Search

Background: Radiation-associated-dysphagia is a serious side effect of radiotherapy (RT) for head and neck cancer (HNC)., Methods: Seventy-six patients had a weekly prospective follow-up from baseline until one week post-RT. Combined mixed model analysis (n = 43) determined the evolution of self-perceived swallowing function, isometric tongue strength (MIP), tongue strength (TS) during swallowing (Pswal), and quality of life (QoL) in these patients during RT., Results: Swallowing deteriorated from the third week on, resulting in an increase of tube dependency from 10% at baseline toward 31% post-RT. Both MIP and Pswal are reduced, with anterior MIP decreasing in 29% of patients and posterior MIP in 17%. Pswal decreases for saliva and a bolus swallow. All QoL subscales except "sleep" were affected during RT., Conclusions: Self-perceived swallowing function, TS and QoL decrease during RT for HNC. Current findings highlight the need for early monitoring of these parameters., (© 2019 Wiley Periodicals, Inc.)

Purpose: A multi-centre study to assess the value of combined surgical resection and radiotherapy for the treatment of desmoid tumours., Patients and Methods: One hundred and ten patients from several European countries qualified for this study. Pathology slides of all patients were reviewed by an independent pathologist. Sixty-eight patients received post-operative radiotherapy and 42 surgery only. Median follow-up was 6 years (1 to 44). The progression-free survival time (PFS) and prognostic factors were analysed., Results: The combined treatment with radiotherapy showed a significantly longer progression-free survival than surgical resection alone (p smaller than 0.001). Extremities could be preserved in all patients treated with combined surgery and radiotherapy for tumours located in the limb, whereas amputation was necessary for 23% of patients treated with surgery alone. A comparison of PFS for tumour locations proved the abdominal wall to be a positive prognostic factor and a localization in the extremities to be a negative prognostic factor. Additional irradiation, a fraction size larger than or equal to 2 Gy and a total dose larger than 50 Gy to the tumour were found to be positive prognostic factors with a significantly lower risk for a recurrence in the univariate analysis. This analysis revealed radiotherapy at recurrence as a significantly worse prognostic factor compared with adjuvant radiotherapy. The addition of radiotherapy to the treatment concept was a positive prognostic factor in the multivariate analysis., Conclusion: Postoperative radiotherapy significantly improved the PFS compared to surgery alone. Therefore it should always be considered after a non-radical tumour resection and should be given preferably in an adjuvant setting. It is effective in limb preservation and for preserving the function of joints in situations where surgery alone would result in deficits, which is especially important in young patients.

Introduction: A simultaneous integrated boost (SIB) intensity modulated radiotherapy (IMRT) in patients with head and neck squamous cell carcinoma (HNSCC) allows to irradiate different target volumes to different dose levels within a single treatment session without increasing the toxicity.Aim: To analyze the outcome and toxicity of patients treated by definitive or postoperative SIB IMRT for HNSCC.Material and Methods: 106 patients with HNSCC of the oral cavity (OC), oropharynx (OP), larynx (L) and hypopharynx (HP), consecutively treated at our cancer center between 3/2012 and 3/2014 were retrospectively analyzed. The prescribed SIB IMRT doses were in the postoperative setting (group A) 60-66 Gy and 53 Gy in 30-33 fractions for PTV high risk and PTV elective, respectively; and 70 Gy and 56 Gy in 35 fractions for PTV high risk and PTV elective, respectively when given as primary treatment (group B). Toxicity was consistently graded according to RTOG/EORTC scale.Results: Median follow-up duration was 31 months. Thirty (28%) patients were postoperatively irradiated (group A) and 76 (72%) patients received definitive IMRT (group B). At 3 years, loco-regional control, distant control and overall survival were 78%, 78%, 57% and 64%, 76%, 52% in the postoperative (group A) and the definitive SIB IMRT group (group B), respectively. The observed acute grade 3 toxicities were dysphagia (44%), oral and/or oropharyngeal mucositis (40%) and dermatitis (21%). Late toxicity was predominantly clinically significant xerostomia (42%), dysgeusia (23%) and dysphagia (8%).Conclusion: SIB IMRT is feasible, safe and effective in the treatment of HNSCC patients. [ABSTRACT FROM AUTHOR]