Prevention and Treatment of the Consequences of Head and Neck Radiotherapy

2003 ◽  
Vol 14 (3) ◽  
pp. 213-225 ◽  
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.

scholarly journals Radiation induced caries: An overview

2018 ◽  
Vol 08 (04) ◽  
pp. 028-033
Author(s):  
Mithra N Hegde ◽  
Ananiya John
Keyword(s):  
Head And Neck ◽  
Structural Changes ◽  
Salivary Flow ◽  
Radiation Caries ◽  
Neck Tumors ◽  
Oral Microflora ◽  
Choice Of Treatment ◽  
Radiation Induced ◽  
Head And Neck Radiotherapy

AbstractAmongst all the different varieties of cancers diagnosed across the world around 6% is found to be head and neck cancer and radiotherapy is the choice of treatment. Head and neck radiotherapy cause several changes in dentition, saliva, oral microflora and food habits of the patient thus increasing the risk of radiation-induced dental caries a common, yet serious complication. This paper analyses the literature pertaining to radiation-induced caries and discusses the predisposing factors, etiology, structural changes in the tooth, clinical features of radiation caries and management. To review this, the Pubmed and Scopus database was searched using the keywords “radiation-induced caries”, “xerostomia”, “effects of radiology” and “head and neck tumors”, “osteoradionecrosis”, “management of radiation caries”, “structural changes in teeth after radiotherapy”, “prevention of radiation caries”. Radiation caries is a rampant form of caries commonly seen within the first 3 months after the radiotherapy. Thus, early dynamic involvement of the dentist in the preventive and therapeutic strategies are important. Furthermore, educating and motivating patients about the risk factors, maintenance of oral hygiene, stimulation of salivary flow, fluoride use, and nutritional orientation are essential to decrease the incidence of radiation caries and eventually enhances the quality of life of patients.

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 Investigation of Radiation-Induced Toxicity in Head and Neck Cancer Patients through Radiomics and Machine Learning: A Systematic Review

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Roberta Carbonara ◽  
Pierluigi Bonomo ◽  
Alessia Di Rito ◽  
Vittorio Didonna ◽  
Fabiana Gregucci ◽  
...  
Keyword(s):  
Machine Learning ◽  
Systematic Review ◽  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Neck Cancer ◽  
Background Radiation ◽  
Radiation Treatment ◽  
Radiation Induced

Background. Radiation-induced toxicity represents a crucial concern in oncological treatments of patients affected by head and neck neoplasms, due to its impact on survivors’ quality of life. Published reports suggested the potential of radiomics combined with machine learning methods in the prediction and assessment of radiation-induced toxicities, supporting a tailored radiation treatment management. In this paper, we present an update of the current knowledge concerning these modern approaches. Materials and Methods. A systematic review according to PICO-PRISMA methodology was conducted in MEDLINE/PubMed and EMBASE databases until June 2019. Studies assessing the use of radiomics combined with machine learning in predicting radiation-induced toxicity in head and neck cancer patients were specifically included. Four authors (two independently and two in concordance) assessed the methodological quality of the included studies using the Radiomic Quality Score (RQS). The overall score for each analyzed study was obtained by the sum of the single RQS items; the average and standard deviation values of the authors’ RQS were calculated and reported. Results. Eight included papers, presenting data on parotid glands, cochlea, masticatory muscles, and white brain matter, were specifically analyzed in this review. Only one study had an average RQS was ≤ 30% (50%), while 3 studies obtained a RQS almost ≤ 25%. Potential variability in the interpretations of specific RQS items could have influenced the inter-rater agreement in specific cases. Conclusions. Published radiomic studies provide encouraging but still limited and preliminary data that require further validation to improve the decision-making processes in preventing and managing radiation-induced toxicities.

scholarly journals Patient-reported quality-of-life outcomes in relation to provider-assessed adverse events during head and neck radiotherapy

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Joshua R. Niska ◽  
Cameron S. Thorpe ◽  
Michele Y. Halyard ◽  
Angelina D. Tan ◽  
Pamela J. Atherton ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Adverse Events ◽  
Head And Neck ◽  
Life Outcomes ◽  
Quality Of Life Outcomes ◽  
Patient Reported ◽  
Head And Neck Radiotherapy

scholarly journals Nanotechnology as an Anti-Infection Strategy in Periprosthetic Joint Infections (PJI)

2021 ◽  
Vol 6 (2) ◽  
pp. 91
Author(s):  
Pier Francesco Indelli ◽  
Stefano Ghirardelli ◽  
Ferdinando Iannotti ◽  
Alessia Maria Indelli ◽  
Gennaro Pipino
Keyword(s):  
Joint Infection ◽  
Treatment Strategies ◽  
High Morbidity ◽  
Treatment Protocols ◽  
Joint Infections ◽  
Prevention And Treatment ◽  
Efficient Control ◽  
Cement Joint ◽  
Clay Nanotubes

Background: Periprosthetic joint infection (PJI) represents a devastating consequence of total joint arthroplasty (TJA) because of its high morbidity and its high impact on patient quality of life. The lack of standardized preventive and treatment strategies is a major challenge for arthroplasty surgeons. The purpose of this article was to explore the potential and future uses of nanotechnology as a tool for the prevention and treatment of PJI. Methods: Multiple review articles from the PubMed, Scopus and Google Scholar databases were reviewed in order to establish the current efficacy of nanotechnology in PJI preventive or therapeutic scenarios. Results: As a prevention tool, anti-biofilm implants equipped with nanoparticles (silver, silk fibroin, poly nanofibers, nanophase selenium) have shown promising antibacterial functionality. As a therapeutic tool, drug-loaded nanomolecules have been created and a wide variety of carrier materials (chitosan, titanium, calcium phosphate) have shown precise drug targeting and efficient control of drug release. Other nanotechnology-based antibiotic carriers (lipid nanoparticles, silica, clay nanotubes), when added to common bone cements, enhanced prolonged drug delivery, making this technology promising for the creation of antibiotic-added cement joint spacers. Conclusion: Although still in its infancy, nanotechnology has the potential to revolutionize prevention and treatment protocols of PJI. Nevertheless, extensive basic science and clinical research will be needed to investigate the potential toxicities of nanoparticles.

scholarly journals Preoperative predictors of dysphagia after transoral surgery

2021 ◽  
Author(s):  
Kazunori Fujiwara ◽  
Kenkichiro Taira ◽  
Ryohei Donishi ◽  
Satoshi Koyama ◽  
Tsuyoshi Morisaki ◽  
...  
Keyword(s):  
Head And Neck ◽  
Forced Expiratory Volume ◽  
Transoral Surgery ◽  
Postoperative Dysphagia ◽  
Swallowing Function ◽  
History Of ◽  
Group A ◽  
Low Bmi ◽  
Head And Neck Radiotherapy

Abstract Background Transoral surgery (TOS) has been used to remove pharyngeal and laryngeal cancers with the objective of improving functional without worsening survival. However, there is a risk of postoperative dysphagia, which can severely impair quality of life. The aim of this study was to evaluate the preoperative predictive factors for postoperative dysphagia in patients undergoing TOS. Methods One hundred and twenty patients who underwent TOS were evaluated in this study. The degree of dysphagia was evaluated using the Functional Outcome Swallowing Scale (FOSS) both preoperatively and 3 months postoperatively. Those whose FOSS stage was maintained postoperatively were classified into the FOSS-M group, while those with increased FOSS stage postopratively were classified into the FOSS-I group. The following parameters were assessed before surgery: age, weight, height, body mass index (BMI), forced expiratory volume in 1 s, and history of head and neck radiotherapy. Videofluoroscopy (VF) was performed preoperatively to evaluate swallowing function using the Penetration-Aspiration Scale (PAS). Results The BMI of the FOSS-M group was significantly higher than that of the FOSS-I group. A history of radiotherapy was significantly more common in the FOSS-I group than in the FOSS-M group. Finally, preoperative PAS in the FOSS-M group was lower than that in the FOSS-I group. Conclusion This study suggested that patients with preoperative aspiration detected using VF might develop postoperative dysphagia severely. In addition, preoperative low BMI and a history of previous radiotherapy for head and neck cancer were associated with postoperative dysphagia. Objective examinations such as VF should be performed preoperatively.

Automatic Parotid Gland Segmentation in MVCT Using Deep Convolutional Neural Networks

2022 ◽  
Vol 3 (2) ◽  
pp. 1-15
Author(s):  
Junqian Zhang ◽  
Yingming Sun ◽  
Hongen Liao ◽  
Jian Zhu ◽  
Yuan Zhang
Keyword(s):  
Parotid Gland ◽  
Head And Neck ◽  
Helical Tomotherapy ◽  
Radiation Treatment ◽  
Automatic Segmentation ◽  
Parotid Glands ◽  
Deep Convolutional Neural Networks ◽  
Megavoltage Computed Tomography ◽  
Radiation Induced ◽  
Segmentation Models

Radiation-induced xerostomia, as a major problem in radiation treatment of the head and neck cancer, is mainly due to the overdose irradiation injury to the parotid glands. Helical Tomotherapy-based megavoltage computed tomography (MVCT) imaging during the Tomotherapy treatment can be applied to monitor the successive variations in the parotid glands. While manual segmentation is time consuming, laborious, and subjective, automatic segmentation is quite challenging due to the complicated anatomical environment of head and neck as well as noises in MVCT images. In this article, we propose a localization-refinement scheme to segment the parotid gland in MVCT. After data pre-processing we use mask region convolutional neural network (Mask R-CNN) in the localization stage after data pre-processing, and design a modified U-Net in the following fine segmentation stage. To the best of our knowledge, this study is a pioneering work of deep learning on MVCT segmentation. Comprehensive experiments based on different data distribution of head and neck MVCTs and different segmentation models have demonstrated the superiority of our approach in terms of accuracy, effectiveness, flexibility, and practicability. Our method can be adopted as a powerful tool for radiation-induced injury studies, where accurate organ segmentation is crucial.

scholarly journals Effect of Surgical Mask on Setup Error in Head and Neck Radiotherapy

2020 ◽  
Vol 19 ◽  
pp. 153303382097402
Author(s):  
Yi Ding ◽  
Pingping Ma ◽  
Wei Li ◽  
Xueyan Wei ◽  
Xiaoping Qiu ◽  
...  
Keyword(s):  
Head And Neck ◽  
Radiation Treatment ◽  
Virus Disease ◽  
T Test ◽  
Setup Error ◽  
Setup Errors ◽  
Significant Difference ◽  
The Mean ◽  
Head And Neck Radiotherapy ◽  
Head Neck

Purpose: With the widespread prevalence of Corona Virus Disease 2019 (COVID-19), cancer patients are suggested to wear a surgical mask during radiation treatment. In this study, cone beam CT (CBCT) was used to investigate the effect of surgical mask on setup errors in head and neck radiotherapy. Methods: A total of 91 patients with head and neck tumors were selected. CBCT was performed to localize target volume after patient set up. The images obtained by CBCT before treatment were automatically registered with CT images and manually fine-tuned. The setup errors of patients in 6 directions of Vrt, Lng, Lat, Pitch, Roll and Rotation were recorded. The patients were divided into groups according to whether they wore the surgical mask, the type of immobilization mask used and the location of the isocenter. The setup errors of patients were calculated. A t-test was performed to detect whether it was statistically significant. Results: In the 4 groups, the standard deviation in the directions of Lng and Pitch of the with surgical mask group were all higher than that in the without surgical mask group. In the head-neck-shoulder mask group, the mean in the Lng direction of the with surgical mask group was larger than that of the without surgical mask group. In the lateral isocenter group, the mean in the Lng and Pitch directions of the with surgical mask group were larger than that of the without surgical mask group. The t-test results showed that there was significant difference in the setup error between the 2 groups ( p = 0.043 and p = 0.013, respectively) only in the Lng and Pitch directions of the head-neck-shoulder mask group. In addition, the setup error of 6 patients with immobilization open masks exhibited no distinguished difference from that of the patients with regular immobilization masks. Conclusion: In the head and neck radiotherapy patients, the setup error was affected by wearing surgical mask. It is recommended that the immobilization open mask should be used when the patient cannot finish the whole treatment with a surgical mask.

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

Antioxidants ◽  
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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