Trismus in patients with head and neck cancer and 5-year overall survival

Abstract

Background: Trismus is a common complication of radiotherapy for head and neck cancer but its impact on survival is unknown. Aims/Objectives: This prospective study evaluates the incidence of trismus in patients with head and neck cancer receiving radiotherapy and the impact of trismus on 5-year overall survival. Material and methods: Two hundred forty-four patients with head and neck cancer were included. All patients received instructions on jaw exercises and were evaluated before initiation of radiotherapy and at 2, 6, and 12 months after termination of radiotherapy. Results: One year after treatment 25% had a reduced maximum interincisal opening (MIO) of 13 mm or more as compared to the pretreatment MIO. Trismus was most prevalent in patients with oral and oropharyngeal cancer. A trend towards worse 5-year overall survival was seen among patients with trismus. Conclusions: The trismus rate was approximately 30% at 12 months. Jaw exercises should primarily be offered to patients with oral and oropharyngeal cancer who are most likely to benefit. Further studies are required to investigate the effect of trismus on survival. Significance: This study identifies patients likely to benefit from jaw exercises and provides basis for further research on trismus and survival. ARTICLE HISTORY

Mapping Health-Related Quality of Life, Anxiety, and Depression in Patients with Head and Neck Cancer Diagnosed with Malnutrition Defined by GLIM

“…The main treatment is external beam radiotherapy (RT) delivered either as a single treatment or combined with surgery and/or pharmacological therapy (chemotherapy or antibody therapy). One of the most reported problems by patients with HNC is treatment-related nutritional problems [4], i.e., smell and taste alterations, xerostomia, mucositis, dysphagia, chewing problems, pain in the oral cavity and throat, and trismus [1,[5][6][7][8]. Eating problems lead to deterioration in nutritional status and a nadir of weight loss has been reported in earlier studies to occur around six months after treatment [9,10].…”

Sarcopenia in head and neck cancer

“…Different research groups have displayed that skeletal muscle cells secrete cytokines, known as myokines. 39,40 These myokines have been shown induce apoptosis in the cells of some tumors. 40,41 A myokine of specific interest has been interleukin 6.…”

“…36 SMM and inflammation have been associated with increased risk of postoperative complications and mortality in various types of cancer such as lung cancer, gastrointestinal cancer, pancreatic cancer, hepatobiliary cancer, breast cancer and cancers of the reproductive system. [37][38][39][40][41][42] Virchow was the first to provide a possible link between inflammation and cancer by observing the presence of leukocytes within tumors in the 19 th century. Since then, various studies published about the significant role of inflammation in cancer and only during the last decade clear evidence has been obtained to show the critical role of inflammation in tumorigenesis.…”

“…Several studies showed that comorbidities are a reliable predictor for perioperative complications and that the ASA classification and ACE-27 index can both accurately measure comorbidities. [35][36][37][38][39] We used Slice-O-Matic to identify skeletal muscle from MRI and CT scans. These two different imaging modalities show significant correlation in quantifying SMI when measured by CSA at the level of C3.…”

“…In most studies, a Hounsfield unit range between -29 and +150 is accepted as being skeletal muscle mass. 39 For abdominal imaging, the area of the psoas, erector spinae, quadratus lumborum, transversus abdominis, external and internal obliques and rectus abdominis muscles on level L3 are segmented on a single axial-slice (figure 2). Introduction Figure 2.…”