Evaluation, Prediction and Treatment of Radiation-
Induced Normal Tissue Damage in Head and Neck Cancer
Volume 6 - Issue 2
Priyanka Bhateja1*, Vidhya Karivedu1, Dukagjin M Blakaj2 and Marcelo Bonomi1
- 1Department on Internal Medicine, Division of Medical Oncology, The Ohio State University, USA
- 2Department of Radiation Oncology, The Ohio State University, USA
Received: March 24, 2021; Published: April 06, 2021
Corresponding author: Priyanka Bhateja, Department on Internal Medicine, Division of Medical Oncology, The Ohio State University, USA
DOI: 10.32474/SJO.2021.06.000233
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Abstract
Locally advanced head and neck squamous cell cancer (HNSCC) requires a multidisciplinary approach and
frequently concurrent chemoradiation (CRT) as a definitive or adjuvant treatment. Oral mucositis (OM) affects 80%
of patients receiving radiation treatment and about half of the patients receiving CRT experience severe grade 3-4
mucositis. Severe mucositis results in high hospitalization rates and treatment interruptions, which can negatively
affect treatment outcomes. The local tumor control rate may be reduced by 0.5 to 1% for each day of unplanned
interruption in radiation treatment. Severe late toxicity occurs in about 43% of patients receiving CRT. Careful
selection of patients for concurrent chemotherapy with attention to detailed assessment and aggressive supportive
care is paramount to minimizing treatment related complications. Here we discuss aspects specific to management
of mucositis, radiation dermatitis, nutritional and dysphagia assessment, and early interventions to avoid long term
toxicity in the subgroup of patients receiving CRT. Investigational and alternate strategies to systemic treatment with
cisplatin that could impact radiation induced normal tissue damage are discussed as well.
Abbreviations: HNSCC: Head and Neck Squamous Cell Cancer; OM: Oral Mucositis; WHO: World Health Organization;
CTCAE: Common Toxicity Criteria Adverse Events; HPV: Human Papilloma Virus; QOL: Quality of Life
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