A prospective study to assess the predictive factors of radiation-induced oral mucositis in head-and-neck carcinoma and its impact on treatment outcome: Long-term results and lessons learned

Background: Radiation-induced oral mucositis (RIOM) is one of the major dose-limiting toxicities in head-and-neck cancer patients. It is due to normal tissue damage by radiation. It is a potential hazard to treatment delivery as it threatens to alter the therapeutic ratio. The radiation oncologist must find a way to balance between tumor control and sparing of normal mucosa to validate the age-old principle of cancer treatment. The onus lies on them to find the contributory factors to curb them accordingly. Objective: The objective of the study was as follows: (1) To find out the factors associated with RIOM in head-neck squamous cell cancer (HNSCC) and (2) to assess the impact of the RIOM on treatment outcome. Materials and Methods: This was a single-institutional, prospective, non-randomized, and open-label study. All cases were treated after informed consent and tumor board approval. This was an observational study with standard treatment according to the stage of the disease. Results: Tumor site, poor oral hygiene, modality of radiation, addiction, and fractionation appeared to be the significant predictive factors of RIOM in HNSCC. Conclusion: This study helps to identify the contributory factors and gives a comprehensive understanding of the same. More multi-institutional subsite-specific studies are warranted to validate the same.

Carcinoma epidermoide de orofaringe. Experiencia institucional / Squamous cell carcinoma of the oropharynx. Institutional experience

Los carcinomas epidermoides de cabeza y cuello (CECC), son un grupo poco frecuente de neoplasias, en los Estados Unidos representan el 3.2% de todos los cánceres1,2. Si bien su frecuencia global se encuentra en disminución, los tumores localizados en la orofaringe han aumentado de forma considerable2. El virus del papiloma humano (HPV) es responsable de este aumento. Se ha descripto que los tumores de orofaringe, asociados al HPV, ocurren en pacientes más jóvenes, con enfermedad de bajo volumen a nivel del tumor primario, pero elevada incidencia de metástasis ganglionares, con adenopatías quísticas2,3. La detección del virus del HPV, por inmunohistoquímica (IHQ) o por reacción en cadena de la polimerasa (PCR) son factores pronósticos importantes que siempre deben ser tenidos en cuenta para el tratamiento de estos tumores (AU)

Epidermoid carcinomas of the head and neck are a rare group of tumors, in the United States they account for 3.2% of all cancers. Although their overall frequency is decreasing, tumors located in the oropharynx have increased considerably. Human papillomavirus (HPV) is responsible for this increase. It has been described that oropharyngeal tumors, associated with HPV, occur in younger patients, with low volume disease at the primary tumor level but a high incidence of lymph node metastases, with cystic lymphadenopathy. Detection of HPV virus by immunohistochemistry (IHC) or polymerase chain reaction (PCR) are important prognostic factors that should always be taken into account for the treatment of these tumors (AU)