Some patients with head and neck cancers treated by radiotherapy with or without chemotherapy presents with an unacceptable morbidity of severe dry mouth, severe mucositis and, extreme toxicity to the neck skin, whereas, in some patient’s this does not happen with the same dosage and technique. This often leads to treatment interruption in many cases. So, it will be of interest to know and predict which patients are likely to develop these side effects of radiotherapy and thus, we can help improve the quality of life of patients by a predictive method.
What life style behaviors and biologic parameters that should be included to predict the risk of extreme radiation toxicity in patients receiving radiotherapy for head and neck cancers ?
Dry mouth as side effect depends on the positions of the salivary glands. If the dose on their positions is to high they see fibrosis and the cited side effects. Red skin is dependent on the pigmentation and the area treatment of the irradiated skin positions. The only way to avoid over reactions is to use adopted irradiation techniques (more fied directions, smaller fracionation dose, help by skin saving drogs like cremes, lotions... ).
Just some first ideas.
Some aspects influencing this scenario from our experience:
- Older patients develop these complications (probably a large study group will enable you to underline an age threshold)
- Body mass index is in direct distribution with the length and aggressive pathology, thus a patient with a normal BMI is less likely to develop these complications (maybe search for some data in research targeting nutrition problems in head and neck carcinoma)
- Associated pathology such as diabetes predispose to these problems
However as a previous scientist answered it is very hard to standardize the data because ideally every patient should have a tailored radiation regimen so you need a very big lot of patients to draw conclusions on p
The paper published last month ( https://www.ncbi.nlm.nih.gov/pubmed/27919336 ) elegantly reviews the current knowledge on oral mucositis including individual responses, especially on its page 295.
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