Adverse events associated with concurrent chemoradiation therapy in patients with head and neck cancer

Daniel J Givens; Lucy Hynds Karnell; Anjali K Gupta; Gerald H Clamon; Nitin A Pagedar; Kristi E Chang; Douglas J Van Daele; Gerry F Funk

doi:10.1001/archoto.2009.174

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Adverse events associated with concurrent chemoradiation therapy in patients with head and neck cancer

Journal article

Open access

Peer reviewed

Adverse events associated with concurrent chemoradiation therapy in patients with head and neck cancer

Daniel J Givens, Lucy Hynds Karnell, Anjali K Gupta, Gerald H Clamon, Nitin A Pagedar, Kristi E Chang, Douglas J Van Daele and Gerry F Funk

Archives of otolaryngology--head & neck surgery, Vol.135(12), pp.1209-1217

12/2009

DOI: 10.1001/archoto.2009.174

PMID: 20026818

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Abstract

To assess toxicities, functional outcomes, and health-related quality of life associated with concurrent chemoradiation therapy (CRT) in patients with head and neck cancer. Prospective and retrospective outcomes study. Tertiary care institution. Participants in the longitudinal Outcomes Assessment Project whose head and neck cancer was treated with CRT between February 1, 2000, and March 1, 2007 (n = 104). Patients prospectively provided functional and health-related quality of life information, including data from the 1-year and most current follow-up visits. Medical records were reviewed to determine toxicity and survival rates. Well-defined acute and late toxicities; functional outcomes (diet, dentition, tracheostomies); head and neck cancer-specific, general health, and depression outcomes; and survival rates. Most patients had oropharyngeal or laryngeal tumors (87.5%) and advanced-stage disease (75.0%). Approximately one-half had hematologic toxicities and toxicity-related treatment delays. Approximately one-quarter had neurotoxicities and/or ototoxicites, moist desquamation, pneumonia, nausea and vomiting requiring hospitalization or intravenous fluids, dehydration or malnutrition requiring hospitalization, and mild or moderate fever. Although patients receiving the current intensity-modulated radiation therapy (IMRT) protocol using the Pinnacle(3) planning system had more toxicity-related treatment delays, they had fewer toxicities and better functional and health-related quality of life outcomes compared with those receiving conventional lateral opposing-field radiation or the initial IMRT protocol using the Best nomos PEACOCK planning system. Patients receiving CRT experience a substantial number of treatment-related adverse events, primarily affecting oropharyngeal and laryngeal function, with improvement noted for the current IMRT protocol. Improving dental prosthetic rehabilitation and including evaluations with speech and swallowing pathologists before and during treatment may enhance patient outcomes.

Oropharyngeal Neoplasms - therapy

Prospective Studies

Humans

Middle Aged

Head and Neck Neoplasms - drug therapy

Head and Neck Neoplasms - therapy

Male

Treatment Outcome

Radiotherapy - adverse effects

Combined Modality Therapy - adverse effects

Head and Neck Neoplasms - radiotherapy

Laryngeal Neoplasms - therapy

Antineoplastic Agents - adverse effects

Quality of Life

Female

Aged

Retrospective Studies

Head and Neck Neoplasms - mortality

Details

Title: Subtitle: Adverse events associated with concurrent chemoradiation therapy in patients with head and neck cancer
Creators: Daniel J Givens - Department of Otolaryngology-Head and Neck Surgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA
Lucy Hynds Karnell
Anjali K Gupta
Gerald H Clamon
Nitin A Pagedar
Kristi E Chang
Douglas J Van Daele
Gerry F Funk
Resource Type: Journal article
Publication Details: Archives of otolaryngology--head & neck surgery, Vol.135(12), pp.1209-1217
DOI: 10.1001/archoto.2009.174
PMID: 20026818
NLM abbreviation: Arch Otolaryngol Head Neck Surg
ISSN: 0886-4470
eISSN: 1538-361X
Publisher: American Medical Association; United States
Grant note: R01 CA106908 / NCI NIH HHS
Language: English
Date published: 12/2009
Academic Unit: Hematology, Oncology, and Blood & Marrow Transplantation; Radiation Oncology; Medicine Administration; Otolaryngology; Internal Medicine
Record Identifier: 9984006360302771

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