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Intensity-Modulated Radiation Therapy and Inverse Planning
Published in W. P. M. Mayles, A. E. Nahum, J.-C. Rosenwald, Handbook of Radiotherapy Physics, 2021
Helen Mayles, John Fenwick, Steve Webb
Two debilitating long-term side effects from radiotherapy for Head and Neck cancers are xerostomia (dry mouth) and dysphagia (swallowing disorders) (Dirix and Nuyts 2010). 3D-CRT plans for treating the pharynx or nasopharynx consist of lateral parallel-opposed fields to the upper neck (treating the tumour) matched to an anterior field to the lower neck (giving a lower dose to neck nodes). The anterior field incorporates a midline block to spare the larynx, oesophagus and other critical midline structures. The motivation for using IMRT for these tumours is to reduce the toxicity to the saliva-producing glands, particularly the parotids glands, and to improve the conformality of the dose distribution to the primary and nodal CTVs (see Figure 37.16 and Gregoire et al. 2007).
Tumours of the oral cavity and pharynx
Published in Anju Sahdev, Sarah J. Vinnicombe, Husband & Reznek's Imaging in Oncology, 2020
Kunwar S S Bhatia, Ann D King, Robert Hermans
Other risk factors for head and neck cancer include poor oral hygiene, ultraviolet radiation (lip cancer), dietary insufficiencies, processed meat consumption and nitrosamine-rich foods, and specific occupational exposures (21–24). A minority of cancers are associated with rare heritable conditions or acquired immunodeficiencies (19).
Treatment of Latent Tuberculosis Infection Including Risk Factors for the Development of Tuberculosis
Published in Lloyd N. Friedman, Martin Dedicoat, Peter D. O. Davies, Clinical Tuberculosis, 2020
Guidelines for testing and treating patients with malignancy for LTBI vary. In the UK, NICE 2016 recommends testing for LTBI and treating patients with hematological malignancies and patients receiving chemotherapy for other malignancies.4 In the United States, CDC guidelines recommend treatment for patients with head and neck cancer. Toxicity of LTBI treatment and interactions with chemotherapy agents should be taken into account, e.g., peripheral neuropathy caused by both INH and some cytotoxic drugs may be alleviated by pyridoxine. RIF may render some agents less effective by increasing their metabolism, such as corticosteroids.
Effects of patient-specific mobility therapy for TMJ, neck, and shoulder dysfunction after submandibular gland tumor surgery: a case report
Published in Physiotherapy Theory and Practice, 2021
Keun-Su Lee, Duck-Won Oh, Joon-Hee Lee
Recent studies have reported that physiotherapy interventions, including exercise therapy, improve the functional status and quality of life of patients with head and neck cancer (Carvalho, Vital, and Soares, 2012; Do et al., 2013; McNeely et al., 2008). However, these investigations report the effects of comprehensive interventions for patients with head and neck cancer and do not describe detailed guidelines for each patient condition. To the best of our knowledge, no specific protocols have been offered for the management of functional problems after RND of submandibular gland tumors. In addition, there is a lack of scientific evidence in the literature to support the effectiveness of exercise therapy on neck and shoulder function after RND (McGarvey, Chiarelli, Osmotherly, and Hoffman, 2011). Accordingly, this report describes the impact of a patient-specific mobility therapy (PSMT) program on limited ROM and functional impairments of the TMJ, neck, and shoulder in a patient who received submandibular gland tumor surgery.
Feasibility of p16 surrogate biomarker as adjunct diagnosis of oral and oropharyngeal malignancy in a resource-constrained country
Published in Acta Oto-Laryngologica, 2021
Marlinda Adham, Noval Aldino, Saffanah Zahra, Lisnawati Rachmadi, Saptawati Bardosono
We observed a moderate prevalence of HPV-positive oropharyngeal SCC in this population of Indonesian patients, accompanied by a lower prevalence of HPV-positive oral SCC. Our findings is similar to a review by Shaikh et al. showing HPV-positivity in 40.53% of oropharyngeal cancer patients, and 37.55% in oral cancer patients in Asia Pacific [2]. Our study further confirmed a lower HPV prevalence in an Asian population compared to North American population where HPV-associated oropharyngeal SCC prevalence was 59.9%, but of similar prevalence in Europe for oropharyngeal and oral cancer (39.9 and 26.6%, respectively) [6]. The most common risk factors in head and neck cancer, smoking, alcohol consumption, and oral sex, were also not prominent in this study. It is reported that an increase in oropharyngeal SCC occurred more in economically-developed countries, where it is associated with a change in sexual behaviour related to oral HPV exposure [7]. Whereas in Indonesia, it is still considered taboo to give out information regarding sexual behaviour, therefore the low prevalence of oral sex in this study may not reflect the actual condition. Although our study did not prove correlation between risk factors and HPV status, HPV-positive patients are often of younger age and non-smokers [8]. Additionally, known risk factors for poor prognosis among HPV-positive oropharyngeal cancer patients include smoking, large primary tumours and more advanced nodal disease [9].
“I would have told you about being forgetful, but I forgot”: the experience of cognitive changes and communicative participation after head and neck cancer
Published in Disability and Rehabilitation, 2020
Susan Bolt, Carolyn Baylor, Michael Burns, Tanya Eadie
Head and neck cancers are primarily squamous cell carcinomas that occur in the oral cavity, pharynx, larynx, nasal cavity, and paranasal sinuses - all critical structures for swallowing, respiration, and communication. Patients treated for head and neck cancers often experience lasting difficulties with verbal communication [1]. In fact, among head and neck cancer survivors, speech outcomes have been identified as the strongest predictor of overall health-related quality of life [2]. Specifically, difficulty communicating in everyday activities, or “communicative participation,” may affect a person’s ability to return to work, establish or maintain relationships, or participate in social contexts [3]. Head and neck cancer patients have identified these roles and activities as extremely important priorities during and after treatment [4,5].