RADIOTHERAPY INDUCED TOXICITY FOR OROPHARYNGEAL CANCER PATIENTS: IMPLICATIONS FOR ORAL HEALTH

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Roxana Irina Iancu, C.C.Mirestean, C.Gh. Buzea, D.T. Iancu

ABSTRACT

Radiotherapy is most often used for the treatment of head and neck tumors as an independent method or in combination with surgery and chemotherapy, the multidisciplinary approach being the therapeutically standard in locally advanced cancers. In the group of head and neck cancers, oropharyngeal cancer presents an increased incidence especially in the young population. Unlike head and neck cancers related to smoking cancers that usually occur in the 6th decade of life, oropharyngeal cancers with viral etiology associated with HPV infection have a favorable prognosis. Long time survivals and the curable potential of this entity have led to the necessity of toxicity reduction strategies to improve the quality of life of these patients. Although modern radiotherapy techniques IMRT and VMAT have greatly reduced the dose received by the radiosensitive organs, the oral mucosa is close to the target volumes or even partially included in these volumes irradiated with high doses leading to acute and late toxicities: oral inflammation, loss of taste, dry mouth syndrome caused by xerostomia and secondary infections. Most commons late effects are dental caries, trismus and osteoradionecrosis. The aim of the study is to evaluate the doses received by organs at risk (the oral cavity, the parotid glands and the mandible) for 20 cases of multimodal treated oropharyngeal cancers and to discuss these data in relation to treatment toxicity.

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