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Radiation treatment breaks and ulcerative mucositis in head and neck cancer.
Oncologist 2008; 13(8):886-98O

Abstract

Unplanned radiation treatment breaks and prolongation of the radiation treatment time are associated with lower survival and locoregional control rates when radiotherapy or concurrent chemoradiotherapy is used in the curative treatment of head and neck cancer. Treatment of head and neck cancer is intense, involving high-dose, continuous radiotherapy, and often adding chemotherapy to radiotherapy. As the intensity of treatment regimens has escalated in recent years, clinical outcomes generally have improved. However, more intensive therapy also increases the incidence of treatment-related toxicities, particularly those impacting the mucosal lining of the oral cavity, pharynx, and cervical esophagus, and results in varying degrees of ulcerative mucositis. Ulcerative mucositis is a root cause of unscheduled radiation treatment breaks, which prolongs the total radiation treatment time. Alterations in radiotherapy and chemotherapy, including the use of continuous (i.e., 7 days/week) radiotherapy to ensure constant negative proliferative pressure, may improve efficacy outcomes. However, these approaches also increase the incidence of ulcerative mucositis, thereby increasing the incidence of unplanned radiation treatment breaks. Conversely, the reduction of ulcerative mucositis to minimize unplanned breaks in radiotherapy may enhance not only tolerability, but also efficacy outcomes. Several strategies to prevent ulcerative mucositis in radiotherapy for head and neck cancer have been evaluated, but none have demonstrated strong efficacy. Continued investigation is needed to identify superior radiation treatment regimens, technology, and supportive care that reduce unplanned radiation treatment breaks with the goal of improving clinical outcomes in head and neck cancer.

Authors+Show Affiliations

Department of Radiation Oncology, Jefferson Medical College, Philadelphia, Pennsylvania 19107-5097, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

18701763

Citation

Russo, Gregory, et al. "Radiation Treatment Breaks and Ulcerative Mucositis in Head and Neck Cancer." The Oncologist, vol. 13, no. 8, 2008, pp. 886-98.
Russo G, Haddad R, Posner M, et al. Radiation treatment breaks and ulcerative mucositis in head and neck cancer. Oncologist. 2008;13(8):886-98.
Russo, G., Haddad, R., Posner, M., & Machtay, M. (2008). Radiation treatment breaks and ulcerative mucositis in head and neck cancer. The Oncologist, 13(8), pp. 886-98. doi:10.1634/theoncologist.2008-0024.
Russo G, et al. Radiation Treatment Breaks and Ulcerative Mucositis in Head and Neck Cancer. Oncologist. 2008;13(8):886-98. PubMed PMID: 18701763.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Radiation treatment breaks and ulcerative mucositis in head and neck cancer. AU - Russo,Gregory, AU - Haddad,Robert, AU - Posner,Marshall, AU - Machtay,Mitchell, Y1 - 2008/08/13/ PY - 2008/8/15/pubmed PY - 2009/1/7/medline PY - 2008/8/15/entrez SP - 886 EP - 98 JF - The oncologist JO - Oncologist VL - 13 IS - 8 N2 - Unplanned radiation treatment breaks and prolongation of the radiation treatment time are associated with lower survival and locoregional control rates when radiotherapy or concurrent chemoradiotherapy is used in the curative treatment of head and neck cancer. Treatment of head and neck cancer is intense, involving high-dose, continuous radiotherapy, and often adding chemotherapy to radiotherapy. As the intensity of treatment regimens has escalated in recent years, clinical outcomes generally have improved. However, more intensive therapy also increases the incidence of treatment-related toxicities, particularly those impacting the mucosal lining of the oral cavity, pharynx, and cervical esophagus, and results in varying degrees of ulcerative mucositis. Ulcerative mucositis is a root cause of unscheduled radiation treatment breaks, which prolongs the total radiation treatment time. Alterations in radiotherapy and chemotherapy, including the use of continuous (i.e., 7 days/week) radiotherapy to ensure constant negative proliferative pressure, may improve efficacy outcomes. However, these approaches also increase the incidence of ulcerative mucositis, thereby increasing the incidence of unplanned radiation treatment breaks. Conversely, the reduction of ulcerative mucositis to minimize unplanned breaks in radiotherapy may enhance not only tolerability, but also efficacy outcomes. Several strategies to prevent ulcerative mucositis in radiotherapy for head and neck cancer have been evaluated, but none have demonstrated strong efficacy. Continued investigation is needed to identify superior radiation treatment regimens, technology, and supportive care that reduce unplanned radiation treatment breaks with the goal of improving clinical outcomes in head and neck cancer. SN - 1549-490X UR - https://www.unboundmedicine.com/medline/citation/18701763/Radiation_treatment_breaks_and_ulcerative_mucositis_in_head_and_neck_cancer_ L2 - http://theoncologist.alphamedpress.org/cgi/pmidlookup?view=long&pmid=18701763 DB - PRIME DP - Unbound Medicine ER -