Late complication of the oral cavity and oropharynx after interstitial neutron therapy with sources of Cf-252

«Radiation and Risk», 2021, vol. 30, No. 2, pp.123-132

DOI: 10.21870/0131-3878-2021-30-2-123-132

Authors

Polkin V.V.– Head of Dep., C. Sc., Med. Contacts: 4 Korolev Str., Obninsk, Kaluga region, Russia, 249035. Tel.: +79108637283; e-mail: This email address is being protected from spambots. You need JavaScript enabled to view it. .
Medvedev V.S. – Chief Researcher, MD, Prof.
Derbugov D.N. – Physician
Isaev P.A. – Lead. Researcher, MD
Vasil`kov S.V. – Researcher
Sevrukov F.E. – Lead. Researcher, C. Sc., Med.
Fedina A.K. – Clinical Resident
Ivanov S.A. – Director, MD, Prof. of RAS. A. Tsyb MRRC.
Kaprin A.D. – Director General, Academician of RAS, MD, Prof. NMRRC.
A. Tsyb MRRC, Obninsk
1 NMRRC, Moscow

Abstract

Radiotherapy is used to treat approximately 80% of patients with cancer of the head and neck. Despite enormous advances in radiotherapy planning and delivery, a significant number of patients will experience radiation-associated toxicities. Many effective management options are available for acute radiotherapy-associated toxicities, but treatment options are much more limited and of variable benefit among patients who develop late sequelae after radiotherapy. The present work is based on observations of 586 patients with oral and oropharynx cancer, for which interstitial neutron therapy was carried out in an independent version or in combination with remote radiation therapy. Radiation injuries occurred in 130 (22.2%) patients, in 92 (15.7%) they appeared in the form of radiation ulcers and in 38 (6.4%) – osteoradionecrosis of the lower jaw. The clinical picture and the course of radiation injuries after interstitial neutron therapy with sources of 252Cf did not differ significantly from radiation complications after photon irradiation.

Key words
head and neck cancer, radiation injures, oral and oropharyngeal cancer, radiotherapy, interstitial neutron therapy, radiation ulcer, osteoradionecrosis, lower jaw, sources of 252Cf, acute toxicities.

References

1. Borras J.M., Barton M., Grau C., Corral J., Verhoeven R., Lemmens V., van Eycken L., Henau K., Primic-Zakelj M., Strojan P., Trojanowski M., Dyzmann-Sroka A., Kubiak A., Gasparotto C., Defourny N., Malicki J., Dunscombe P., Coffey M., Lievens Y. The impact of cancer incidence and stage on optimal utilization of radiotherapy: methodology of a population, based analysis by the ESTRO-HERO project. Radiother. Oncol., 2015, vol. 116, no. 1, pp. 45-50. DOI: 10.1016/j.radonc.2015.04.021.

2. Barnett G.C., West C.M., Dunning A.M., Elliott R.M., Coles C.E., Pharoah P.D., Burnet N.G. Normal tissue reactions to radiotherapy: towards tailoring treatment dose by genotype. Nat. Rev. Cancer, 2009, vol. 9, no. 2, pp. 134-142. DOI: 10.1038/nrc2587.

3. Jellema A.P., Slotman B.J., Doornaert P., Leemans C.R., Langendijk J.A. Impact of radiation-induced xerostomia on quality of life after primary radiotherapy among patients with head and neck cancer. Int. J. Radiat. Oncol. Biol. Phys., 2007, vol. 69, no. 3, pp. 751-760.

4. Langendijk J.A., Doornaert P., Verdonck-de Leeuw I.M., Leemans C.R., Aaronson N.K., Slotman B.J. Impact of late treatment-related toxicity on quality of life among patients with head and neck cancer treated with radiotherapy. J. Clin. Oncol., 2008, vol. 26, no. 22, pp. 3770-3776.

5. Machtay М., Moughan J., Trotti A., Garden A.S., Weber R.S., Cooper J.S., Forastiere A., Kian Ang K. Factors associated with severe late toxicity after concurrent chemoradiation for locally advanced head and neck cancer: an RTOG analysis. J. Clin. Oncol., 2008, vol. 26, no. 21, pp. 3582-3589.

6. Pignon J.P., le Maître A., Maillard E., Bourhis J., MACH-NC Collaborative Group. Meta-analysis of chemotherapy in head and neck cancer (MACH-NC): an update on 93 randomised trials and 17,346 patients. Radiother. Oncol., 2009, vol. 92, no. 1, pp. 4-14.

7. Wijers O.B., Levendag P.C., Braaksma M.M., Boonzaaijer M., Visch L.L., Schmitz P.I. Patients with head and neck cancer cured by radiation therapy: a survey of the dry mouth syndrome in long-term survivors. Head Neck, 2002, vol. 24, no. 8, pp. 737-747.

8. Nutting C.M., Morden J.P., Harrington K.J., Urbano T.G., Bhide S.A., Clark C., Miles E.A., Miah A.B., Newbold K., Tanay M., Adab F., Jefferies S.J., Scrase C., Yap B.K., A'Hern R.P., Sydenham M.A., Emson M., Hall E.; PARSPORT trial management group. Parotid-sparing intensity modulated versus con-ventional radiotherapy in head and neck cancer (PARSPORT): a phase 3 multicentre randomised controlled trial. Lancet Oncol., 2011, no. 12, pp. 127–136.

9. Christianen M.E.M.C., Verdonck-de Leeuw I.M., Doornaert P., Chouvalova O., Steenbakkers R.J.H.M., Koken Ph.W., Leemans C.R., Oosting S.F., Roodenburg J.L.N., van der Laan B.F.A.M., Slotman B.J., Bijl H.P., Langendijk J.A. Patterns of long-term swallowing dysfunction after definitive radiotherapy or chemo-radiation. Radiother. Oncol., 2015, vol. 117, no. 1, pp. 139-144.

10. Buglione M., Cavagnini R., Di Rosario F., Sottocornola L., Maddalo M., Vassalli L., Grisanti S., Salgarello S., Orlandi E., Paganelli C., Majorana A., Gastaldi G., Bossi P., Berruti A., Pavanato G., Ni-colai P., Maroldi R., Barasch A., Russi E.G., Raber-Durlacher J., Murphy B., Magrini S.M. Oral toxicity management in head and neck cancer patients treated with chemotherapy and radiation: dental pathologies and osteoradionecrosis (Part 1) literature review and consensus statement. Crit. Rev. Oncol. Hematol., 2016, vol. 97, pp. 131-142.

11. Dhanda J., Pasquier D., Newman L., Shaw R. Current concepts in osteoradionecrosis after head and neck radiotherapy. Clin. Oncol. (R. Coll. Radiol.), 2016, vol. 28, no. 7, pp. 459-466.

12. Peterson D.E., Doerr W., Hovan A., Pinto A., Saunders D., Elting L.S., Spijkervet F.K., Brennan M.T. Osteoradionecrosis in cancer patients: the evidence base for treatment-dependent frequency, current management strategies, and future studies. Support Care Cancer, 2010, vol. 18, no. 8, pp. 1089-1098.

13. De Felice F., Musio D., Tombolini V. Osteoradionecrosis and intensity modulated radiation therapy: an over-view. Crit. Rev. Oncol. Hematol., 2016, vol. 107, pp. 39-43.

14. Studer G., Bredell M., Studer S., Huber G., Glanzmann C. Risk profile for osteoradionecrosis of the mandible in the IMRT era. Strahlenther. Onkol., 2016, vol. 192, no. 1, pp. 32-39. DOI: 10.1007/s00066-015-0875-6.

15. Kaprin A.D., Galkin V.N., Zhavoronkov L.P., Ivanov V.K., Ivanov S.A., Romanko Yu.S. Synthesis of basic and applied research is the basis of obtaining high-quality findings and translating them into clinical practice. Radiatsiya i Risk – Radiation and Risk, 2017, vol. 26, no. 2, pp. 26-40. (In Russian).

16. Kaprin A.D., Mardynskiy Yu.S., Smirnov V.P., Ivanov S.A., Kostin A.A., Polikhov S.A., Reshetov I.V., Fat’yanova A.S., Denisenko M.V., Epatova T.V., Korenev S.V., Tereshchenko A.V., Filonenko E.V., Gafarov M.M., Romanko Yu.S. The history of radiation therapy (part I). Biomedical Photonics, 2019, vol. 8, no. 1, pp. 52-62. DOI: org/10.24931/2413-9432-2019-8-1-52-62. (In Russian).

Full-text article (in Russian)