Details

Autor(en) / Beteiligte

• Chow, James C.H.
• Ho, Jason C.S.
• Cheung, Ka Man
• Johnson, David
• Ip, Bonaventure Y.M.
• Beitler, Jonathan J.
• Strojan, Primož
• Mäkitie, Antti A.
• Eisbruch, Avraham
• Ng, Sweet Ping
• Nuyts, Sandra
• Mendenhall, William M.
• Babighian, Silvia
• Ferlito, Alfio

Titel

Neurological complications of modern radiotherapy for head and neck cancer

Ist Teil von

• Radiotherapy and oncology, 2024-05, Vol.194, p.110200-110200, Article 110200

Ort / Verlag

Ireland: Elsevier B.V

Erscheinungsjahr

2024

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• •Multiple neurological structures and organs are inadvertently irradiated during radiotherapy for head and neck cancer.•Radiation-associated neurological complications significantly impair patients’ quality of life.•This article reviews ten distinct radiation-associated neurological complications in head and neck cancer survivors who underwent modern radiotherapy.•Current incidence data, prevention strategies, and potential management options of these complications are discussed. 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.