Parotid gland – Oral Cancer News

Improving QOL in head and neck cancer as survival improves

Source: www.medscape.com Author: Zosia Chustecka In patients undergoing radiation treatment for head and neck cancer, reducing the radiation to organs not affected by cancer is key to improving quality of life post-treatment. Several studies presented here at the 2014 Multidisciplinary Head and Neck Cancer Symposium described new approaches to sparing radiation delivered to the salivary glands and to the voice box, without any loss of cancer control, but with a reported reduction in adverse effects, such as xerostomia (dry mouth), and an anticipated reduction in loss of voice and speech quality. Improvements in such outcomes are becoming increasingly important as the epidemiology of head and neck cancer is changing, and the increase in human papillomavirus-positive disease means that patients are being diagnosed their 50s and will, in many cases, go on to live for decades after their definitive cancer treatment, researchers commented at a press briefing. Xerostomia can make it difficult to speak, as well as chew and swallow, and can lead to dental problems. "Dry mouth might seem trivial, but it actually has a significant effect on quality of life," commented Tyler Robin, PhD, an MD candidate in his final year at the University of Colorado Medical School in Denver. To reduce this adverse effect, intensity-modulated radiation techniques are already directing the beam away from the parotid gland, which is responsible for stimulated saliva production, for example during eating. But for the rest of the time, saliva is produced unstimulated from the submandibular gland. "This gland actually produces the [...]

Oral Cancer Foundation News Team - A2014-02-28T14:23:04-07:00February, 2014|Oral Cancer News|

Acupuncture can prevent radiation-induced chronic dry mouth

Source: http://www.virtualmedicalcentre.com Author: staff When given alongside radiation therapy for head and neck cancer, acupuncture has shown for the first time to reduce the debilitating side effect of xerostomia, according to new research from The University of Texas MD Anderson Cancer Center and Fudan University Shanghai Cancer Center. The study, published in the journal Cancer, reported findings from the first randomised controlled trial of acupuncture for the prevention of xerostomia. Xerostomia, or severe dry mouth, is characterised by reduced salivary flow, which commonly affects patients receiving radiotherapy for head and neck cancer. Most current treatments are palliative and offer limited benefit, according to Lorenzo Cohen, Ph.D., professor in MD Anderson's Departments of General Oncology and Behavioral Science and director of the Integrative Medicine Program. The condition impairs quality of life for patients, as it creates difficulties eating, speaking and sleeping, while also increasing the risk for oral infections. "There have been a number of small studies examining the benefits of acupuncture after xerostomia develops, but no one previously examined if it could prevent xerostomia," said Cohen, who is also the study's principal investigator. "We found incorporating acupuncture alongside radiotherapy diminished the incidence and severity of this side effect." Cohen and his colleagues examined 86 patients with nasopharyngeal carcinoma, treated at Fudan University Shanghai Cancer Center. Forty patients were randomised to acupuncture and 46 to the standard of care. Those in the treatment arm received acupuncture therapy three times per week during the seven-week course of radiotherapy. Patients were evaluated before [...]

Oral Cancer Foundation News Team - A2011-11-27T14:18:34-07:00November, 2011|Oral Cancer News|

Proper dental care for cancer patients: why it is important

Source: newcanaan.patch.com Author: Alan B. Sheiner DDS Common side effects from radiation therapy are not stressed enough in dental schools, but they can be managed and even prevented. A few weeks ago, I was contacted by a retired physician with whom I had not spoken for a number of years since he retired from practice to become a “gentleman farmer” in the country. While I was happy to hear from him, his news was not so good. He was calling because he had been treated for base of tongue cancer and his teeth were “coming apart”. His cancer treatment consisted of chemotherapy and radiation therapy. Unfortunately, he somehow “slipped through the cracks” and his oral cavity was now suffering from some of the side effects of the cancer therapy – fortunately he is currently cancer free. The oral cavity, one of the most complex and visible organ systems in the body, is invariably compromised as a result of treatment for head and neck cancer. Whether the malignancy is to be treated by surgery, radiation therapy, chemotherapy or a combination of these modalities, the function, if not also the form, of the oral cavity will be impacted. Aside from the obvious physical changes after cancer surgery to the head and neck region, there are issues which usually accompany radiation therapy to the head and neck region. There may be side effects from cancer therapy, some of which can be devastating, but preventable or manageable with proper precautions and care. The most [...]

Oral Cancer Foundation News Team - A2011-10-23T09:33:21-07:00October, 2011|Oral Cancer News|

Less xerostomia occurs with IMRT in head and neck cancer

Source: www.medscape.com Author: Roxanne Nelson Intensity-modulated radiotherapy (IMRT) might be a better treatment option for patients with squamous cell carcinoma of the head and neck. Compared with conventional radiation therapy, IMRT significantly decreases the incidence of xerostomia and improves quality of life, according to a study published online January 13 in the Lancet Oncology. British researchers report that at 12 months, grade 2 or higher xerostomia was significantly lower with IMRT than with conventional radiotherapy (38% vs 74%; P = .0027). At 2 years, the incidence of grade 2 or higher xerostomia continued to be significantly less common with IMRT than with standard radiotherapy; 9 patients (29%) reported xerostomia in the IMRT group, compared with 20 (83%) in the conventional therapy group. The authors note that there were no significant differences in locoregional control or overall survival between the 2 patient groups. Lead author Christopher M. Nutting, MD, FRCR, consultant and honorary senior lecturer in clinical oncology at the Royal Marsden Hospital and Institute of Cancer Research, London, United Kingdom, and colleagues note that their results "strongly support a role for IMRT in squamous cell carcinoma of the head and neck." Spares the Parotid Gland, Similar Outcomes Head and neck oncology expert Ted Teknos, MD, agrees. "One of the advantages of IMRT is that you can deliver radiation very accurately and you can spare normal structures to a much higher degree than conventional radiation therapy," said Dr. Teknos, director of the Division of Head and Neck Surgery at Ohio State [...]

Oral Cancer Foundation News Team - A2011-01-23T18:03:06-07:00January, 2011|Oral Cancer News|

Intensity-modulated radiation offers treatment advantages over conventional therapy for head and neck cancer

Source: www.docguide.com Author: John Otrompke Patients treated with simultaneously integrated boost treatment using intensity-modulated radiation therapy (IMRT) experience better overall survival, disease-free survival, and local recurrence rates, as well as decreased dermatitis and better postoperative salivary function that those treated with conventional radiation. "IMRT treatment was described as 'boosted' because we use 2 different doses in the same patient, who gets a dose of 2.12 gy to 1 part of their anatomy, while another part gets 1.8 gy," said Sebastien Clavel, MD, University of Montreal, Montreal, Quebec, on November 3 at the American Society of Therapeutic Radiology and Oncology (ASTRO) 51st Annual Meeting. In the study, 249 patients with stage III and IV oropharyngeal carcinoma were treated between 2000 and 2007. Of these, 100 received IMRT, while 149 patients received conventional radiation therapy. After a 33-month median follow-up, 95.4% of those treated with IMRT were still alive, compared with 75.8% of those in the conventional arm. Disease-free survival was 89.3% for the IMRT group, compared with 71.6% in the conventional radiation arm. In addition, local control was 92.4% in the IMRT patients, compared with 85.3% in the conventional group. "With the old technique, the rays were shooting from both sides, whereas with IMRT, the rays come from all directions," said Dr. Clavel. "When using IMRT, we also always give them a 3-mm margin with the skin, both of which result in fewer cases of dermatitis." IMRT patients experienced a 20% decrease in dermatitis grades 3 and 4. "If we are [...]

Oral Cancer Foundation News Team - A2009-11-11T08:45:27-07:00November, 2009|Oral Cancer News|

Parotid gland sparing IMRT for head and neck cancer improves xerostomia related quality of life

Source: Radiation Oncology, December 9, 2008; 3(1): 41. Authors: C M van Rij, W D Oughlane-Heemsbergen, A H Ackerstaff, E A Lamers, A Jm Balm, and C Rn Rasch ABSTRACT: Background and purpose: To assess the impact of intensity modulated radiotherapy (IMRT) versus conventional radiation on late xerostomia and Quality of Life aspects in head and neck cancer patients. Patients and methods: Questionnaires on xerostomia in rest and during meals were sent to all patients treated between January 1999 and December 2003 with a T1-4, N0-2 M0 head and neck cancer, with parotid gland sparing IMRT or conventional bilateral neck irradiation to a dose of at least 60 Gy, who were progression free and had no disseminated disease (n= 192). Overall response was 85 % (n = 163); 97 % in the IMRT group (n = 75) and 77 % in the control group (n = 88) the median follow-up was 2.6 years. The prevalence of complaints was compared between the two groups, correcting for all relevant factors at multivariate ordinal regression analysis. RESULTS: Patients treated with IMRT reported significantly less difficulty transporting and swallowing their food and needed less water for a dry mouth during day, night and meals. They also experienced fewer problems with speech and eating in public. Laryngeal cancer patients in general had fewer complaints than oropharynx cancer patients but both groups benefited from IMRT. Within the IMRT group the xerostomia scores were better for those patients with a mean parotid dose to the "spared" parotid [...]

Webmaster2008-12-17T10:25:00-07:00December, 2008|Oral Cancer News|