Neurological complications of modern radiotherapy for head and neck cancer.

Autor: Chow JCH; Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region. Electronic address: cch932@ha.org.hk., Ho JCS; Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region., Cheung KM; Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong Special Administrative Region., Johnson D; Department of Clinical Oncology, Prince of Wales Hospital, Hong Kong Special Administrative Region., Ip BYM; Division of Neurology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong Special Administrative Region; Li Ka Shing Institute of Health Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong Special Administrative Region., Beitler JJ; Harold Alfond Center for Cancer Care, Maine General Hospital, Augusta, ME, USA., Strojan P; Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia., Mäkitie AA; Department of Otorhinolaryngology, Head and Neck Surgery, Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland., Eisbruch A; Department of Radiation Oncology, University of Michigan Medicine, Ann Arbor, MI, USA., Ng SP; Department of Radiation Oncology, Olivia Newton-John Cancer Centre, Austin Health, Melbourne, Australia., Nuyts S; Department of Radiation Oncology, Leuven Cancer Institute, University Hospitals Leuven, KU Leuven - University of Leuven, Leuven, Belgium; Laboratory of Experimental Radiotherapy, Department of Oncology, University of Leuven, Leuven, Belgium., Mendenhall WM; Department of Radiation Oncology, University of Florida College of Medicine, Gainesville, FL, USA., Babighian S; Department of Ophthalmology, Ospedale Sant'Antonio, Azienda Ospedaliera, Padova, Italy., Ferlito A; Coordinator of the International Head and Neck Scientific Group, Padua, Italy.
Jazyk: angličtina
Zdroj: Radiotherapy and oncology : journal of the European Society for Therapeutic Radiology and Oncology [Radiother Oncol] 2024 May; Vol. 194, pp. 110200. Date of Electronic Publication: 2024 Mar 02.
DOI: 10.1016/j.radonc.2024.110200
Abstrakt: Radiotherapy is one of the mainstay treatment modalities for the management of non-metastatic head and neck cancer (HNC). Notable improvements in treatment outcomes have been observed in the recent decades. Modern radiotherapy techniques, such as intensity-modulated radiotherapy and charged particle therapy, have significantly improved tumor target conformity and enabled better preservation of normal structures. However, because of the intricate anatomy of the head and neck region, multiple critical neurological structures such as the brain, brainstem, spinal cord, cranial nerves, nerve plexuses, autonomic pathways, brain vasculature, and neurosensory organs, are variably irradiated during treatment, particularly when tumor targets are in close proximity. Consequently, a diverse spectrum of late neurological sequelae may manifest in HNC survivors. These neurological complications commonly result in irreversible symptoms, impair patients' quality of life, and contribute to a substantial proportion of non-cancer deaths. Although the relationship between radiation dose and toxicity has not been fully elucidated for all complications, appropriate application of dosimetric constraints during radiotherapy planning may reduce their incidence. Vigilant surveillance during the course of survivorship also enables early detection and intervention. This article endeavors to provide a comprehensive review of the various neurological complications of modern radiotherapy for HNC, summarize the current incidence data, discuss methods to minimize their risks during radiotherapy planning, and highlight potential strategies for managing these debilitating toxicities.
Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2024 Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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