1
|
The quality of life of men one year after radiotherapy for head and neck cancer: The fine details of experience matter. Radiography (Lond) 2022; 28:654-659. [PMID: 35594812 DOI: 10.1016/j.radi.2022.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 03/22/2022] [Accepted: 04/22/2022] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Radiographers and radiation therapists (RTT) meet cancer patients at the diagnosis, radiation treatment and late check-ups. This study aims to gain insight into men's experience concerning the quality of life one year after completing radiation therapy for head and neck cancer to contribute to radiographers' and RTT's understanding of patients' experiences during treatment. METHODS Six male head and neck cancer survivors were enrolled and interviewed one year after radiation therapy. Semi-structured interview transcriptions were coded to include statements about their experience of quality of life. Siri Næss' definition of quality of life is used as a theoretical framework. RESULTS This study generated four categories related to the personal experience concerned with the quality of life one year after radiotherapy treatment: Overwhelmed by information, Talking about mental well-being, Transitions - Cured but not healed, and The Fine Details to Quality of Life. There is a tendency that the patients do not express their emotions but express their assessments. CONCLUSION This study contributes to a nuanced understanding concerning the possibility of high quality of life despite many late effects among men with head and neck cancer. The informants are overwhelmed by information before and after the course of treatment. The fine details in quality of life have a significant influence on the everyday life of head and neck cancer survivors. The findings have implications for radiographers' and RTT's communication, which requires knowledge of the patient's overall course of treatment. IMPLICATIONS FOR PRACTICE The study indicates that it is vital for informants to be seen. Radiographers and RTT's must know of the patients' course of treatment and apply this in the dialogue with the patients.
Collapse
|
2
|
Safak G, Celiker M, Tümkaya L, Mercantepe T, Rakici S, Cinar S, Yilmaz A, Terzi S, Demir E, Celebi Erdivanlı O, Ozergin Coşkun Z, Karakaş S, Birinci M, Dursun E. Comparison of effects of dexmedetomidine and amifostine against X-ray radiation-induced parotid damage. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2022; 61:241-253. [PMID: 35147734 DOI: 10.1007/s00411-022-00964-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 01/21/2022] [Indexed: 06/14/2023]
Abstract
Radiotherapy can be employed as a therapeutic modality alone in the early stages of cancer and is used together with other treatments such as surgery and chemotherapy in more advanced stages. However, exposure to ionizing radiation in association with radiotherapy affects several organs in the head and neck and can give rise to early and late side effects. Exposure to ionizing radiation used in radiotherapy is known to cause cell damage by leading to oxygen stress through the production of free oxygen radicals (such as superoxide radicals, hydroxyl radical, hydrogen peroxide, and singlet oxygen), depending on the total radiation dosage, the fractionation rate, radiosensitivity, and linear energy transfer. The purpose of the present study was to determine the potential protective role of a powerful and highly selective α2-adrenoreceptor agonist with a broad pharmacological spectrum against salivary gland damage induced by ionizing radiation exposure. Forty Sprague-Dawley rats were divided into five groups-control, ionizing radiation, ionizing radiation + dexmedetomidine (100 µg/kg), ionizing radiation + dexmedetomidine (200 µg/kg), and ionizing radiation + amifostine (200 mg/kg). Following exposure to ionizing radiation, we observed necrosis, fibrosis, and vascular congestions in parotid gland epithelial cells. We also observed increases in malondialdehyde (MDA) and cleaved Caspase-3 levels and a decrease in glutathione (GSH). In groups receiving dexmedetomidine, we observed necrotic epithelial cells, fibrosis and vascular congestion in parotid gland tissue, a decrease in MDA levels, and an increase in GSH. Dexmedetomidine may be a promising antioxidant agent for the prevention of oxidative damage following radiation exposure.
Collapse
Affiliation(s)
- Gökhan Safak
- Department of Otolaryngology, Faculty of Medicine, Recep Tayyip Erdogan University, İki nolu sehitler caddesi, Rize, 53010, Turkey.
| | - Metin Celiker
- Department of Otolaryngology, Faculty of Medicine, Recep Tayyip Erdogan University, İki nolu sehitler caddesi, Rize, 53010, Turkey
| | - Levent Tümkaya
- Department of Histology and Embryology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, 53010, Turkey
| | - Tolga Mercantepe
- Department of Histology and Embryology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, 53010, Turkey
| | - Sema Rakici
- Department of Radiation Oncology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, 53010, Turkey
| | - Seda Cinar
- Department of Histology and Embryology, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, 53010, Turkey
| | - Adnan Yilmaz
- Department of Biochemistry, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, 53010, Turkey
| | - Suat Terzi
- Department of Otolaryngology, Faculty of Medicine, Recep Tayyip Erdogan University, İki nolu sehitler caddesi, Rize, 53010, Turkey
| | - Emine Demir
- Department of Otolaryngology, Faculty of Medicine, Altınbas University, Rize, 34000, Turkey
| | - Ozlem Celebi Erdivanlı
- Department of Otolaryngology, Faculty of Medicine, Recep Tayyip Erdogan University, İki nolu sehitler caddesi, Rize, 53010, Turkey
| | - Zerrin Ozergin Coşkun
- Department of Otolaryngology, Faculty of Medicine, Recep Tayyip Erdogan University, İki nolu sehitler caddesi, Rize, 53010, Turkey
| | - Sibel Karakaş
- Department of Biochemistry, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, 53010, Turkey
| | - Mehmet Birinci
- Departments of Otolaryngology, Of State Hospital, Trabzon, 61000, Turkey
| | - Engin Dursun
- Department of Otolaryngology, Faculty of Medicine, Recep Tayyip Erdogan University, İki nolu sehitler caddesi, Rize, 53010, Turkey
| |
Collapse
|
3
|
Doo AR, Hwang H, Ki MJ, Lee JR, Kim DC. Effects of preoperative oral carbohydrate administration on patient well-being and satisfaction in thyroid surgery. Korean J Anesthesiol 2018; 71:394-400. [PMID: 29684984 PMCID: PMC6193600 DOI: 10.4097/kja.d.18.27143] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 08/22/2017] [Indexed: 12/16/2022] Open
Abstract
Background Although the positive effects of preoperative oral carbohydrate administration on clinical outcomes followingmajor surgery have been reported continuously, there are few investigations of them in minor surgical patients. Thepresent study was designed to examine the effects of preoperative oral carbohydrate administration on patient well-beingand satisfaction in patients undergoing thyroidectomy. Methods Fifty adults aged 20–65 years and scheduled for elective thyroidectomy in first schedule in the morning wereallocated to one of two groups. The Control group (n = 25) was requested to obey traditional preoperative fasting aftermidnight prior to the day of surgery. The Carbohydrate group (n = 25) also fasted overnight but drank 400 ml of carbohydrate-richdrink 2 hours before induction of anesthesia. Patient well-being (thirst, hunger, mouth dryness, nauseaand vomiting, fatigue, anxiety and sleep quality) and satisfaction were assessed just before the operating room admission(preoperative) and 6 hours following surgery (postoperative). Other secondary outcomes including oral Schirmer’s testand plasma glucose concentrations were also evaluated. Results The two groups were homogenous in patient characteristics. Seven parameters representing patient well-beingevaluated on NRS (0–10) and patient satisfaction scored on a 5-point scale were not statistically different between thetwo groups preoperatively and postoperatively. There were no statistically significant differences in secondary outcomes. Conclusions Preoperative oral carbohydrate administration does not appear to improve patient well-being and satisfactioncompared with midnight fasting in patients undergoing thyroidectomy in first schedule in the morning.
Collapse
Affiliation(s)
- A Ram Doo
- Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea
| | - Hyunsup Hwang
- Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea
| | - Min-Jong Ki
- Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea
| | - Jun-Rae Lee
- Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea
| | - Dong-Chan Kim
- Department of Anesthesiology and Pain Medicine, Chonbuk National University Medical School and Hospital, Jeonju, Korea
| |
Collapse
|
4
|
Zhou N, Chu C, Dou X, Chen W, He J, Yan J, Zhou Z, Yang X. Early evaluation of radiation-induced parotid damage in patients with nasopharyngeal carcinoma by T2 mapping and mDIXON Quant imaging: initial findings. Radiat Oncol 2018; 13:22. [PMID: 29422068 PMCID: PMC5806279 DOI: 10.1186/s13014-018-0970-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 02/05/2018] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Radiation-induced parotid damage is a common complication in patients with nasopharyngeal carcinoma (NPC) treated with radiotherapy to head and neck region, which severely reduce the life quality of those patients. The aim of this study was to early evaluate the changes of irradiated parotid glands with T2 mapping and mDIXON Quant imaging. METHODS Forty-one patients with NPC underwent conventional magnetic resonance imaging for nasopharynx and neck, and T2 mapping and mDIXON Quant imaging for bilateral parotid glands within 2 weeks before radiotherapy (pre-RT), 5 weeks after the beginning of radiotherapy (mid-RT), and 4 weeks after radiotherapy (post-RT). Parotid volume, T2 values, fat fraction (FF) values, and mean radiation dose were recorded and analyzed. RESULTS From pre-RT to mid-RT, parotid volume decreased (atrophy rate, 27.0 ± 11.5%), while parotid T2 and FF values increased (change rate, 6.0 ± 6.2% for T2 value and 9.1 ± 9.9% for FF value) significantly. From mid-RT to post-RT, parotid T2 value continuously increased (change rate, 4.6 ± 7.7%), but parotid FF value decreased (change rate, - 9.9 ± 18.2%) significantly. Change rate of parotid T2 value significantly correlated with parotid atrophy rate from pre-RT to post-RT (r = 0.313, P = 0.027). Multiple linear regression analysis showed that parotid T2 value (standardized coefficient [SC] = - 0.259, P = 0.001) and FF value (SC = - 0.320, P = 0.014) negatively correlated with parotid volume, while parotid T2 value positively correlated with MR scan time point (SC = 0.476, P = 0.001) significantly. Parotid T2 and FF values showed excellent reproducibility (intraclass correlation coefficient, 0.935-0.992). CONCLUSIONS T2 mapping and mDIXON Quant imaging is useful for noninvasive evaluation of radiation-induced parotid damage.
Collapse
Affiliation(s)
- Nan Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008 China
| | - Chen Chu
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008 China
| | - Xin Dou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008 China
| | - Weibo Chen
- Philips Healthcare, Shanghai, 200233 China
| | - Jian He
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008 China
| | - Jing Yan
- The Comprehensive Cancer Centre of Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, 210008 China
| | - Zhengyang Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008 China
| | - Xiaofeng Yang
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA 30322 USA
| |
Collapse
|
5
|
Zhou N, Chen W, Pan X, He J, Yan J, Zhou Z, Yang X. Early evaluation of radiation-induced parotid damage with diffusion kurtosis imaging: a preliminary study. Acta Radiol 2018; 59:212-220. [PMID: 28509567 DOI: 10.1177/0284185117710051] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background Radiation-induced parotid gland damage is a common complication of radiotherapy (RT) in patients with nasopharyngeal carcinoma (NPC), which always causes xerostomia, dysphagia, dental caries, and even sleep disorders. Early evaluation of radiation-induced parotid damage is required to facilitate early interventions. Purpose To early-evaluate radiation-induced parotid damage using diffusion kurtosis imaging (DKI) in patients with NPC undergoing RT. Material and Methods Thirty-two patients with NPC underwent DKI for parotid glands pre-RT (two weeks before RT), mid-RT (five weeks after RT began), and post-RT (four weeks after RT). Parotid volume, apparent diffusion coefficient (ADC), corrected diffusion coefficient (D), excess diffusion kurtosis coefficient (K) values, mean radiation dose, and xerostomia degrees were recorded and analyzed. Results During RT, parotid ADC (change rates = 41.3 ± 25.2% at mid-RT, 70.8 ± 34.3% at post-RT) and D (change rates = 41.9 ± 25.2% at mid-RT, 63.2 ± 30.2% at post-RT) increased, while parotid volume (atrophy rates = 31.5 ± 7.9% at mid-RT, 30.6 ± 10.3% at post-RT) and K (change rates = -17.8 ± 11.0% at mid-RT, -29.8 ± 9.0% at post-RT) decreased significantly (all P < 0.001). At post-RT, the change rate of parotid D values was significantly positively correlated with the mean radiation dose ( r = 0.455, P < 0.001). Parotid ADC, D, and K values showed excellent intra- and inter-observer agreement (intraclass correlation coefficient = 0.946-0.985). Conclusion Radiation-induced parotid damage in patients with NPC undergoing RT could be effectively evaluated by DKI in the early stage.
Collapse
Affiliation(s)
- Nan Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, PR China
| | - Weibo Chen
- Shanghai Key Laboratory of Magnetic Resonance, East China Normal University, Shanghai, PR China
| | - Xia Pan
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, PR China
| | - Jian He
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, PR China
| | - Jing Yan
- The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, Jiangsu Province, PR China
| | - Zhengyang Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu Province, PR China
| | - Xiaofeng Yang
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, USA
| |
Collapse
|
6
|
Apparent diffusion coefficient histogram analysis can evaluate radiation-induced parotid damage and predict late xerostomia degree in nasopharyngeal carcinoma. Oncotarget 2017; 8:70226-70238. [PMID: 29050274 PMCID: PMC5642549 DOI: 10.18632/oncotarget.19602] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 06/27/2017] [Indexed: 12/17/2022] Open
Abstract
We investigated apparent diffusion coefficient (ADC) histogram analysis to evaluate radiation-induced parotid damage and predict xerostomia degrees in nasopharyngeal carcinoma (NPC) patients receiving radiotherapy. The imaging of bilateral parotid glands in NPC patients was conducted 2 weeks before radiotherapy (time point 1), one month after radiotherapy (time point 2), and four months after radiotherapy (time point 3). From time point 1 to 2, parotid volume, skewness, and kurtosis decreased (P < 0.001, = 0.001, and < 0.001, respectively), but all other ADC histogram parameters increased (all P < 0.001, except P = 0.006 for standard deviation [SD]). From time point 2 to 3, parotid volume continued to decrease (P = 0.022), and SD, 75th and 90th percentiles continued to increase (P = 0.024, 0.010, and 0.006, respectively). Early change rates of parotid ADCmean, ADCmin, kurtosis, and 25th, 50th, 75th, 90th percentiles (from time point 1 to 2) correlated with late parotid atrophy rate (from time point 1 to 3) (all P < 0.05). Multiple linear regression analysis revealed correlations among parotid volume, time point, and ADC histogram parameters. Early mean change rates for bilateral parotid SD and ADCmax could predict late xerostomia degrees at seven months after radiotherapy (three months after time point 3) with AUC of 0.781 and 0.818 (P = 0.014, 0.005, respectively). ADC histogram parameters were reproducible (intraclass correlation coefficient, 0.830 - 0.999). ADC histogram analysis could be used to evaluate radiation-induced parotid damage noninvasively, and predict late xerostomia degrees of NPC patients treated with radiotherapy.
Collapse
|
7
|
Early Changes of Irradiated Parotid Glands Evaluated by T1rho-Weighted Imaging. J Comput Assist Tomogr 2017; 41:472-476. [DOI: 10.1097/rct.0000000000000547] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
8
|
Zhou N, Chu C, Dou X, Li M, Liu S, Zhu L, Liu B, Guo T, Chen W, He J, Yan J, Zhou Z, Yang X, Liu T. Early evaluation of irradiated parotid glands with intravoxel incoherent motion MR imaging: correlation with dynamic contrast-enhanced MR imaging. BMC Cancer 2016; 16:865. [PMID: 27821130 PMCID: PMC5100256 DOI: 10.1186/s12885-016-2900-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 10/30/2016] [Indexed: 12/13/2022] Open
Abstract
Background Radiation-induced parotid damage is one of the most common complications in patients with nasopharyngeal carcinoma (NPC) undergoing radiotherapy (RT). Intravoxel incoherent motion (IVIM) magnetic resonance (MR) imaging has been reported for evaluating irradiated parotid damage. However, the changes of IVIM perfusion-related parameters in irradiated parotid glands have not been confirmed by conventional perfusion measurements obtained from dynamic contrast-enhanced (DCE) MR imaging. The purposes of this study were to monitor radiation-induced parotid damage using IVIM and DCE MR imaging and to investigate the correlations between changes of these MR parameters. Methods Eighteen NPC patients underwent bilateral parotid T1-weighted, IVIM and DCE MR imaging pre-RT (2 weeks before RT) and post-RT (4 weeks after RT). Parotid volume; IVIM MR parameters, including apparent diffusion coefficient (ADC), pure diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f); and DCE MR parameters, including maximum relative enhancement (MRE), time to peak (TTP), Wash in Rate, and the degree of xerostomia were recorded. Correlations of parotid MR parameters with mean radiation dose, atrophy rate and xerostomia degree, as well as the relationships between IVIM and DCE MR parameters, were investigated. Results From pre-RT to post-RT, all of the IVIM and DCE MR parameters increased significantly (p < 0.001 for ADC, D, f, MRE, Wash in Rate; p = 0.024 for D*; p = 0.037 for TTP). Change rates of ADC, f and MRE were negatively correlated with atrophy rate significantly (all p < 0.05). Significant correlations were observed between the change rates of D* and MRE (r = 0.371, p = 0.026) and between the change rates of D* and TTP (r = 0.396, p = 0.017). The intra- and interobserver reproducibility of IVIM and DCE MR parameters was good to excellent (intraclass correlation coefficient, 0.633–0.983). Conclusions Early radiation-induced changes of parotid glands could be evaluated by IVIM and DCE MR imaging. Certain IVIM and DCE MR parameters were correlated significantly.
Collapse
Affiliation(s)
- Nan Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Chen Chu
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Xin Dou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Ming Li
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Song Liu
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China
| | - Lijing Zhu
- The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, 210008, China
| | - Baorui Liu
- The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, 210008, China
| | - Tingting Guo
- Department of Radiology, Nanjing Drum Tower Hospital Clinical College of Traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210008, China
| | - Weibo Chen
- Philips Healthcare, Shanghai, 200233, China
| | - Jian He
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
| | - Jing Yan
- The Comprehensive Cancer Centre of Drum Tower Hospital, Medical School of Nanjing University & Clinical Cancer Institute of Nanjing University, Nanjing, 210008, China.
| | - Zhengyang Zhou
- Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, 210008, China.
| | - Xiaofeng Yang
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30322, USA
| | - Tian Liu
- Department of Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, GA, 30322, USA
| |
Collapse
|
9
|
Nair RP, Zheng C, Sunavala-Dossabhoy G. Retroductal Submandibular Gland Instillation and Localized Fractionated Irradiation in a Rat Model of Salivary Hypofunction. J Vis Exp 2016. [PMID: 27168158 DOI: 10.3791/53785] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Normal tissues that lie within the portals of radiation are inadvertently damaged. Salivary glands are often injured during head and neck radiotherapy. Irreparable cell damage results in a chronic loss of salivary function that impairs basic oral activities, and increases the risk of oral infections and dental caries. Salivary hypofunction and its complications gravely impact a patient's comfort. Current symptomatic management of the condition is ineffective, and newer therapies to assuage the condition are needed. Salivary glands are exocrine glands, which expel their secretions into the mouth via excretory ducts. Cannulation of these ducts provides direct access to the glands. Retroductal delivery of a contrast agent to major salivary glands is a routine out-patient procedure for diagnostic imaging. Using a similar procedure, localized treatment of the glands is feasible. However, performing this technique in preclinical studies with small animals poses unique challenges. In this study we describe the technique of retroductal administration in rat submandibular glands, a procedure that was refined in Dr. Bruce Baum's laboratory (NIH)(1), and lay out a procedure for local gland irradiation.
Collapse
Affiliation(s)
| | - Changyu Zheng
- Molecular Physiology and Therapeutics Branch, National Institute of Dental and Craniofacial Research, NIH, DHHS
| | | |
Collapse
|
10
|
Abstract
The sense of taste, or gustation, is mediated by taste buds, which are housed in specialized taste papillae found in a stereotyped pattern on the surface of the tongue. Each bud, regardless of its location, is a collection of ∼100 cells that belong to at least five different functional classes, which transduce sweet, bitter, salt, sour and umami (the taste of glutamate) signals. Taste receptor cells harbor functional similarities to neurons but, like epithelial cells, are rapidly and continuously renewed throughout adult life. Here, I review recent advances in our understanding of how the pattern of taste buds is established in embryos and discuss the cellular and molecular mechanisms governing taste cell turnover. I also highlight how these findings aid our understanding of how and why many cancer therapies result in taste dysfunction.
Collapse
Affiliation(s)
- Linda A Barlow
- Department of Cell and Developmental Biology, Graduate Program in Cell Biology, Stem Cells and Development and the Rocky Mountain Taste and Smell Center, University of Colorado, School Medicine, Anschutz Medical Campus, Aurora, CO 80045, USA
| |
Collapse
|
11
|
|
12
|
Liu C, Kong X, Gong G, Liu T, Li B, Yin Y. Error in the parotid contour delineated using computed tomography images rather than magnetic resonance images during radiotherapy planning for nasopharyngeal carcinoma. Jpn J Radiol 2014; 32:211-6. [DOI: 10.1007/s11604-014-0286-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Accepted: 01/09/2014] [Indexed: 10/25/2022]
|
13
|
Payne KF, Balasundaram I, Deb S, Di Silvio L, Fan KF. Tissue engineering technology and its possible applications in oral and maxillofacial surgery. Br J Oral Maxillofac Surg 2014; 52:7-15. [DOI: 10.1016/j.bjoms.2013.03.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 03/09/2013] [Indexed: 12/27/2022]
|
14
|
|
15
|
Exploring the dynamic core microbiome of plaque microbiota during head-and-neck radiotherapy using pyrosequencing. PLoS One 2013; 8:e56343. [PMID: 23437114 PMCID: PMC3578878 DOI: 10.1371/journal.pone.0056343] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2012] [Accepted: 01/08/2013] [Indexed: 12/14/2022] Open
Abstract
Radiotherapy is the primary treatment modality used for patients with head-and-neck cancers, but inevitably causes microorganism-related oral complications. This study aims to explore the dynamic core microbiome of oral microbiota in supragingival plaque during the course of head-and-neck radiotherapy. Eight subjects aged 26 to 70 were recruited. Dental plaque samples were collected (over seven sampling time points for each patient) before and during radiotherapy. The V1–V3 hypervariable regions of bacterial 16S rRNA genes were amplified, and the high-throughput pyrosequencing was performed. A total of 140 genera belonging to 13 phyla were found. Four phyla (Actinobacteria, Bacteroidetes, Firmicutes, and Proteobacteria) and 11 genera (Streptococcus, Actinomyces, Veillonella, Capnocytophaga, Derxia, Neisseria, Rothia, Prevotella, Granulicatella, Luteococcus, and Gemella) were found in all subjects, supporting the concept of a core microbiome. Temporal variation of these major cores in relative abundance were observed, as well as a negative correlation between the number of OTUs and radiation dose. Moreover, an optimized conceptual framework was proposed for defining a dynamic core microbiome in extreme conditions such as radiotherapy. This study presents a theoretical foundation for exploring a core microbiome of communities from time series data, and may help predict community responses to perturbation as caused by exposure to ionizing radiation.
Collapse
|
16
|
Cruz ÉDPD, Toporcov TN, Rotundo LDB, Biazevic MGH, Brasileiro RS, Carvalho MBD, Kowalski LP, Antunes JLF. Food restrictions of patients who are undergoing treatment for oral and oropharyngeal cancer. Eur J Oncol Nurs 2012; 16:253-7. [DOI: 10.1016/j.ejon.2011.06.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2011] [Revised: 05/26/2011] [Accepted: 06/12/2011] [Indexed: 10/17/2022]
|
17
|
Lu TL, Sun WG, Zhao W, Chen T. Preparation of amifostine polylactide-co-glycolide microspheres and its irradiation protective to mouse through oral administration. Drug Dev Ind Pharm 2011; 37:1473-80. [DOI: 10.3109/03639045.2011.587429] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
18
|
Risk of Xerostomia in Association With the Receipt of Radiation Therapy in Older Patients With Head and Neck Cancer. Am J Ther 2011; 18:206-15. [DOI: 10.1097/mjt.0b013e3181c960dc] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
19
|
Shao ZY, Tang ZS, Yan C, Jiang YT, Ma R, Liu Z, Huang ZW. Effects of intensity-modulated radiotherapy on human oral microflora. JOURNAL OF RADIATION RESEARCH 2011; 52:834-839. [PMID: 22104273 DOI: 10.1269/jrr.11085] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
This study aimed to evaluate changes in the biodiversity of the oral microflora of patients with head and neck cancer treated with postoperative intensity-modulated radiotherapy (IMRT) or conventional radiotherapy (CRT). Pooled dental plaque samples were collected during the radiation treatment from patients receiving IMRT (n = 13) and CRT (n = 12). Denaturing gradient gel electrophoresis (DGGE) was used to analyze the temporal variation of these plaque samples. The stimulated and unstimulated salivary flow rates were also compared between IMRT and CRT patients. Reductions in the severity of hyposalivation were observed in IMRT patients compared with CRT patients. We also observed that the temporal stability of the oral ecosystem was significantly higher in the IMRT group (69.96 ± 7.82%) than in the CRT group (51.98 ± 10.45%) (P < 0.05). The findings of the present study suggest that IMRT is more conducive to maintaining the relative stability of the oral ecosystem than CRT.
Collapse
Affiliation(s)
- Zi-Yang Shao
- Division of Radiation Oncology, Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, PR China
| | | | | | | | | | | | | |
Collapse
|
20
|
Simcock R, Jenkins V. Acupuncture and Xerostomia. Acupunct Med 2010; 28:167-8. [DOI: 10.1136/aim.2010.003293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Richard Simcock
- Brighton & Sussex University Hospitals NHS Trust, Sussex Cancer Centre, Brighton, UK
| | - Valerie Jenkins
- Cancer Research Psychosocial Oncology Group, Brighton & Sussex Medical School, University of Sussex, Brighton, UK
| |
Collapse
|
21
|
Palaniyandi S, Odaka Y, Green W, Abreo F, Caldito G, Benedetti AD, Sunavala-Dossabhoy G. Adenoviral delivery of Tousled kinase for the protection of salivary glands against ionizing radiation damage. Gene Ther 2010; 18:275-82. [DOI: 10.1038/gt.2010.142] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
|
22
|
Pamujula S, Graves RA, Moiseyev R, Bostanian LA, Kishore V, Mandal TK. Preparation of polylactide-co-glycolide and chitosan hybrid microcapsules of amifostine using coaxial ultrasonic atomizer with solvent evaporation. J Pharm Pharmacol 2010; 60:283-9. [DOI: 10.1211/jpp.60.3.0002] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Abstract
The objective of this study was to evaluate the effect of various processing and formulation factors on the characteristics of amifostine hybrid microcapsules. Amifostine-loaded hybrid microcapsules were prepared using PLGA and chitosan. In short, amifostine powder was dissolved in de-aerated water with or without chitosan. The amifostine solution was later emulsified into PLGA solution in dichloromethane containing phosphatidylcholine. The resultant emulsion was fed through the inner capillary of a coaxial ultrasonic atomizer. The liquid fed through the coaxial outer capillary was either water or chitosan solution. The atomized droplets were collected into PVA solution and the droplets formed microcapsules immediately. The hybrid microcapsules prepared with chitosan solution only as an outer layer liquid showed the maximum efficiency of encapsulation (30%). The median sizes of all three formulations were 33–44 μm. These formulations with chitosan showed positive zeta-potential and sustained drug release with 13–45% amifostine released in 24 h. When chitosan was incorporated into inner as well as outer liquid layers, the drug release increased significantly, 45% (compared with other formulations) released in 24 h and almost 100% released in 11 days. Hybrid microcapsules of amifostine showed moderately high efficiency of encapsulation. The cationic charge (due to the presence of chitosan) of these particles is expected to favour oral absorption and thus overall bioavailability of orally administered amifostine.
Collapse
Affiliation(s)
- Sarala Pamujula
- College of Pharmacy, Xavier University of Louisiana, New Orleans, Louisiana 70125, USA
| | - Richard A Graves
- College of Pharmacy, Xavier University of Louisiana, New Orleans, Louisiana 70125, USA
| | - Raisa Moiseyev
- College of Pharmacy, Xavier University of Louisiana, New Orleans, Louisiana 70125, USA
| | - Levon A Bostanian
- College of Pharmacy, Xavier University of Louisiana, New Orleans, Louisiana 70125, USA
| | - Vimal Kishore
- College of Pharmacy, Xavier University of Louisiana, New Orleans, Louisiana 70125, USA
| | - Tarun K Mandal
- College of Pharmacy, Xavier University of Louisiana, New Orleans, Louisiana 70125, USA
| |
Collapse
|
23
|
|
24
|
Teymoortash A, Müller F, Juricko J, Bieker M, Mandic R, Librizzi D, Höffken H, Pfestroff A, Werner JA. Botulinum toxin prevents radiotherapy-induced salivary gland damage. Oral Oncol 2009; 45:737-9. [PMID: 19213593 DOI: 10.1016/j.oraloncology.2008.11.014] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2008] [Revised: 11/20/2008] [Accepted: 11/20/2008] [Indexed: 11/28/2022]
Abstract
Radiotherapy of head and neck malignancies results in severe damage to salivary glands. Irradiation-induced sialadenitis with xerostomia leads to a significant deterioration of the quality of life which lasts life-long. Here we show in a preliminary study that intraglandular application of botulinum toxin performed prior to radiation reduces significantly the radiation induced toxicity of the glandular tissue in rats.
Collapse
Affiliation(s)
- Afshin Teymoortash
- Department of Otolaryngology, Head and Neck Surgery, Philipp University, Marburg, Germany.
| | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Rogers LQ, Courneya KS, Robbins KT, Rao K, Malone J, Seiz A, Reminger S, Markwell SJ, Burra V. Factors associated with fatigue, sleep, and cognitive function among patients with head and neck cancer. Head Neck 2009; 30:1310-7. [PMID: 18642320 DOI: 10.1002/hed.20873] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fatigue, sleep disturbances, and cognitive impairment are prevalent and clinically important problems among head and neck cancer patients. Our study aim was to determine the most important correlates of these problems among patients with head and neck cancer. METHODS A cross-sectional, self-administered survey was completed by 58 (response rate 79%) patients with head and neck cancer in an academic oncology clinic. RESULTS Multiple linear-regression analyses demonstrated that fatigue was associated with younger age (beta=-0.22), previous radiation therapy (beta=0.23), fewer months since cancer diagnosis (beta=-0.25), and depression (beta=0.40). Sleep dysfunction was associated with younger age (beta=-0.31) and higher symptom index (beta=0.39). Cognitive dysfunction was associated with higher symptom index only (beta=-0.49). CONCLUSIONS Younger age, previous radiation, more recent cancer diagnosis, depression, and more severe symptoms may be associated with fatigue, sleep, and/or cognitive dysfunction. These results suggest at-risk subgroups warranting more aggressive screening and potentially supportive care interventions.
Collapse
Affiliation(s)
- Laura Q Rogers
- Department of Medicine, SIU School of Medicine, Springfield, Illinois, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
26
|
Juan CJ, Chen CY, Jen YM, Liu HS, Liu YJ, Hsueh CJ, Wang CY, Chou YC, Chai YT, Huang GS, Chung HW. Perfusion characteristics of late radiation injury of parotid glands: quantitative evaluation with dynamic contrast-enhanced MRI. Eur Radiol 2008; 19:94-102. [PMID: 18661135 DOI: 10.1007/s00330-008-1104-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2007] [Revised: 05/28/2008] [Accepted: 06/05/2008] [Indexed: 10/21/2022]
Abstract
We aimed to quantitatively investigate the alteration of parotid perfusion after irradiation using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) based on a two-compartment tracer kinetic model. This study enrolled 19 patients (53.2 +/- 14.9 years) treated by head and neck radiotherapy and 19 age-relevant and sex-matched subjects as a control group. Perfusion parameters (K ( el ), k (21) and A) of parotid glands were analyzed based on the Brix model from T1-weighted DCE-MRI. Suitability of the Brix model was evaluated via Monte Carlo simulation for the goodness-of-fit. Analysis of nonlinear goodness-of-fit showed that the Brix model is appropriate in evaluating the parotid perfusion (R(2) = 0.938 +/- 0.050). The irradiated parotid glands showed significantly lower K ( el ) (P < 0.0005) and k (21) (P < 0.05) and consequently significantly higher value of peak enhancement (P < 0.0005) and time-to-peak (P < 0.0005) compared with non-irradiated ones, suggestive of gradual and prolonged accumulation and delayed wash-out of contrast agent due to increased extracellular extravascular space and decreased vascular permeability in the irradiated glands. Linear regression analysis showed dose-dependent perfusion changes of the irradiated parotid glands. We conclude that quantitative DCE-MRI is a potential tool in investigating parotid gland perfusion changes after radiotherapy.
Collapse
Affiliation(s)
- Chun-Jung Juan
- Department of Radiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan, Republic of China
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
de Castro G, Snitcovsky IML, Gebrim EMMS, Leitão GM, Nadalin W, Ferraz AR, Federico MHH. High-dose cisplatin concurrent to conventionally delivered radiotherapy is associated with unacceptable toxicity in unresectable, non-metastatic stage IV head and neck squamous cell carcinoma. Eur Arch Otorhinolaryngol 2007; 264:1475-82. [PMID: 17643256 DOI: 10.1007/s00405-007-0395-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2007] [Accepted: 06/28/2007] [Indexed: 10/23/2022]
Abstract
Unresectable head and neck squamous cell carcinoma (HNSCC), non-metastatic, comprises a heterogeneous group of patients (pts), formed of stage III and IV pts. Since the available literature had not distinguished among these two groups, we prospectively addressed whether the recommended regimen involving cisplatin 100 mg/m2 concurrent to conventionally delivered radiotherapy (RT) is feasible in stage IV pts, based on the efficacy and safety of this regimen. A total of 30 pts were enrolled onto this study. Chemoradiation (CRT) consisted of RT 70 Gy, delivered in 35 daily fractions of 2 Gy, in 7 weeks, concurrent to cisplatin 100 mg/m2 on days 1, 22 and 43. Supportive treatment was provided as needed. Twenty-eight pts had tumors staged as T4 and 20 had N2 or N3 cervical involvement. The most common primary sites were the oral cavity and the oropharynx (23 pts). We observed six complete responses and 12 partial responses, with an overall response rate of 60%. A high rate of treatment-related toxicities was observed, with three deaths during CRT, and 26 pts suffering from one or more grade 3/4 toxicities, mainly dysphagia, mucositis, dermatitis, vomiting, infection or anemia. A prolonged treatment time was observed (63 days), as a result of unplanned treatment breaks. The lack of requirement of red blood cell transfusion was favorably related to the response to the treatment (93% vs. 50%, P=0.033). For the whole population, with a median follow-up of 20.8 months, the median progression-free survival (PFS) was 8.0 months, and the median overall survival (OS) was 17.3 months. Longer median PFS and OS were seen in responding pts (12.8 vs. 4.1 months, P=0.0001; and not reached (NR) vs. 10.4 months, P=0.0037, respectively), as well as in those pts not requiring red blood cell transfusion (12.8 vs. 3.9 months, P=0.0162; and NR vs. 10.4 months, P=0.0176, respectively). In conclusion, this concurrent CRT regimen is hardly delivered in stage IV, unresectable, locally advanced HNSCC pts, due to treatment-related toxicities and longer RT duration. As a subset of pts may benefit from this regimen, adequate patient selection and aggressive supportive measures are essential.
Collapse
Affiliation(s)
- Gilberto de Castro
- Centro de Oncologia-InRad, Hospital das Clínicas da Faculdade de Medicina da USP, Av. Dr. Ovídio Pires de Campos, s/n-2o andar, São Paulo, SP, 05403-010, Brazil.
| | | | | | | | | | | | | |
Collapse
|
28
|
Goessler UR, Stern-Straeter J, Riedel K, Bran GM, Hörmann K, Riedel F. Tissue engineering in head and neck reconstructive surgery: what type of tissue do we need? Eur Arch Otorhinolaryngol 2007; 264:1343-56. [PMID: 17628823 DOI: 10.1007/s00405-007-0369-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2007] [Accepted: 05/25/2007] [Indexed: 01/14/2023]
Abstract
Craniofacial tissue loss due to congenital defects, disease or injury is a major clinical problem. The head and neck region is composed of several tissues. The most prevalent method of reconstruction is autologous grafting. Often, there is insufficient host tissue for adequate repair of the defect side, and extensive donor site morbidity may result from the secondary surgical procedure. The field of tissue engineering has the potential to create functional replacements for damaged or pathologic tissues.
Collapse
Affiliation(s)
- Ulrich Reinhart Goessler
- Department of Otolaryngology, Head and Neck Surgery, University Hospital Mannheim, University of Heidelberg, 68135, Mannheim, Germany.
| | | | | | | | | | | |
Collapse
|