Dysphagia, hypothyroidism, and osteoradionecrosis after radiation therapy for head and neck cancer
Pihla Ranta, Eero Kytö, Linda Nissi, Ilpo Kinnunen, Tero Vahlberg, Heikki Minn, Eeva Haapio, Lassi Nelimarkka, Heikki Irjala
Abstract
Abstract Objectives To analyze the long‐term side effects of radiation therapy (RT) for head and neck cancer (HNC). Methods Retrospective chart analysis of all 688 HNC patients treated during 2010–2015 at Turku University Hospital, Finland. All patients who survived for more than a year after RT/chemoRT were included ( n = 233). Intensity modulated RT (IMRT) with standard fractionation was applied in each case. Results One hundred and six patients (45%) reported persisting dysphagia, for which neck RT increased risk. Definitive neck RT to high‐risk volume did not increase late toxicity risks compared to elective neck RT. Radiation‐induced hypothyroidism (29%, n = 67) was more common among younger patients and females. Osteoradionecrosis (12%, n = 29) was more common in the oral cavity cancer group (20.7%, n = 92) compared to all other subsites. Conclusions Late toxicities of RT for HNC are common. Age, gender, tumor subsite, and neck RT affect susceptibility to long‐term side effects. Level of evidence 4.