recurrence may benefit from elective neck RT.

N. Monadi, Ph.d., D. Shahbazi-Gahrouei, S. Monadi, L. Mahani, A. Shams, A. Akhavan, R. Mohammadi,
Volume 21, Issue 3 (7-2023)
Abstract

Background: This study aims to evaluate and compare Three-Dimensional Conformal Radiotherapy (3D-CRT) versus Helical Tomotherapy (HT) based on treatment planning and selection of the most appropriate method to reduce side effects. Materials and Methods: Treatment planning was performed on images of 20 patients with head and neck cancer with lymph node involvement by HT and 3D-CRT techniques in Seyed Al-Shohada hospital, Isfahan, Iran. The quality of target coverage, the exposure of normal tissue, and radiation delivery efficiency in two studied methods were compared. Results: Tomotherapy showed significant improvement over 3D-CRT in terms of D2%, D50% Dmean, V95%, CI (conformity index), and HI (homogeneity index) for PTV (planning target volume) and in terms of D2%, D98%, Dmean, V95%, CI and HI for PTV Nodal. The mean dose received by 98% of PTV (D98%) increased in HT compared to 3D-CRT. Whereas, higher doses received in organs at risk (OARs) in 3D-CRT compared to HT. Conclusion: Results showed improvements in target quality for HT over 3D-CRT, including dosimetric coverage of target volumes, homogeneity and conformity indices, and reduction of the volume of cold and hot spots. Tomotherapy also performed better than that of 3D-CRT in OARs. Overall, with the satisfactory results obtained here, HT technique has considerable promise for treating head and neck cancers with the involvement of regional lymph nodes.

M.d., H. Takano, H. Tanaka, T. Ono, M. Kajima, Y. Manabe, M. Matsuo,
Volume 21, Issue 4 (10-2023)
Abstract

The monocyte-to-lymphocyte ratio (MLR) has been reported as a useful prognosticator in various types of cancers. We studied the usefulness of MLR as a prognosticator for head and neck squamous cell carcinoma (HNSCC) in patients with oropharyngeal, hypopharyngeal, and laryngeal cancer who received radical concurrent chemoradiotherapy (CRT) or bioradiotherapy (BRT). Materials and Methods: This study included 76 HNSCC patients diagnosed between January 2015 and April 2020. We obtained their haematological records within one month before radiotherapy and calculated the MLR. Kaplan-Meier method and Cox proportional hazard model were performed to evaluate the association of MLR with locoregional recurrence-free survival (LRFS), progression-free survival (PFS), and overall survival (OS). Results: The Kaplan–Meier survival analysis for MLR showed a significant difference (p = 0.0326) in OS. Univariate and multivariate analysis revealed that the lower MLR group was associated with better OS (hazard ratio [HR] = 0.345, 95 % confidence interval [CI] = 0.124–0.960, p = 0.042 and HR = 0.305, 95% CI = 0.102-0.916, p = 0.034, respectively). Multivariate analysis also revealed that N 2-3 was significant independent predictor of LFRS and PFS (HR = 4.47, 95% CI = 1.43–14.0, p = 0.0286 and HR = 4.94, 95% CI = 1.84-13.2, p < 0.01, respectively). Conclusion: MLR was useful as a prognostic predictor for OS in patients with HNSCC who received radical concurrent CRT or BRT. MLR may be more reflective of OS than of LRFS or PFS.


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International Journal of Radiation Research
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