Functional outcomes after organ preservation treatment in head and neck cancer: a critical review of the literature

Rieger, Jana; Zalmanowitz, Jana; Wolfaardt, Johan

doi:10.1016/j.ijom.2006.03.026

Cited by 72 publications

(55 citation statements)

References 63 publications

(96 reference statements)

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“…Reference lists from the selected review papers were analyzed for other relevant citations [29,75,77]. These were then obtained and subjected to the same process as the articles retrieved from the database search.…”

Section: Exclusion Criteriamentioning

confidence: 99%

Functional outcomes and rehabilitation strategies in patients treated with chemoradiotherapy for advanced head and neck cancer: a systematic review

Molen

Rossum

Burkhead

et al. 2008

Eur Arch Otorhinolaryngol

110

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Organ preservation with radiotherapy and concomitant chemotherapy has become an accepted treatment modality in advanced head and neck cancer. Unfortunately, organ preservation is not synonymous with function preservation. The aim of this review was to systematically assess the eVects of the disease and chemoradiotherapy (CRT) on functions such as swallowing, mouth opening, nutrition, pain and quality of life in patients with head and neck cancer. Another aim was to search for (evidence-based) techniques or strategies known to alleviate or rehabilitate the loss of function(s) associated with CRT. Two databases were searched (time period, January 1997 to August 2007) for the terms head and neck cancer, chemotherapy or cisplatin and radiotherapy, and the functional outcomes swallowing, trismus, nutrition, pain and quality of life or a variation of those words. In total, 15 relevant articles were identiWed that met the inclusion criteria. The majority of the studies that met the criteria focused on the outcomes swallowing, quality of life, and nutrition. Two studies reported on the outcome pain, but no paper reported on the outcome trismus. Only two papers mentioned rehabilitation options, but speciWc information was lacking. Further long-term prospective research is essential, not only to determine the function impairment caused by the tumor and CRT, but also to assess the eVects of known and newly developed rehabilitation measures. Therefore, in September 2006, the Netherlands Cancer Institute started a randomised clinical trial (RCT): Prevention of trismus, swallowing and speech problems in patients treated with chemoradiotherapy for advanced head and neck cancer. This systematic review was carried out to collect the baseline information for the future outcomes of this RCT.

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Section: Exclusion Criteriamentioning

confidence: 99%

Functional outcomes and rehabilitation strategies in patients treated with chemoradiotherapy for advanced head and neck cancer: a systematic review

Molen

Rossum

Burkhead

et al. 2008

Eur Arch Otorhinolaryngol

110

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“…11,12,[17][18][19] Higher doses of radiation therapy have been associated with higher rates of long-term enteral feeding. 17,20 Our group previously reported that there was no association between mean total radiation dose and G-tube dependence 6 months post-CRT. However, there was an association with total radiation dose to the pharyngeal constrictors and G-tube dependence beyond 6 months post-CRT.…”

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confidence: 99%

Management of patients treated with chemoradiotherapy for head and neck cancer without prophylactic feeding tubes: The University of Pittsburgh experience

et al. 2009

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Objectives/Hypothesis:Mucositis and dysphagia are common complications of chemoradiotherapy (CRT) for head and neck cancer that may necessitate nutritional support with a gastrostomy tube (G‐tube).Methods:We reviewed records of patients who underwent and completed CRT, which included at least one traditional chemotherapeutic, for previously untreated head and neck cancer. G‐tubes were placed as needed. The timing and duration of G‐tube placement and treatment‐related complications and risk factors for long‐term G‐tube use were analyzed.Results:A total of 91 consecutive patients who received CRT, 68 as primary and 23 as postoperative treatment, were studied. Radiation doses ranged from 59.4 to 74 Gy (median, 70 Gy). Seventy‐nine percent of patients received platinum‐based therapy during CRT. Severe mucositis occurred in 40% of patients. Forty percent of patients required G‐tube placement (15 prior to CRT and 21 during CRT). Median duration of G‐tube use was 5.8 months. Two patients who had a G‐tube placed during CRT developed a G‐tube‐related complication. At 6 and 12 months, 15 (18%) and four (6%) patients who were disease free were using G‐tubes, respectively. Patients with G‐tubes placed prior to CRT or advanced T stage had longer G‐tube dependence.Conclusions:With aggressive supportive care it is feasible to avoid G‐tubes in the majority of patients undergoing CRT for head and neck cancer. G‐tube placement prior to CRT due to pre‐existing dysphagia and advanced T stage are associated with prolonged G‐tube dependence. Laryngoscope, 2010

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“…1 The main purpose of non-surgical oncologic therapy is to preserve breathing, swallowing and communication fuctions. 2,3 A current debate is the impact of this type of therapy on laryngeal function and quality of life, since treatment may cause malnutrition, dehydration, weight loss, pain, dysphonia, dysphagia and ototoxicity. 4 Radiotherapy alone may cause several dysfunctions in different degrees, such as: xerostomy, odynophagia, weight loss, and a need for alternative feeding routes.…”

Section: Introductionmentioning

confidence: 99%

Deglutição após tratamento não cirúrgico (radioterápico/ radioquimioterápico) do câncer de laringe

Portas¹,

Socci

Scian³

et al. 2011

Braz. j. otorhinolaryngol. (Impr.)

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Radiation therapy and radiochemotherapy protocols can cause swallowing difficulties. Aim: To evaluate swallowing in patients undergoing radiation therapy and radiochemotherapy protocol only for the treatment of laryngeal tumors. Methods: A prospective study of 20 patients, with a mean age of 62 years, at the end of oncological therapy. Six patients (30%) underwent radiation therapy, and 14 patients (70%) underwent combined therapy. The mean time between treatment and an evaluation of swallowing was 8.5 months. Videofluoroscopy was done to assess the preparatory, oral and pharyngeal phases of swallowing. Results: All patients had only an oral diet. Normal swallowing was present in only 25% of patients. The swallowing videofluoroscopic examination identified the following changes: bolus formation (85%), bolus ejection (60%), oral cavity stasis (55%), changes in the onset of the pharyngeal phase (100%), decreased laryngeal elevation (65%), and hypopharyngeal stasis (80%). Laryngeal penetration was observed in 25% of the cases; 40% presented tracheal aspiration. The grade of penetration/ aspiration was mild in 60% of cases. Aspiration was silent in 35% of patients. Although 75% of patients had dysphagia, only 25% complained of swallowing difficulties. Conclusion: Patients with laryngeal cancer that underwent radiation therapy/combined treatment can present changes in all swallowing phases, or may be asymptomatic.

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Functional outcomes after organ preservation treatment in head and neck cancer: a critical review of the literature

Cited by 72 publications

References 63 publications

Functional outcomes and rehabilitation strategies in patients treated with chemoradiotherapy for advanced head and neck cancer: a systematic review

Functional outcomes and rehabilitation strategies in patients treated with chemoradiotherapy for advanced head and neck cancer: a systematic review

Management of patients treated with chemoradiotherapy for head and neck cancer without prophylactic feeding tubes: The University of Pittsburgh experience

Deglutição após tratamento não cirúrgico (radioterápico/ radioquimioterápico) do câncer de laringe

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