1
|
Rosati D, Mastino P, Romeo M, de Soccio G, Pentangelo D, Petrella C, Barbato C, Minni A. Taste and Smell Alterations (TSAs) in Cancer Patients. Diseases 2024; 12:130. [PMID: 38920562 PMCID: PMC11203271 DOI: 10.3390/diseases12060130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 05/30/2024] [Accepted: 06/19/2024] [Indexed: 06/27/2024] Open
Abstract
Recently, smell and taste disorders have seen renewed interest, as these symptoms are frequent complications of SARS-CoV-2 infection, since approximately 60% of patients affected by COVID-19 have shown olfactory and gustatory alterations. Otolaryngology pays attention to taste and smell abnormalities (TSAs), especially when associated with oncology. TSAs are common symptoms in people affected by cancer, yet they are ignored and underestimated. The clinical outcome of TSAs in cancer evidences the importance of identifying them with chemotherapy or radiotherapy in general, and they are associated with many types of cancer. We recognize the findings of the literature on TSAs in cancer, evaluating how it is important to consider and identify these disorders concerning reduced food enjoyment or inappropriate nutrient intake, and modulating the nutritional status, quality of life, and impact of therapy. This review aims to critically evaluate and recognize the assessment and clinical perspectives of taste and smell disorders in a cancer population.
Collapse
Affiliation(s)
- Davide Rosati
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
| | - Pierluigi Mastino
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
| | - Martina Romeo
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
| | - Giulia de Soccio
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
| | - Daniele Pentangelo
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
| | - Carla Petrella
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Roma, Italy;
| | - Christian Barbato
- Institute of Biochemistry and Cell Biology (IBBC), National Research Council (CNR), Sapienza University of Rome, Policlinico Umberto I, Viale del Policlinico 155, 00161 Roma, Italy;
| | - Antonio Minni
- Division of Otolaryngology-Head and Neck Surgery, Ospedale San Camillo de Lellis, ASL Rieti-Sapienza University, Viale Kennedy, 02100 Rieti, Italy; (D.R.); (P.M.); (M.R.)
- Department of Sense Organs DOS, Sapienza University of Rome, Viale del Policlinico 155, 00161 Roma, Italy
| |
Collapse
|
2
|
He C, Chen Y, Guo L, Zheng M, Wan J, Fan S, Zhang X, Deng Z, Zhao X, Yin S, Zhao X, Peng H, Fu X, Xiao P. Voice Changes of Patients With Nasopharyngeal Carcinoma in Eleven Years After Radiotherapy: A Cross-Sectional Study. J Voice 2024:S0892-1997(24)00136-X. [PMID: 38772832 DOI: 10.1016/j.jvoice.2024.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2024] [Revised: 04/10/2024] [Accepted: 04/11/2024] [Indexed: 05/23/2024]
Abstract
OBJECTIVES The objective of this study was to assess voice changes in patients with nasopharyngeal carcinoma (NPC) using subjective and objective assessment tools and to make inferences regarding the underlying pathological causes for different phases of radiotherapy (RT). METHODS A total of 187 (123 males and 64 females) patients with post-RT NPC with no recurrence of malignancy or other voice diseases and 17 (11 males and 6 females) healthy individuals were included in this study. The patients were equally divided into 11 groups according to the number of years after RT. The acoustic analyses, GRBAS (grade, roughness, breathiness, asthenia, and strain) scales, and Voice Handicap Index (VHI)-10 scores were collected and analyzed. RESULTS The fundamental frequency (F0) parameters in years 1 and 2 and year 11 were significantly lower in patients with NPC than in healthy individuals. The maximum phonation times in years 1 and 11 were significantly shorter than those in healthy individuals. The jitter parameters were significantly different between year 1 and from years 8 to 11 and the healthy individuals. The shimmer parameters were significantly different between years 1, from years 9 to 11, and healthy individuals. Hoarseness was the most prominent problem compared to other items of the GRBAS. The VHI-10 scores were significantly different between years 1 and 2 and year 11 after RT in patients with NPC. CONCLUSIONS Voice quality was worse in the first 2 years and from years 8 to 11 but remained relatively normal from years 3 to 7 after RT. Patient-reported voice handicaps began during year 3 after RT. The most prominent problem was perceived hoarseness, which was evident in the first 2 years and from years 9 to 11 after RT. The radiation-induced mucous edema, laryngeal intrinsic muscle fibrosis, nerve injuries, upper respiratory tract changes, and decreased lung capacity might be the pathological reasons for voice changes in post-RT patients with NPC.
Collapse
Affiliation(s)
- Cui He
- Department of Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China.
| | - Yixin Chen
- Hearing and Speech Science Department, Guangzhou Xinhua University, Guangzhou City, Guangdong Province, China
| | - Libing Guo
- Department of Oncology, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Mingfen Zheng
- Department of Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Jian Wan
- Department of Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Suxiao Fan
- Department of Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Xuhui Zhang
- Department of Oncology, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Zeyi Deng
- Department of Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Xiangdong Zhao
- Department of Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Shengsong Yin
- Department of Oncology, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Xueman Zhao
- Department of Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Hong Peng
- Department of Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Xiangjun Fu
- Department of Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| | - Ping Xiao
- Department of Otolaryngology Head and Neck Surgery, Guangdong Second Provincial General Hospital, Guangzhou City, Guangdong Province, China
| |
Collapse
|
3
|
Sharma S, Kumar Upadhyay A, Prakash A, Singodia P, Ravi Kiran S, Shankar R. Treatment Complications of Head and Neck Cancers and Rehabilitation Measures: A Narrative Review. Cureus 2024; 16:e61173. [PMID: 38933634 PMCID: PMC11204137 DOI: 10.7759/cureus.61173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2024] [Indexed: 06/28/2024] Open
Abstract
Head and neck cancers (HNCs) are malignant tumors mainly from squamous cells in the head and neck tissues. Treatment involves a multidisciplinary approach with surgery, radiotherapy, and chemotherapy. However, the long-term prognosis for patients with advanced-stage tumors is guarded, with a median survival time of approximately 24 months. HNC patients have very high rates of depression and anxiety and the highest suicide rate among all cancers due to the intense and challenging nature of the treatment, underscoring the importance of our collective efforts. Rehabilitation success depends on various factors, including tumor, patient, and treatment-related factors. Patients may require post-treatment oral rehabilitation measures, including implants, obturators, and flexible dentures. These measures are crucial, but they often need to be more utilized. Patients may face challenges in maintaining oral hygiene and managing mucositis. Additionally, it is essential to address other intricacies such as trismus, xerostomia, gustatory dysfunctions, neuropathy, speech impairments, and psychological disturbances. Unfortunately, there is little literature on post-treatment rehabilitative measures. Despite its crucial role in improving patients' quality of life, rehabilitation often receives inadequate attention compared to treatment. Our narrative review, which covers various factors that affect rehabilitation, including oral rehabilitation measures and post-treatment complications, is anticipated to deliver practical insights to professionals and inspire positive changes in their regular practice.
Collapse
Affiliation(s)
- Swati Sharma
- Prosthodontics, Crown and Bridge & Oral Implantology, Tata Main Hospital, Jamshedpur, IND
| | | | | | | | - Sarat Ravi Kiran
- Oral and Maxillofacial Surgery, Tata Main Hospital, Jamshedpur, IND
| | - Rama Shankar
- Oral and Maxillofacial Surgery, Tata Main Hospital, Jamshedpur, IND
| |
Collapse
|
4
|
Fijardo M, Kwan JYY, Bissey PA, Citrin DE, Yip KW, Liu FF. The clinical manifestations and molecular pathogenesis of radiation fibrosis. EBioMedicine 2024; 103:105089. [PMID: 38579363 PMCID: PMC11002813 DOI: 10.1016/j.ebiom.2024.105089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2024] [Revised: 02/25/2024] [Accepted: 03/12/2024] [Indexed: 04/07/2024] Open
Abstract
Advances in radiation techniques have enabled the precise delivery of higher doses of radiotherapy to tumours, while sparing surrounding healthy tissues. Consequently, the incidence of radiation toxicities has declined, and will likely continue to improve as radiotherapy further evolves. Nonetheless, ionizing radiation elicits tissue-specific toxicities that gradually develop into radiation-induced fibrosis, a common long-term side-effect of radiotherapy. Radiation fibrosis is characterized by an aberrant wound repair process, which promotes the deposition of extensive scar tissue, clinically manifesting as a loss of elasticity, tissue thickening, and organ-specific functional consequences. In addition to improving the existing technologies and guidelines directing the administration of radiotherapy, understanding the pathogenesis underlying radiation fibrosis is essential for the success of cancer treatments. This review integrates the principles for radiotherapy dosimetry to minimize off-target effects, the tissue-specific clinical manifestations, the key cellular and molecular drivers of radiation fibrosis, and emerging therapeutic opportunities for both prevention and treatment.
Collapse
Affiliation(s)
- Mackenzie Fijardo
- Research Institute, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Department of Cell and Systems Biology, University of Toronto, Toronto, Ontario, Canada
| | - Jennifer Yin Yee Kwan
- Research Institute, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
| | | | - Deborah E Citrin
- Radiation Oncology Branch, National Cancer Institute, Bethesda, MD, United States of America
| | - Kenneth W Yip
- Research Institute, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Department of Cell and Systems Biology, University of Toronto, Toronto, Ontario, Canada
| | - Fei-Fei Liu
- Research Institute, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Radiation Medicine Program, Princess Margaret Cancer Centre, Toronto, Ontario, Canada; Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada; Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.
| |
Collapse
|
5
|
Soejima S, Wu CH, Matsuse H, Terakado M, Okano S, Inoue T, Kumai Y. Swallowing-related muscle inflammation and fibrosis induced by a single dose of radiation exposure in mice. Lab Anim Res 2024; 40:12. [PMID: 38561867 PMCID: PMC10983736 DOI: 10.1186/s42826-024-00199-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 03/12/2024] [Accepted: 03/20/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Although radiotherapy is commonly used to treat head and neck cancer, it may lead to radiation-associated dysphagia (RAD). There are various causes of RAD, however, the mechanism has not yet been fully identified. Currently, the only effective treatment for RAD is rehabilitation. Additionally, there are few available animal models of RAD, necessitating the development of new models to establish and evaluate RAD treatments. We hypothesize that radiation-induced neck muscle fibrosis could be one of the causes of RAD due to impairment of laryngeal elevation. Therefore, in this study, we focused on the changes in inflammation and fibrosis of the strap muscles (Sternohyoid, Sternothyroid, and Thyrohyoid muscles) after a single-dose irradiation. This research aims to provide a reference animal model for future studies on RAD. RESULTS Compared to control mice, those treated with 72-Gy, but not 24-Gy, irradiation had significantly increased tumor necrosis factor-α (TNF-α) (p < 0.01) and α-smooth muscle actin (αSMA) (p < 0.05) expression at 10 days and significantly increased expression levels of motif chemokine ligand-2 (CCL2), α-SMA, tumor growth factor-β1 (TGF-β1), type1 collagen, and interleukin-1β (IL-1β) (p < 0.05) in the muscles at 1 month by real-time PCR analysis. The results of immunohistochemistry showed that the deposition of type 1 collagen gradually increased in extracellular space after radiation exposure, and the positive area was significantly increased at 3 months compared to non-irradiated control. CONCLUSIONS A single dose of 72-Gy irradiation induced significant inflammation and fibrosis in the strap muscles of mice at 1 month, with immunohistochemical changes becoming evident at 3 months. This cervical irradiation-induced fibrosis model holds potential for establishing an animal model for RAD in future studies. LEVEL OF EVIDENCE N/A.
Collapse
Affiliation(s)
- Shuntaro Soejima
- Department of Otolaryngology Head and Neck Surgery Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Chia-Hsien Wu
- Department of Physiology of Visceral Function and Body Fluid, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Haruna Matsuse
- Department of Otolaryngology Head and Neck Surgery Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Mariko Terakado
- Department of Otolaryngology Head and Neck Surgery Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Shinji Okano
- Department of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Tsuyoshi Inoue
- Department of Physiology of Visceral Function and Body Fluid, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Yoshihiko Kumai
- Department of Otolaryngology Head and Neck Surgery Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan.
| |
Collapse
|
6
|
Stradling EJ, Barnhart MK, Robinson RA, Mogg PJ, Ward EC, Smee RI. Implementing flexible endoscopic evaluation of swallow screening within annual cancer surveillance appointments to monitor for late-stage radiation-induced dysphagia: A feasibility study. Head Neck 2024; 46:615-626. [PMID: 38151916 DOI: 10.1002/hed.27615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 09/14/2023] [Accepted: 12/12/2023] [Indexed: 12/29/2023] Open
Abstract
BACKGROUND Late-stage progressive decline of swallowing function after radiotherapy for head and neck cancer (HNC) is often difficult to monitor. This study examined the feasibility and clinical outcomes of speech-language pathology implementing flexible endoscopic evaluation of swallow (FEES) screening during annual cancer surveillance visits to monitor late-stage swallowing function. METHODS Patients >2 years post treatment who attended routine oncological visits underwent FEES screening. Feasibility (service data, stakeholder survey) and swallowing outcomes (oral intake, secretions, internal lymphedema, penetration-aspiration, and residue) were collected. RESULTS Screening was completed with 70% (50/71) of eligible patients. Medical staff and speech-language pathologists indicated the protocol was worthwhile and achievable to incorporate into practice. Almost all patients were willing to complete the protocol annually. FEES outcomes identified 84% with dysphagia versus only 26% self-reported dysphagia. CONCLUSION Findings indicate FEES screening incorporated into annual oncological reviews is feasible and effective at monitoring late-stage swallowing function following HNC.
Collapse
Affiliation(s)
- Emma J Stradling
- Department of Speech Pathology, Prince of Wales Hospital, South-Eastern Sydney Local Health District, Randwick, New South Wales, Australia
- Department of Radiation Oncology, Comprehensive Cancer Centre, POWH, Randwick, New South Wales, Australia
| | - Molly K Barnhart
- Department of Speech Pathology, Prince of Wales Hospital, South-Eastern Sydney Local Health District, Randwick, New South Wales, Australia
- Department of Radiation Oncology, Comprehensive Cancer Centre, POWH, Randwick, New South Wales, Australia
| | - Rachelle A Robinson
- Department of Speech Pathology, Prince of Wales Hospital, South-Eastern Sydney Local Health District, Randwick, New South Wales, Australia
| | - Penny J Mogg
- Department of Speech Pathology, Prince of Wales Hospital, South-Eastern Sydney Local Health District, Randwick, New South Wales, Australia
| | - Elizabeth C Ward
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Queensland, Australia
- Centre of Functioning and Health Research, Metro South Hospital and Health Service, Brisbane, Queensland, Australia
| | - Robert I Smee
- Department of Radiation Oncology, Comprehensive Cancer Centre, POWH, Randwick, New South Wales, Australia
- Department of Radiation Oncology, Tamworth Base Hospital, Tamworth, New South Wales, Australia
- The Clinical Teaching School, University New South Wales, Kensington, New South Wales, Australia
| |
Collapse
|
7
|
Valencia-Sanchez BA, Li RJ, Wax MK, Ng J, Andersen PE, Loyo M. Masseteric Nerve Transfer for Facial Paralysis Secondary to Parotid Malignancy: A Retrospective Case Series. Facial Plast Surg Aesthet Med 2024; 26:103-108. [PMID: 37428610 DOI: 10.1089/fpsam.2023.0052] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2023] Open
Abstract
Background: The objective outcomes of masseteric nerve transfer in the setting of parotid malignancy are unclear. Objective: To measure objective facial reanimation outcomes of masseteric nerve transfer in patients with parotid malignancy who underwent parotidectomy with facial nerve resection. Materials and Methods: Retrospective review of patients who underwent masseteric nerve transfer for facial paralysis secondary to parotid malignancy was carried out at a tertiary referral hospital from August 2017 to November 2021. Objective facial reanimation outcomes were analyzed using Emotrics. Minimal follow-up of 6 months was required for inclusion. Results: Eight patients (five males) with a median age of 75.5 years (range 53-91) met inclusion criteria. Fifty percent had metastatic squamous cell carcinoma, and 50% had primary parotid malignancy. Five patients underwent concomitant cancer resection with facial nerve reconstruction. Seven patients received postoperative adjuvant radiotherapy. After reinnervation, patients had improved oral commissure excursion (from 1.51 mm ±1.27 to 3.77 mm ±1.81; p < 0.01) and facial symmetry during smile. Conclusion: In this study, masseteric nerve transfer enhanced oral commissure excursion and facial symmetry during smile in patients with parotid malignancy and facial nerve resection.
Collapse
Affiliation(s)
- Bastien A Valencia-Sanchez
- School of Medicine and Health Sciences TecSalud, Monterrey Institute of Technology and Higher Education, Monterrey, Nuevo León, Mexico
| | - Ryan J Li
- Department of Otolaryngology - Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA
| | - Mark K Wax
- Department of Otolaryngology - Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA
| | - John Ng
- Department of Ophthalmology, Oregon Health & Science Casey Eye Institute, Portland, Oregon, USA
| | - Peter E Andersen
- Department of Otolaryngology - Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA
| | - Myriam Loyo
- Department of Otolaryngology - Head & Neck Surgery, Oregon Health & Science University, Portland, Oregon, USA
| |
Collapse
|
8
|
Masumoto A, Yokoyama K, Namba M, Sasamura K, Yoshimura RI. A Case of Radiation-Induced Brachial Plexopathy Below the Tolerance Dose. Cureus 2024; 16:e52283. [PMID: 38357089 PMCID: PMC10865071 DOI: 10.7759/cureus.52283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
This case report details a rare instance of radiation-induced brachial plexopathy (RIBP) occurring below the typical tolerance dose in a 55-year-old woman following chemoradiotherapy for apical non-small cell lung carcinoma. Despite receiving a radiation dose considered safe (47-48 Gray in 25 fractions), she developed sensory abnormalities and motor weakness in the right upper limb. The diagnostic distinction between RIBP and tumor recurrence was achieved using MRI, which showed characteristic features of radiation-induced damage. The patient's medical history included smoking and rheumatoid arthritis, highlighting the role of patient-specific factors in the development of RIBP. The case underscores the importance of recognizing RIBP as a potential diagnosis in patients with new-onset brachial plexopathy post-radiation therapy, even when radiation exposure is within conventional safety limits. This report contributes to the literature by demonstrating that RIBP can occur at lower-than-expected radiation doses, especially in the presence of contributing factors like neurotoxic chemotherapy and individual patient risks. It emphasizes the need for careful assessment and management in such cases to distinguish between RIBP and cancer recurrence.
Collapse
Affiliation(s)
- Akane Masumoto
- Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, Tokyo, JPN
| | - Kota Yokoyama
- Radiology, Tokyo Medical and Dental University, Tokyo, JPN
| | - Meika Namba
- Radiology, Japanese Red Cross Musashino Hospital, Tokyo, JPN
| | - Kazuma Sasamura
- Radiology, Japanese Red Cross Musashino Hospital, Tokyo, JPN
| | - Ryo-Ichi Yoshimura
- Radiation Therapeutics and Oncology, Tokyo Medical and Dental University, Tokyo, JPN
| |
Collapse
|
9
|
O'Connor LM, Skehan K, Goodwin J, Kumar M. MRI sequence optimisation methods to identify cranial nerve course for radiotherapy planning. J Med Radiat Sci 2023; 70:509-517. [PMID: 37421243 PMCID: PMC10715361 DOI: 10.1002/jmrs.700] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 06/14/2023] [Indexed: 07/10/2023] Open
Abstract
INTRODUCTION Magnetic resonance imaging (MRI) is being increasingly used to improve radiation therapy planning by allowing visualisation of organs at risk that cannot be well-defined on computed tomography (CT). Diagnostic sequences are increasingly being adapted for radiation therapy planning, such as the use of heavily T2-weighted 3D SPACE (Sampling Perfection with Application optimised Contrasts using different flip angle Evolution) sequence for cranial nerve identification in head and neck tumour treatment planning. METHODS A 3D isotropic T2 SPACE sequence used for cranial nerve identification was adapted for radiation therapy purposes. Distortion was minimised using a spin-echo-based sequence, 3D distortion correction, isocentre scanning and an increased readout bandwidth. Radiation therapy positioning was accounted for by utilising two small flex, 4-channel coils. The protocol was validated for cranial nerve identification in clinical applications and distortion minimisation using an MRI QA phantom. RESULTS Normal anatomy of the cranial nerves CI-CIX, were presented, along with a selection of clinical applications and abnormal anatomy. The usefulness of cranial nerve identification is discussed for several case studies, particularly in proximity to tumours extending into the base of skull region. In-house testing validated that higher bandwidths of 600 Hz resulted in minimal displacement well below 1 mm. CONCLUSION The use of MRI for radiation therapy planning allows for greater individualisation and prediction of patient outcomes. Dose reduction to cranial nerves can decrease late side effects such as cranial neuropathy. In addition to current applications, future directions include further applications of this technology for radiation therapy treatments.
Collapse
Affiliation(s)
- Laura M. O'Connor
- Department of Radiation OncologyCalvary Mater HospitalNewcastleNew South WalesAustralia
- School of Health SciencesUniversity of Newcastle, University DriveNewcastleNew South WalesAustralia
| | - Kate Skehan
- Department of Radiation OncologyCalvary Mater HospitalNewcastleNew South WalesAustralia
| | - Jonathan Goodwin
- Department of Radiation OncologyCalvary Mater HospitalNewcastleNew South WalesAustralia
- School of Information and Physical SciencesUniversity of NewcastleNewcastleNew South WalesAustralia
| | - Mahesh Kumar
- Department of Radiation OncologyCalvary Mater HospitalNewcastleNew South WalesAustralia
- School of Medicine and Public HealthUniversity of Newcastle, University DriveNewcastleNew South WalesAustralia
| |
Collapse
|
10
|
Petersson K, Finizia C, Pauli N, Dotevall H, Tuomi L. A randomized controlled study evaluating the head-lift exercise in head and neck cancer patients with radiation-induced dysphagia: effect on swallowing function and health-related quality of life over 12 months. Eur Arch Otorhinolaryngol 2023; 280:5445-5457. [PMID: 37584752 PMCID: PMC10620310 DOI: 10.1007/s00405-023-08183-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 08/07/2023] [Indexed: 08/17/2023]
Abstract
PURPOSE Dysphagia is common after radiotherapy for head and neck cancer (HNC) and can affect health-related quality of life (HRQL). This randomized controlled trial aimed to evaluate the effect of the head-lift exercise (HLE) over 12 months in HNC patients with radiation-induced dysphagia. METHODS Sixty-one patients with dysphagia were randomized to intervention group (n = 30) and control group (n = 31) at 6-36 months after completion of radiotherapy for HNC. Dysphagia-specific HRQL was measured with the MD Anderson Dysphagia Inventory (MDADI); general and HNC-specific HRQL was measured with the European Organization for Research and Treatment of Cancer Quality of Life questionnaire Core 30 (EORTC QLQ-C30) and QLQ-H&N35. Measurements were made at baseline, and at 8 weeks and 12 months after start of intervention. RESULTS Adherence to the intervention was good throughout the year. When comparing change from baseline reports to each follow-up no statistically significant differences between the groups were found in any of the HRQL instruments. There were some statistically significant changes within groups compared to baseline. The intervention group improved self-rated swallowing function on the MDADI at 8 weeks (emotional domain, p = 0.03; functional domain, p = 0.007; total score, p = 0.01) and the control at twelve months (emotional domain, p = 0.03; functional domain, p = 0.02; physical domain, p = 0.004; total score, p = 0.002). CONCLUSION In this randomized control study, no effect was observed short term or at 12 months on HRQL after use of the HLE as rehabilitation for radiation-induced dysphagia.
Collapse
Affiliation(s)
- Kerstin Petersson
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Department of Otorhinolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Region Västra Götaland, 41345, Gothenburg, Sweden.
| | - Caterina Finizia
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Region Västra Götaland, 41345, Gothenburg, Sweden
| | - Nina Pauli
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Region Västra Götaland, 41345, Gothenburg, Sweden
| | - Hans Dotevall
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Otorhinolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Region Västra Götaland, 41345, Gothenburg, Sweden
| | - Lisa Tuomi
- Department of Otorhinolaryngology, Head and Neck Surgery, Sahlgrenska University Hospital, Region Västra Götaland, 41345, Gothenburg, Sweden
- Institute of Neuroscience and Physiology, Speech and Language Pathology Unit, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| |
Collapse
|
11
|
Yang T, Du X, Xu L. Radioprotective effect of Ginkgolide B on brain: the mediating role of DCC/MST1 signaling. Int J Radiat Biol 2023; 100:371-384. [PMID: 37934907 DOI: 10.1080/09553002.2023.2281515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 10/24/2023] [Indexed: 11/09/2023]
Abstract
PURPOSE The risk of brain exposure to ionizing radiation increases gradually due to the extensive application of nuclear technology in medical, industrial, and aerospace fields. Radiation-induced brain injury (RBI) is highly likely to cause a wide range of neurological complications, including schizophrenia, Alzheimer's disease (AD), depression. Ginkgolide B (GB) is one of the effective active components extracted from ginkgo biloba leaves, exerts protective effects on CNS, which is involved in the regulation of the Hippo signaling pathway. MST1, as one of the core kinases of the Hippo pathway, participated in regulating cell proliferation, differentiation, and apoptosis. However, it remains unclear whether GB attenuates radiation brain injury (RBI) and whether the radioprotective effect of GB refers to MST1 signaling. Hence, our study aimed to explore the radiation protection effect and the potential mechanism of GB. MATERIALS AND METHODS C57BL/6 mice were stimulated with an X-ray (20 Gy) to establish an RBI model. Then, morris water maze test (MWM) and step-down passive avoidance test (SDPAT) were used to assess the learning and memory function of mice. The open field test (OFT), tail suspension test (TST), and forced swimming test (FST) were used to assess changes in locomotor activity and hopelessness. Besides, X-ray-stimulated SH-SY5Y cells were used to verify the radioprotective effect of GB. Immunofluorescence double staining, Dihydroethidium (DHE), western blot, and flow cytometry were used to explore the role of DCC/MST1 signaling in RBI. RESULTS In this study, X-ray-treated mice exhibited cognitive impairment and depression-like behavior, which was ameliorated by GB treatment. GB also reduced the ROS production and the number of TUNEL-positive cells in the hippocampus. Moreover, GB increased the protein levels of p-AKT and Bcl2, while decreased the protein levels of MST1, p-p38, p-JNK, cleaved-caspase-3 and Bax both in vivo and in vitro. Additionally, exogenous Netrin-1 alleviated X-ray-induced ROS production and apoptosis, whereas knockout of Netrin-1 receptor DCC abolished the protective effect of GB. CONCLUSION Oxidative stress and MST1-mediated neuronal apoptosis participated in radiation-induced cognitive impairment and depression-like behaviors, and modulation of DCC by GB was an effective intervention against RBI.
Collapse
Affiliation(s)
- Tao Yang
- School of Pharmacy, Jiangsu Key Laboratory of Inflammation and Molecular Drug Targets, Nantong University, Nantong, Jiangsu, China
- Department of Radiotherapy, Affiliated Hospital of Nantong University, Nantong, Jiangsu, China
| | - Xiao Du
- Division of Clinical Pharmacy, Department of Pharmacy, Drum Tower Hospital Affiliated to Medical School of Nanjing University, Nanjing, China
| | - Lixing Xu
- School of Pharmacy, Jiangsu Key Laboratory of Inflammation and Molecular Drug Targets, Nantong University, Nantong, Jiangsu, China
| |
Collapse
|
12
|
Lyons KM, Cannon RD, Beumer J, Bakr MM, Love RM. Microbial Analysis of Obturators During Maxillofacial Prosthodontic Treatment Over an 8-Year Period. Cleft Palate Craniofac J 2023; 60:1426-1441. [PMID: 35642284 DOI: 10.1177/10556656221104940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of the study was to investigate the microbial colonization (by Candida species, anaerobic and facultative anaerobic bacteria) of maxillary obturators used for the restoration of maxillary defects, including during radiotherapy. Retrospective cohort study. Fifteen patients requiring a maxillary obturator prosthesis had swabs of their obturators and adjacent tissues taken at different stages of their treatment over a period of 8 years. Identification of microbial species from the swabs was carried out using randomly amplified polymorphic DNA polymerase chain reaction (RAPD PCR) analysis, checkerboard DNA-DNA hybridization, CHROMagar Candida chromogenic agar, and DNA sequencing. Candida species were detected in all patients and all patients developed mucositis and candidiasis during radiotherapy which was associated with an increase in colonization of surfaces with Candida spp., particularly C albicans. Microbial colonization increased during radiotherapy and as an obturator aged, and decreased following a reline, delivery of a new prosthesis, or antifungal treatment during radiotherapy. Microbial colonization of maxillary obturators was related to the stage of treatment, age of the obturator material, radiotherapy and antifungal medications, and antifungal treatment may be recommended if C albicans colonization of palatal tissues is greater than 105 colony-forming units per cm2 following the first week of radiotherapy.
Collapse
Affiliation(s)
- Karl M Lyons
- Department of Oral Rehabilitation and Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - Richard D Cannon
- Department of Oral Sciences and Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, Dunedin, New Zealand
| | - John Beumer
- Division of Advanced Prosthodontics, School of Dentistry, University of California, Los Angeles, CA, USA
| | - Mahmoud M Bakr
- School of Medicine and Dentistry, Griffith University, Queensland, Australia
| | - Robert M Love
- School of Medicine and Dentistry, Griffith University, Queensland, Australia
| |
Collapse
|
13
|
Skolka M, Shelly S, Pinto MV, Dubey D, Oishi T, Uhm JH, Santilli A, Staff NP, Spinner RJ, Dyck PJB, Robertson CE, Klein CJ. Clinical, Neurophysiologic, and Pathologic Features in Patients With Early-Onset Postradiation Neuropathy. Neurology 2023; 101:e1455-e1460. [PMID: 37400240 PMCID: PMC10573132 DOI: 10.1212/wnl.0000000000207545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/05/2023] [Indexed: 07/05/2023] Open
Abstract
OBJECTIVES The objective of this study was to study early-onset radiation-induced neuropathy reviewing neurologic course, steroid response, and available nerve biopsies. METHODS Patients coded with radiation-induced neuropathy within 6 months of radiation were reviewed from January 1,1999, to August 31, 2022. Patients had to have electrodiagnostically confirmed neuropathy localized within or distal to radiation fields. Neurologic course and nerve biopsies were reviewed. RESULTS Twenty-eight patients (16 male and 12 female patients, mean age 63.8 years) were identified. The average radiation dose was 4,659 cGy (range 1,000-7,208). Tumor infiltration was not observed on MRI and PET. Postradiation onsets averaged 2 months (range 0-5). Localizations included brachial (n = 4) plexopathies, lumbosacral (n = 12) plexopathies, radiculopathies (n = 10), and mononeuropathies (n = 2). Neuropathic pain (n = 25) and weakness (n = 25) were typical. The clinical courses were subacute monophasic (n = 14), chronic progressive (n = 8), or static (n = 1), and 5 were without follow-up. Nerve biopsies (n = 8) showed an inflammatory ischemic process with perivascular inflammatory infiltrates (n = 7) or microvasculitis (n = 2). Nine patients, 7 with monophasic courses, received steroid burst therapy with symptom improvement in 8. No patients recovered entirely back to baseline. DISCUSSION In contrast to chronic radiation-induced neuropathy, early-onset patients most commonly have painful monophasic courses with residual deficits, possibly steroid responsive. An ischemic inflammatory pathogenesis is suggested.
Collapse
Affiliation(s)
- Michael Skolka
- From the Department of Neurology (M.S., M.V.P., D.D., T.O., J.H.U., A.S., N.P.S., P.J.B.D., C.E.R., C.J.K.), Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Rambam Health Care Clinic, Haifa, Israel; Department of Neurosurgery (R.J.S.); and Department of Laboratory Medicine and Pathology (C.J.K.), Mayo Clinic, Rochester, MN
| | - Shahar Shelly
- From the Department of Neurology (M.S., M.V.P., D.D., T.O., J.H.U., A.S., N.P.S., P.J.B.D., C.E.R., C.J.K.), Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Rambam Health Care Clinic, Haifa, Israel; Department of Neurosurgery (R.J.S.); and Department of Laboratory Medicine and Pathology (C.J.K.), Mayo Clinic, Rochester, MN
| | - Marcus V Pinto
- From the Department of Neurology (M.S., M.V.P., D.D., T.O., J.H.U., A.S., N.P.S., P.J.B.D., C.E.R., C.J.K.), Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Rambam Health Care Clinic, Haifa, Israel; Department of Neurosurgery (R.J.S.); and Department of Laboratory Medicine and Pathology (C.J.K.), Mayo Clinic, Rochester, MN
| | - Divyanshu Dubey
- From the Department of Neurology (M.S., M.V.P., D.D., T.O., J.H.U., A.S., N.P.S., P.J.B.D., C.E.R., C.J.K.), Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Rambam Health Care Clinic, Haifa, Israel; Department of Neurosurgery (R.J.S.); and Department of Laboratory Medicine and Pathology (C.J.K.), Mayo Clinic, Rochester, MN
| | - Tatsuya Oishi
- From the Department of Neurology (M.S., M.V.P., D.D., T.O., J.H.U., A.S., N.P.S., P.J.B.D., C.E.R., C.J.K.), Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Rambam Health Care Clinic, Haifa, Israel; Department of Neurosurgery (R.J.S.); and Department of Laboratory Medicine and Pathology (C.J.K.), Mayo Clinic, Rochester, MN
| | - Joon H Uhm
- From the Department of Neurology (M.S., M.V.P., D.D., T.O., J.H.U., A.S., N.P.S., P.J.B.D., C.E.R., C.J.K.), Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Rambam Health Care Clinic, Haifa, Israel; Department of Neurosurgery (R.J.S.); and Department of Laboratory Medicine and Pathology (C.J.K.), Mayo Clinic, Rochester, MN
| | - Ashley Santilli
- From the Department of Neurology (M.S., M.V.P., D.D., T.O., J.H.U., A.S., N.P.S., P.J.B.D., C.E.R., C.J.K.), Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Rambam Health Care Clinic, Haifa, Israel; Department of Neurosurgery (R.J.S.); and Department of Laboratory Medicine and Pathology (C.J.K.), Mayo Clinic, Rochester, MN
| | - Nathan P Staff
- From the Department of Neurology (M.S., M.V.P., D.D., T.O., J.H.U., A.S., N.P.S., P.J.B.D., C.E.R., C.J.K.), Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Rambam Health Care Clinic, Haifa, Israel; Department of Neurosurgery (R.J.S.); and Department of Laboratory Medicine and Pathology (C.J.K.), Mayo Clinic, Rochester, MN
| | - Robert J Spinner
- From the Department of Neurology (M.S., M.V.P., D.D., T.O., J.H.U., A.S., N.P.S., P.J.B.D., C.E.R., C.J.K.), Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Rambam Health Care Clinic, Haifa, Israel; Department of Neurosurgery (R.J.S.); and Department of Laboratory Medicine and Pathology (C.J.K.), Mayo Clinic, Rochester, MN
| | - P James B Dyck
- From the Department of Neurology (M.S., M.V.P., D.D., T.O., J.H.U., A.S., N.P.S., P.J.B.D., C.E.R., C.J.K.), Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Rambam Health Care Clinic, Haifa, Israel; Department of Neurosurgery (R.J.S.); and Department of Laboratory Medicine and Pathology (C.J.K.), Mayo Clinic, Rochester, MN
| | - Carrie Elizabeth Robertson
- From the Department of Neurology (M.S., M.V.P., D.D., T.O., J.H.U., A.S., N.P.S., P.J.B.D., C.E.R., C.J.K.), Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Rambam Health Care Clinic, Haifa, Israel; Department of Neurosurgery (R.J.S.); and Department of Laboratory Medicine and Pathology (C.J.K.), Mayo Clinic, Rochester, MN
| | - Christopher J Klein
- From the Department of Neurology (M.S., M.V.P., D.D., T.O., J.H.U., A.S., N.P.S., P.J.B.D., C.E.R., C.J.K.), Mayo Clinic, Rochester, MN; Department of Neurology (S.S.), Rambam Health Care Clinic, Haifa, Israel; Department of Neurosurgery (R.J.S.); and Department of Laboratory Medicine and Pathology (C.J.K.), Mayo Clinic, Rochester, MN.
| |
Collapse
|
14
|
Shoukry M, Noland SS. The Role of Surgery in the Management of Radiation-Induced Brachial Plexopathy. Hand (N Y) 2023:15589447231196902. [PMID: 37715704 DOI: 10.1177/15589447231196902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/18/2023]
Abstract
Radiation-induced brachial plexopathy (RIBP) is a rare long-term complication of radiation therapy often causing pain, motor deficit, and overall quality of life reduction for affected patients. While a standard treatment for RIBP is yet to be established, management consists mostly of symptom management through the use of medications and physical therapy. There is a lack of evidence regarding the efficacy of surgical treatment. Omentoplasties and other vascularized flaps are commonly discussed options for eliminating neuropathic pain associated with RIBP. However, these approaches show no meaningful improvement in motor function. While limited, current literature suggests that nerve transfers may be an option for relief of neuropathic pain as well as restoration of motor function. This review of literature explores the options available to those affected by RIBP with a focus on the role of surgery.
Collapse
Affiliation(s)
- Mira Shoukry
- Mayo Clinic Alix School of Medicine, Scottsdale, AZ, USA
| | - Shelley S Noland
- Division of Hand & Peripheral Nerve Surgery, Department of Orthopedic Surgery, Mayo Clinic, Phoenix, AZ, USA
| |
Collapse
|
15
|
Eke I, Guo HH, Loo BW, Sung AW, Diehn M, Vitzthum L, Chin AL, Gensheimer MF. Unilateral Diaphragmatic Paralysis After Stereotactic Ablative Radiation Therapy to a Lung Tumor Abutting the Course of the Phrenic Nerve. Pract Radiat Oncol 2023; 13:e383-e388. [PMID: 37150318 DOI: 10.1016/j.prro.2023.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/24/2023] [Accepted: 04/29/2023] [Indexed: 05/09/2023]
Abstract
We present the case of a woman with metastatic adenoid cystic carcinoma who received stereotactic ablative radiation therapy with a total dose of 50 Gy in 4 fractions to 2 lung metastases and developed symptomatic left phrenic nerve injury 2 years after radiation. The maximum dose to the approximate location of the phrenic nerve was 57.7 Gy, which corresponds to a biologically effective dose for late effects (using α/β ratio = 3) of 335.14 Gy. Here, we discuss the case, planning considerations by radiation oncologists and medical physicists, and the multidisciplinary medical management of this patient.
Collapse
Affiliation(s)
- Iris Eke
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - H Henry Guo
- Department of Radiology, Stanford University School of Medicine, Stanford, California
| | - Billy W Loo
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California; Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Arthur W Sung
- Department of Medicine, Stanford University School of Medicine, Stanford, California
| | - Maximilian Diehn
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California; Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California; Institute for Stem Cell Biology & Regenerative Medicine, Stanford University School of Medicine, Stanford, California
| | - Lucas Vitzthum
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - Alexander L Chin
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California
| | - Michael F Gensheimer
- Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California.
| |
Collapse
|
16
|
Pérez IMM, Pérez SEM, García RP, Lupgens DDZ, Martínez GB, González CR, Yán NK, Hernández FR. Exercise-based rehabilitation on functionality and quality of life in head and neck cancer survivors. A systematic review and meta-analysis. Sci Rep 2023; 13:8523. [PMID: 37237097 DOI: 10.1038/s41598-023-35503-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
Head and Neck Cancer (HNC) is a globally rare cancer that includes a variety of tumors affecting the upper aerodigestive tract. It presents with difficulty breathing or swallowing and is mainly treated with radiation therapy, chemotherapy, or surgery for tumors that have spread locally or throughout the body. Alternatively, exercise can be used during cancer treatment to improve function, including pain relief, increase range of motion and muscle strength, and reduce cancer-related fatigue, thereby enhancing quality of life. Although existing evidence suggests the adjunctive use of exercise in other cancer types, no previous studies have examined the effects on HNC survivors. The aim of this meta-analysis was to quantify the effect of exercise-based rehabilitation on functionality and quality of life in HNC survivors who underwent surgery and/or chemoradiotherapy. A systematic review and meta-analysis were carried out following PRISMA statement and registered in PROSPERO (CRD42023390300). The search was performed in MEDLINE (PubMED), Cochrane Library, CINAHL and Web of Science (WOS) databases from inception to 31st December 2022 using the terms "cancer", "head and neck neoplasms", "exercise", "rehabilitation", "complications", "muscle contraction", "muscle stretching exercises" combining with booleans "AND"/"OR". PEDro scale, Cochrane Risk of Bias Tool and GRADE were used to assess methodological quality, risk of bias and grade of recommendation of included studies respectively. 18 studies (n = 1322) were finally included which 1039 (78.6%) were men and 283 (21.4%) were women. In patients who underwent radio-chemotherapy, overall pain [SMD = - 0.62 [- 4.07, 2.83] CI 95%, Z = 0.35, p = 0.72] and OP [SMD = - 0.07 [- 0.62, 0.48] CI 95%, Z = 0.25, p = 0.81] were slightly reduced with exercise in comparison to controls. Besides, lower limb muscle strength [SMD = - 0.10 [- 1.52, 1.32] CI 95%, Z = 0.14, p = 0.89] and fatigue [SMD = - 0.51 [- 0.97, - 0.057] CI 95%, Z = 2.15, p < 0.01] were also improved in those who receive radio-chemoradiation. In HNC survivors treated with neck dissection surgery, exercise was superior to controls in overall pain [SMD = - 1.04 [- 3.31, 1.23] CI 95%, Z = 0.90, p = 0.37] and, in mid-term, on shoulder pain SMD = - 2.81 [- 7.06, 1.43] CI 95%, Z = 1.76, p = 0.08]. No differences in quality of life were found at any of the follow-up periods. There is evidence of fair to good methodological quality, low to moderate risk of bias, and weak recommendations supporting the use of exercise-based rehabilitation to increase functionality. However, no evidence was found in favor of the use of this modality for improving the quality of life of HNC survivors who underwent chemoradiotherapy or surgery.
Collapse
Affiliation(s)
- Isidro Miguel Martín Pérez
- Departamento de Medicina Física y Farmacología, Área de Radiología y Medicina Física, Facultad de Ciencias de la Salud, Universidad de la Laguna, 38200, Santa Cruz de Tenerife, Spain
- Escuela de Doctorado y Estudios de Posgrado, Universidad de la Laguna, 38203, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain
| | - Sebastián Eustaquio Martín Pérez
- Departamento de Medicina Física y Farmacología, Área de Radiología y Medicina Física, Facultad de Ciencias de la Salud, Universidad de la Laguna, 38200, Santa Cruz de Tenerife, Spain.
- Escuela de Doctorado y Estudios de Posgrado, Universidad de la Laguna, 38203, San Cristóbal de La Laguna, Santa Cruz de Tenerife, Spain.
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300, La Orotava, Santa Cruz de Tenerife, Spain.
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Sport Sciences, Universidad Europea de Madrid, 28670, Villaviciosa de Odón, Madrid, Spain.
| | - Raquel Pérez García
- Departamento de Medicina Física y Farmacología, Área de Radiología y Medicina Física, Facultad de Ciencias de la Salud, Universidad de la Laguna, 38200, Santa Cruz de Tenerife, Spain
| | - Diego de Zárate Lupgens
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300, La Orotava, Santa Cruz de Tenerife, Spain
| | - Germán Barrachina Martínez
- Musculoskeletal Pain and Motor Control Research Group, Faculty of Health Sciences, Universidad Europea de Canarias, 38300, La Orotava, Santa Cruz de Tenerife, Spain
| | - Carolina Rodríguez González
- Departamento de Medicina Física y Farmacología, Área de Radiología y Medicina Física, Facultad de Ciencias de la Salud, Universidad de la Laguna, 38200, Santa Cruz de Tenerife, Spain
- Hospital Universitario de Canarias, 38320, San Cristóbal de la Laguna, Santa Cruz de Tenerife, Spain
| | - Nart Keituqwa Yán
- Departamento de Medicina Física y Farmacología, Área de Radiología y Medicina Física, Facultad de Ciencias de la Salud, Universidad de la Laguna, 38200, Santa Cruz de Tenerife, Spain
- Hospital Universitario de Canarias, 38320, San Cristóbal de la Laguna, Santa Cruz de Tenerife, Spain
| | - Fidel Rodríguez Hernández
- Departamento de Medicina Física y Farmacología, Área de Radiología y Medicina Física, Facultad de Ciencias de la Salud, Universidad de la Laguna, 38200, Santa Cruz de Tenerife, Spain
| |
Collapse
|
17
|
Hayek S, Libresco G, Barda N, Chao C, Xu L, Cannavale KL, Izraeli S, Armenian SH. Chronic health conditions among long-term survivors of adolescent and young adult (AYA) cancer: A comparison of outcomes in Israel and the United States. Cancer 2023; 129:1763-1776. [PMID: 36929478 DOI: 10.1002/cncr.34740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/17/2023] [Accepted: 02/13/2023] [Indexed: 03/18/2023]
Abstract
BACKGROUND There is a paucity of information on health outcomes of adolescent and young adult (AYA) cancer survivors living outside North America and Europe. This study compared outcomes in AYA cancer survivors in Israel with individuals without cancer and similar demographics and access to health care, and to AYA cancer survivors living in the United States. METHODS This study included 12,674 2-year survivors of AYA (aged 15-39 years) cancer diagnosed between 2000 and 2018 at Clalit Health Services (CHS) in Israel. CHS participants without cancer (N = 50,696) were matched 4:1 to survivors on age, sex, ethnicity, and membership duration. Poisson regression was used to determine incidence rate ratios (IRRs) for chronic conditions. The US Kaiser Permanente Southern California AYA cohort (N = 6778) was used to estimate weighted (age, sex) standardized incidence ratios (SIRs) for CHS survivors. RESULTS CHS AYA cancer survivors were more likely to have any chronic condition (IRR, 1.6 95% CI, 1.5-1.7), compared with participants without cancer. Survivors had an increased risk across nearly all conditions examined, with especially elevated risks for osteoporosis (IRR, 4.7; 95% CI, 4.1-5.5) and cardiomyopathy (IRR, 4.2 95% CI, 3.4-5.3). Compared with the Kaiser Permanente Southern California cohort, CHS survivors had an overall lower (SIR, 0.68; 95% CI, 0.65-0.72) incidence of developing any health condition, with noticeably lower incidence of hyperlipidemia (SIR, 0.7; 95% CI, 0.64-0.75). CONCLUSION AYA cancer survivors in Israel are at increased risk for developing chronic conditions compared with individuals without cancer, but the overall incidence was lower than in US survivors. These findings may allow for refinement of surveillance recommendations for AYA survivors, taking into consideration regional differences in sociodemographic characteristics and cancer care. PLAIN LANGUAGE SUMMARY The burden of chronic conditions was consistently greater in Israeli adolescent and young adult cancer survivors compared with individuals without cancer, with clear differences in risk of specific conditions by cancer diagnosis. However, the overall incidence of chronic conditions in Israeli survivors was generally lower than in US survivors.
Collapse
Affiliation(s)
- Samah Hayek
- Clalit Research Institute, Clalit Health Services, Ramat Gan, Israel.,Department of Epidemiology, School of Public Health, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Gilad Libresco
- Clalit Research Institute, Clalit Health Services, Ramat Gan, Israel
| | - Noam Barda
- ARC Innovation Center, Sheba Medical Center, Ramat Gan, Israel.,Software and Information Systems Engineering, Ben-Gurion University, Be'er Sheva, Israel.,Department of Biomedical Informatics, Harvard Medical School, Boston, Massachusetts, USA
| | - Chun Chao
- Kaiser Permanente Southern California, Pasadena, California, USA
| | - Lanfang Xu
- MedHealth Statistical Consulting, Solon, Ohio, USA
| | | | - Shai Izraeli
- Division of Pediatric Hematology, Oncology, Schneider Children's Medical Center, Tel-Aviv, Israel.,Department of Molecular Genetics and Biochemistry, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.,Department of Systems Biology, Beckman Research Institute, City of Hope, Duarte, California, USA
| | - Saro H Armenian
- Department of Population Sciences, City of Hope, Duarte, California, USA.,Department of Pediatrics, City of Hope, Duarte, California, USA
| |
Collapse
|
18
|
Raoof E, Slavin E, Power K, Wisotzky E. Evaluation and Management of Pain in Radiation Fibrosis Syndrome. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2023. [DOI: 10.1007/s40141-023-00386-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
|
19
|
Steger E, Mattson B, Montano M. Notes on Surviving Head and Neck Cancer: Paving the Road Ahead. Adv Biol (Weinh) 2022; 6:e2200306. [PMID: 36522134 DOI: 10.1002/adbi.202200306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
|
20
|
Evaluation and Management of Radiation-Induced Plexopathies. CURRENT PHYSICAL MEDICINE AND REHABILITATION REPORTS 2022. [DOI: 10.1007/s40141-022-00374-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
21
|
Shin DS, Kim TH, Rah JE, Kim D, Yang HJ, Lee SB, Lim YK, Jeong J, Kim H, Shin D, Son J. Assessment of a Therapeutic X-ray Radiation Dose Measurement System Based on a Flexible Copper Indium Gallium Selenide Solar Cell. SENSORS (BASEL, SWITZERLAND) 2022; 22:5819. [PMID: 35957376 PMCID: PMC9370937 DOI: 10.3390/s22155819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Revised: 08/02/2022] [Accepted: 08/02/2022] [Indexed: 06/15/2023]
Abstract
Several detectors have been developed to measure radiation doses during radiotherapy. However, most detectors are not flexible. Consequently, the airgaps between the patient surface and detector could reduce the measurement accuracy. Thus, this study proposes a dose measurement system based on a flexible copper indium gallium selenide (CIGS) solar cell. Our system comprises a customized CIGS solar cell (with a size 10 × 10 cm2 and thickness 0.33 mm), voltage amplifier, data acquisition module, and laptop with in-house software. In the study, the dosimetric characteristics, such as dose linearity, dose rate independence, energy independence, and field size output, of the dose measurement system in therapeutic X-ray radiation were quantified. For dose linearity, the slope of the linear fitted curve and the R-square value were 1.00 and 0.9999, respectively. The differences in the measured signals according to changes in the dose rates and photon energies were <2% and <3%, respectively. The field size output measured using our system exhibited a substantial increase as the field size increased, contrary to that measured using the ion chamber/film. Our findings demonstrate that our system has good dosimetric characteristics as a flexible in vivo dosimeter. Furthermore, the size and shape of the solar cell can be easily customized, which is an advantage over other flexible dosimeters based on an a-Si solar cell.
Collapse
Affiliation(s)
- Dong-Seok Shin
- Proton Therapy Center, National Cancer Center, Goyang 10408, Korea
| | - Tae-Ho Kim
- Proton Therapy Center, National Cancer Center, Goyang 10408, Korea
| | - Jeong-Eun Rah
- Department of Radiation Oncology, Myongji Hospital, Goyang 10475, Korea
| | - Dohyeon Kim
- Proton Therapy Center, National Cancer Center, Goyang 10408, Korea
| | - Hye Jeong Yang
- Proton Therapy Center, National Cancer Center, Goyang 10408, Korea
| | - Se Byeong Lee
- Proton Therapy Center, National Cancer Center, Goyang 10408, Korea
| | - Young Kyung Lim
- Proton Therapy Center, National Cancer Center, Goyang 10408, Korea
| | - Jonghwi Jeong
- Proton Therapy Center, National Cancer Center, Goyang 10408, Korea
| | - Haksoo Kim
- Proton Therapy Center, National Cancer Center, Goyang 10408, Korea
| | - Dongho Shin
- Proton Therapy Center, National Cancer Center, Goyang 10408, Korea
| | - Jaeman Son
- Department of Radiation Oncology, Seoul National University Hospital, Seoul 03080, Korea
| |
Collapse
|
22
|
Hemmi T, Suzuki J, Ishii R, Ikeda R, Kobayashi Y, Ikushima H, Nomura K, Sugawara M, Ohkoshi A, Katori Y. Effect of treatments for head and neck cancer on sinus shadow on computed tomography. Auris Nasus Larynx 2022; 49:1019-1026. [PMID: 35341622 DOI: 10.1016/j.anl.2022.03.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/10/2022] [Accepted: 03/15/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Head and neck surgeries may cause changes in the nasal airflow, and radiotherapy irreversibly damages paranasal sinus epithelial cells. Some chemotherapeutic drugs have been reported to negatively affect airway ciliary activity in mice, and chronic rhinosinusitis could be an adverse effect of head and neck cancer (HNC) treatment. To evaluate whether HNC treatment is a risk factor for developing sinonasal mucosal thickening that may reflect paranasal sinus inflammation, we compared pre- and post-treatment paranasal sinus computed tomography (CT) images of patients treated for HNC at a single university hospital. METHODS The patients who received curative treatment for HNC (oral, pharyngeal, and laryngeal cancers) and started receiving first-line therapy between January 2015 and December 2019 were included. Data on age, sex, primary lesion, clinical stage, treatment, smoking history, drinking history, comorbidities (diabetes and chronic lung disease), and pre- and post-treatment (three months and one year after the final treatment) paranasal sinus CT images were analyzed from medical records. Pre- and post-treatment paranasal sinus CT images were scored using the Lund-Mackay (LM) staging system. RESULTS In total, 245 patients participated in this study. Three months after the final treatment, 80.4% of patients had no change in their total LM scores (p=0.621). Almost 80% of patients who underwent total laryngectomy also had no change in their total LM scores (p=0.833). One-third of patients with nasopharyngeal cancer (NPC) had worse LM scores after treatment (5/15), although no significant difference was observed (p=0.171). None of the various factors collected were significantly related to changes in LM scores three months after the completion of treatment. One year after the final treatment, 211 patients were included and no significant changes in the pre-and post-LM scores were observed in the same analyses, while changes in LM scores were significantly different between T categories (T1-2 vs. T3-4) (p=0.020). CONCLUSION We found no significant changes in the LM scores after HNC treatment in all the patients, which implies that HNC treatment may not be an apparent risk factor for sinonasal mucosal inflammation.
Collapse
Affiliation(s)
- Tomotaka Hemmi
- Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Jun Suzuki
- Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.
| | - Ryo Ishii
- Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Ryoukichi Ikeda
- Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Yuta Kobayashi
- Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Hiroyuki Ikushima
- Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Kazuhiro Nomura
- Department of Otolaryngology, Tohoku Kosai Hospital, 2-3-11 Kokubun-cho, Aoba-ku, Sendai, Miyagi 980-0803, Japan
| | - Mitsuru Sugawara
- Department of Otolaryngology, Tohoku Kosai Hospital, 2-3-11 Kokubun-cho, Aoba-ku, Sendai, Miyagi 980-0803, Japan
| | - Akira Ohkoshi
- Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Yukio Katori
- Department of Otolaryngology, Head and Neck Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| |
Collapse
|
23
|
Parke SC, Langelier DM, Cheng JT, Kline-Quiroz C, Stubblefield MD. State of Rehabilitation Research in the Head and Neck Cancer Population: Functional Impact vs. Impairment-Focused Outcomes. Curr Oncol Rep 2022; 24:517-532. [PMID: 35182293 DOI: 10.1007/s11912-022-01227-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Management of head and neck cancer (HNC) typically involves a morbid combination of surgery, radiation, and systemic therapy. As the number of HNC survivors grows, there is growing interest in rehabilitation strategies to manage HNC-related comorbidity. In this review, we summarize the current state of HNC rehabilitation research. RECENT FINDINGS We have organized our review using the World Health Organization's International Classification of Function (ICF) model of impairment, activity, and participation. Specifically, we describe the current research on rehabilitation strategies to prevent and treat impairments including dysphagia, xerostomia, dysgeusia, dysosmia, odynophagia, trismus, first bite syndrome, dysarthria, dysphonia, lymphedema, shoulder syndrome, cervicalgia, cervical dystonia and dropped head syndrome, deconditioning, and fatigue. We also discuss the broader impact of HNC-related impairment by exploring the state of rehabilitation literature on activity, participation, psychosocial distress, and suicidality in HNC survivors. We demonstrate that research in HNC rehabilitation continues to focus primarily on impairment-driven interventions. There remains a dearth of HNC rehabilitation studies directly examining the impact of rehabilitation interventions on outcomes related to activity and participation. More high-quality interventional studies and reviews are needed to guide prevention and treatment of functional loss in HNC survivors.
Collapse
Affiliation(s)
- Sara C Parke
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Arizona, Phoenix, USA.
| | - David Michael Langelier
- Cancer Rehabilitation and Survivorship, Princess Margaret Cancer Centre Toronto, Ontario, Canada
| | - Jessica Tse Cheng
- Department of Palliative, Rehabilitation, and Integrative Medicine, MD Anderson Cancer Center, TX, Houston, USA
| | - Cristina Kline-Quiroz
- Department of Physical Medicine & Rehabilitation, Vanderbilt University Medical Center, TN, Nashville, USA
| | - Michael Dean Stubblefield
- Department of Physical Medicine and Rehabilitation - Rutgers New Jersey Medical School, Kessler Institute for Rehabilitation, 1199 Pleasant Valley Way, NJ, 07052, West Orange, USA
| |
Collapse
|
24
|
Mechanism and Protection of Radiotherapy Induced Sensorineural Hearing Loss for Head and Neck Cancer. BIOMED RESEARCH INTERNATIONAL 2022; 2021:3548706. [PMID: 34970625 PMCID: PMC8714384 DOI: 10.1155/2021/3548706] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/18/2021] [Accepted: 12/08/2021] [Indexed: 12/15/2022]
Abstract
Purpose Radiotherapy-induced sensorineural hearing loss (RISNHL) is a common adverse effect in patients with head and neck cancer. Given that there are few studies on the pathogenesis of RISNHL at present, we summarized the possible pathogenesis of RISNHL and possible protective measures found at present by referring to relevant literatures. Methods We performed a comprehensive literature search in the PubMed database, using keywords “sensorineural hearing loss,” “radiotherapy,” and “cancer,” among others. The literature was examined for the possible mechanism and preventive measures of sensorineural hearing loss induced by radiotherapy. Results We found that the incidence of RISNHL was closely related to the damage directly caused by ionizing radiation and the radiation-induced bystander effect. It also depends on the dose of radiation and the timing of chemotherapy. Studies confirmed that RISNHL is mainly involved in post-RT inflammatory response and changes in reactive oxygen species, mitogen-activated protein kinase, and p53 signaling pathways, leading to specific manners of cell death. We expect to reduce the incidence of hearing loss through advanced radiotherapy techniques, dose limitation of organs at risk, application of cell signaling inhibitors, use of antioxidants, induction of cochlear hair cell regeneration, and cochlear implantation. Conclusion RISNHL is associated with radiation damage to DNA, oxidative stress, and inflammation of cochlear cells, stria vascularis endothelial cells, vascular endothelial cells, spiral ganglion neurons, and other supporting cells. At present, the occurrence mechanism of RISNHL has not been clearly illustrated, and further studies are needed to better understand the underlying mechanism, which is crucial to promote the formulation of better strategies and prevent the occurrence of RISNHL.
Collapse
|
25
|
Murugesan A, Raghuraman MS, Chilukuri S, Raja T. Hydro-dissection of Dorsal Scapular Nerve for Neuropathy Post Radical Neck Dissection and Radiation: A Case Report. Indian J Palliat Care 2021; 27:577-579. [PMID: 34898955 PMCID: PMC8655671 DOI: 10.25259/ijpc_114_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Accepted: 09/26/2021] [Indexed: 11/22/2022] Open
Abstract
Neuropathy of dorsal scapular nerve (DSN) following neck dissections or radiotherapy has not been reported so far nor has its treatment in the form of hydro-dissection. Hydro-dissection of nerve under ultrasound guidance has been receiving more attention in the recent past and it is a minimally invasive procedure. We report here a case of neuropathy of DSN following radiotherapy in a patient for whom we could at least provide pain relief as a palliative measure during his last 6 months of life.
Collapse
Affiliation(s)
- Anand Murugesan
- Department of Anaesthesia and Pain Management, Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India
| | - M S Raghuraman
- Department of Anesthesiology and Pain medicine, Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India
| | - Srinivas Chilukuri
- Department of Radiation Oncology, Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India
| | - Thirumalai Raja
- Department of Radiation Oncology, Apollo Proton Cancer Centre, Chennai, Tamil Nadu, India
| |
Collapse
|
26
|
An Atypical Presentation of Sinonasal Tract Alveolar Rhabdomyosarcoma in a Young Male Patient Submitted to Multimodality Treatment. Case Rep Oncol Med 2021; 2021:8401755. [PMID: 34754521 PMCID: PMC8572639 DOI: 10.1155/2021/8401755] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/08/2021] [Indexed: 11/18/2022] Open
Abstract
Rhabdomyosarcoma (RMS), a malignant tumor derived from the neoplastic proliferation of striated skeletal muscle cells, is the most common pediatric soft tissue sarcoma. Its treatment is mainly based on neoadjuvant chemotherapy (QT+), surgical resection, and adjuvant radiotherapy (RT+). RT+ has shown satisfactory results for locoregional control of the disease, in spite of promoting local side effects. The present case report was aimed at describing the clinical and therapeutic characteristics and the management of complications resulting from multimodal therapy in a patient with an atypical presentation of RMS in the sinonasal tract. A 20-year-old Afro-descendant man complained of an expansive tumor lesion, with left eye proptosis that reduced visual acuity and caused severe regional pain. Imaging analysis showed an extensive and infiltrative lesion in the periorbital region, sinonasal tract, left maxilla, and orbital roof. According to the histopathological analysis, the diagnosis was established corresponding to parameningeal alveolar RMS that was unresectable. Treatment was initiated with three cycles of QT+ which showed partial response and later RT+. After completing half of the RT+ sessions, the patient showed a complete response with reduction in tumor volume and improvement in pain and local conditions. Side effects such as alopecia and dermatological changes induced by radiation were observed. Moreover, painful erythematous areas were observed in the region of the hard and soft palate, uvula, and oropharynx, compatible with Grade 2 mucositis lesions. After the cytological swab test, some of them were diagnosed as herpes simplex lesions; thickening and decrease in salivary flow were also found. A local drug therapy approach was instituted, and photobiomodulation was performed to manage oral complications. RT+ was shown to be effective in locoregional control of the disease; however, the early management of its undesirable effects on the surrounding tissues was required.
Collapse
|
27
|
Behling F, Bersali I, Santacroce A, Hempel J, Kandilaris K, Schittenhelm J, Tatagiba M. Transition of a vestibular schwannoma to a malignant peripheral nerve sheath tumor with loss of H3K27 trimethylation after radiosurgery-a case report and review of the literature. Neurosurg Rev 2021; 45:915-922. [PMID: 34392463 PMCID: PMC8827336 DOI: 10.1007/s10143-021-01620-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 07/17/2021] [Accepted: 07/30/2021] [Indexed: 01/19/2023]
Affiliation(s)
- Felix Behling
- Department of Neurosurgery, Eberhard-Karls University of Tübingen, Hoppe-Seyler Street 3, 72076, Tübingen, Germany. .,Comprehensive Cancer Center Tübingen, Eberhard-Karls University, Tübingen, Germany.
| | - Imane Bersali
- Department of Neurosurgery, Eberhard-Karls University of Tübingen, Hoppe-Seyler Street 3, 72076, Tübingen, Germany
| | - Antonio Santacroce
- Department of Neurosurgery, St. Barbara-Klinik Hamm-Heessen, Hamm, Germany
| | - Johann Hempel
- Comprehensive Cancer Center Tübingen, Eberhard-Karls University, Tübingen, Germany.,Department of Diagnostic and Interventional Neuroradiology, Eberhard-Karls University, Tübingen, Germany
| | - Kosmas Kandilaris
- Comprehensive Cancer Center Tübingen, Eberhard-Karls University, Tübingen, Germany.,Department of Neuropathology, Eberhard-Karls University, Tübingen, Germany
| | - Jens Schittenhelm
- Comprehensive Cancer Center Tübingen, Eberhard-Karls University, Tübingen, Germany.,Department of Neuropathology, Eberhard-Karls University, Tübingen, Germany
| | - Marcos Tatagiba
- Department of Neurosurgery, Eberhard-Karls University of Tübingen, Hoppe-Seyler Street 3, 72076, Tübingen, Germany.,Comprehensive Cancer Center Tübingen, Eberhard-Karls University, Tübingen, Germany
| |
Collapse
|
28
|
Molecular and Neural Mechanism of Dysphagia Due to Cancer. Int J Mol Sci 2021; 22:ijms22137033. [PMID: 34210012 PMCID: PMC8269194 DOI: 10.3390/ijms22137033] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 06/24/2021] [Accepted: 06/28/2021] [Indexed: 12/21/2022] Open
Abstract
Cancer is one of the most common causes of death worldwide. Along with the advances in diagnostic technology achieved through industry–academia partnerships, the survival rate of cancer patients has improved dramatically through treatments that include surgery, radiation therapy, and pharmacotherapy. This has increased the population of cancer “survivors” and made cancer survivorship an important part of life for patients. The senses of taste and smell during swallowing and cachexia play important roles in dysphagia associated with nutritional disorders in cancer patients. Cancerous lesions in the brain can cause dysphagia. Taste and smell disorders that contribute to swallowing can worsen or develop because of pharmacotherapy or radiation therapy; metabolic or central nervous system damage due to cachexia, sarcopenia, or inflammation can also cause dysphagia. As the causes of eating disorders in cancer patients are complex and involve multiple factors, cancer patients require a multifaceted and long-term approach by the medical care team.
Collapse
|