Neurocognitive Function After (Chemo)-Radiotherapy for Head and Neck Cancer

Welsh, Liam; Dunlop, A.; McGovern, T.; McQuaid, D.; Dean, Jamie; Gulliford, S.; Bhide, Shree; Harrington, Kevin; Nutting, Chris; Newbold, Kate

doi:10.1016/j.clon.2014.06.014

Cited by 49 publications

(40 citation statements)

References 92 publications

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“…109,110 Cancer treatment may exacerbate these problems as the negative impact of RT-based therapy on neurocognitive function has been well documented. 111 Patients experience declines in short-term memory, language abilities, and verbal fluency after RT-based therapy with higher RT doses associated with greater cognitive decline. 103,112–114 These changes have significant implications for patients’ ability to engage in daily activities, such as their ability to drive.…”

Section: Methodsmentioning

confidence: 99%

The Older Adult With Locoregionally Advanced Head and Neck Squamous Cell Carcinoma: Knowledge Gaps and Future Direction in Assessment and Treatment

Maggiore

Zumsteg

BrintzenhofeSzoc

et al. 2017

International Journal of Radiation Oncology*Biology*Physics

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Older adults with squamous cell carcinomas of the head and neck (HNSCC) pose unique treatment and supportive care challenges to oncologists and other cancer care providers. The majority of patients with HNSCC present with locoregionally advanced (LA) disease, for which combined modality treatment integrating chemotherapy and radiation therapy is often necessary to maximize tumor control. However, applying these approaches to an older population with concomitant comorbidities and higher risk for functional impairments remains challenging, and is exacerbated by the paucity of studies involving older adults. The purpose of this paper is to identify knowledge gaps in the evaluation and management of older adults with HNSCC and their caregivers, particularly those undergoing concurrent chemoradiation, through a review of the literature conducted by clinicians, researchers, and patient advocates. The findings highlight the importance of a geriatric assessment and the therapeutic paradigms and challenges relevant to this population. Furthermore, we identify the need for additional research and interventions related to key supportive care issues that arise during and after treatment in older adults with LA-HNSCC. Based on our findings, we prioritized these issues to guide future patient-oriented research endeavors to address these knowledge gaps and thus better serve this growing patient population.

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Section: Methodsmentioning

confidence: 99%

The Older Adult With Locoregionally Advanced Head and Neck Squamous Cell Carcinoma: Knowledge Gaps and Future Direction in Assessment and Treatment

Maggiore

Zumsteg

BrintzenhofeSzoc

et al. 2017

International Journal of Radiation Oncology*Biology*Physics

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“…Concurrent radiation and chemotherapy has become the most common treatment for advanced‐staged OPSCC . This combined therapy is well‐known to be associated with significant acute and long‐term toxicities, mucositis, radiation fibrosis, early and late dysphagia, aspiration, hypothyroidism, carotid atherosclerosis, and stroke . In recognition of this, new therapeutic strategies that attempt to reduce the toxicity of treatment are under investigation .…”

Section: Introductionmentioning

confidence: 99%

The Benefit of Adjuvant Radiation in Surgically‐Treated T1‐2 N1 Oropharyngeal Squamous Cell Carcinoma

Monroe

Buchmann

Hunt

et al. 2017

Laryngoscope Investig Oto

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ImportanceThe benefit of adjuvant radiation in surgically treated T1‐2N1 oropharyngeal cancer without adverse pathologic features remains unclearObjectivesTo compare population‐level survival outcomes in surgically‐treated T1‐2N1 oropharyngeal squamous cell carcinoma (OPSCC) with and without the use of adjuvant radiation.Study DesignRetrospective population‐based study using the Surveillance, Epidemiology, and End Results (SEER) registry data from 1998–2011.SettingPopulation‐level study.ParticipantsPatients with T1‐2N1 OPSCC treated with surgical resection and neck dissection with or without adjuvant radiation.Intervention(s) for Clinical Trials or Exposure(s) for observational studiesThe use of postoperative adjuvant radiation.Main Outcome(s) and MeasuresOverall and disease‐specific survival.ResultsRadiation was utilized in 74% of patients and was positively associated with extracapsular extension and well‐differentiated histology. The use of radiation was associated with improved mean overall survival (124 v. 108 months, p=0.023) and a non‐significant increase in mean disease‐specific survival (138 v. 131 months, p=0.053).Conclusions and RelevanceThe use of adjuvant radiation is associated with improved survival in surgically‐treated T1‐2N1 squamous cell carcinoma of the oropharynx with unknown HPV status.Level of EvidenceIV

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“…Before either protons or radiobiological de-escalation strategies are tested in the UK there is a need, as highlighted by Welsh et al [1], for prospective collection of data on NCF. A comprehensive review of relevant NCF assessments is beyond the scope of these articles, but a battery of labour intensive validated tests may be required to provide Table 1 Organ at risk doses for TomoTherapy Ò and intensity-modulated proton therapy (IMPT) re-plans compared with the original doses received with no optimisation of oral mucosa dose.…”

Section: Contents Lists Available At Sciencedirectmentioning

confidence: 99%

“…Delivery of a clinically significant radiation dose to the brain, as a consequence of intensity-modulated radiotherapy (IMRT) for head and neck cancer, and its potential to cause both acute and late neurotoxicity are highlighted in this issue of Clinical Oncology by Welsh et al [1]. The current lack of prospective data on post-chemotherapy IMRT neurocognitive function (NCF) for patients with nonnasopharyngeal head and neck cancer and the need for further investigation are emphasised.…”

mentioning

confidence: 98%

Can Protons or Altered Fractionation Decrease Neurotoxicity after Chemoradiation in Head and Neck Cancer?

et al. 2014

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Neurocognitive Function After (Chemo)-Radiotherapy for Head and Neck Cancer

Cited by 49 publications

References 92 publications

The Older Adult With Locoregionally Advanced Head and Neck Squamous Cell Carcinoma: Knowledge Gaps and Future Direction in Assessment and Treatment

The Older Adult With Locoregionally Advanced Head and Neck Squamous Cell Carcinoma: Knowledge Gaps and Future Direction in Assessment and Treatment

The Benefit of Adjuvant Radiation in Surgically‐Treated T1‐2 N1 Oropharyngeal Squamous Cell Carcinoma

Can Protons or Altered Fractionation Decrease Neurotoxicity after Chemoradiation in Head and Neck Cancer?

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