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1.
Rev. Bras. Cancerol. (Online) ; 68(2)Abr.-Jun. 2022.
Article in Portuguese | LILACS | ID: biblio-1371205

ABSTRACT

Introdução: A radiodermatite é caracterizada por lesões cutâneas decorrentes da exposição à radiação ionizante, acometendo entre 80%- 90% dos pacientes submetidos à radioterapia na região da cabeça e pescoço. Objetivo: Avaliar a efetividade do uso do creme de camomila em relação ao creme de calêndula na prevenção da radiodermatite aguda em participantes submetidos à radioterapia para câncer de cabeça e pescoço. Método: Ensaio clínico randomizado, duplo-cego, prospectivo, com análise quantitativa. Foram avaliados 23 participantes, aleatoriamente designados para o grupo que fez uso do creme de camomila (n=12) ou para o grupo do creme de calêndula (n=11). A pele no campo de irradiação foi avaliada na primeira sessão de radioterapia, a cada cinco sessões, e após 30 dias do término do tratamento, de acordo com os critérios da Radiation Therapy Oncology Group (RTOG). Resultados: Os participantes apresentaram radiodermatite em todas as avaliações, do grau 1 ao 3, exceto na primeira avaliação. O nível médio mais elevado foi observado, em ambos os grupos, na sexta avaliação (2,10±0,73 no grupo do creme de camomila e 2,37±0,51 no de calêndula). No grupo camomila, o maior grau de radiodermatite foi o 3, na quinta e sexta avaliações; enquanto, no calêndula, o grau 3 foi observado pela primeira vez na sexta avaliação, permanecendo até a oitava. Não houve diferença estatisticamente significativa nos grupos avaliados. Conclusão: Houve equivalência na efetividade do uso do creme de camomila em relação ao creme calêndula na prevenção de radiodermatites agudas em pacientes com câncer de cabeça e pescoço em radioterapia


Introduction: Radiodermatitis is characterized by skin lesions resulting from exposure to ionizing radiation, affecting between 80-90% of patients undergoing radiotherapy in the head and neck region. Objective: To evaluate the effectiveness of using chamomile cream compared with calendula cream in preventing acute radiodermatitis in participants undergoing radiotherapy for head and neck cancer. Method: Randomized, double-blind, prospective clinical trial with quantitative analysis. 23 participants randomly assigned to the group that used chamomile cream (n=12) or to the calendula cream group (n=11) were evaluated. The skin in the irradiation field was evaluated in the first radiotherapy session, every five sessions and after 30 days after the end of the treatment, according to the criteria of the Radiation Therapy Oncology Group (RTOG). Results: Participants had radiodermatitis in all the assessments, from grades 1 to 3, except in the first assessment. The highest mean level was observed in both groups in the sixth assessment (2.10±0.73 in the chamomile and 2.37±0.51 in the calendula group, respectively). In the chamomile group, the highest degree of radiodermatitis was 3, in the fifth and sixth evaluations, while in the calendula, grade 3 was observed for the first time in the sixth evaluation, remaining until the eighth. There was no statistically significant difference in the groups evaluated. Conclusion: There was equivalence in the effectiveness of the use of chamomile cream compared with calendula cream in the prevention of acute radiodermatitis in patients with head and neck cancer undergoing radiotherapy


Introducción: La radiodermatitis se caracteriza por lesiones cutáneas derivadas de la exposición a radiaciones ionizantes, que afectan entre el 80 y el 90% de los pacientes sometidos a radioterapia en la región de cabeza y cuello. Objetivo: Evaluar la efectividad del uso de la crema de manzanilla en relación con la crema de caléndula para prevenir la radiodermatitis aguda en participantes sometidos a radioterapia para el cáncer de cabeza y cuello. Método: Ensayo clínico prospectivo, aleatorizado, doble ciego con análisis cuantitativo. Se evaluaron 23 participantes, asignados aleatoriamente al grupo que usó la crema de manzanilla (n=12) o al grupo crema de caléndula (n=11). La piel en el campo de irradiación se evaluó en la primera sesión de radioterapia, cada cinco sesiones y a los 30 días de finalizado el tratamiento, según los criterios del Grupo de Oncología Radioterápica (RTOG). Resultados: Los participantes presentaron radiodermatitis en todas las evaluaciones, desde el 1º al 3º grado, excepto en la primera evaluación. El nivel medio más alto se observó, en ambos grupos, en la sexta evaluación (2,10±0,73 en el grupo manzanilla y 2,37±0,51 en el de caléndula). En el grupo manzanilla, el mayor grado de radiodermatitis fue 3, en la quinta y sexta evaluaciones, mientras que en la caléndula se observó por primera vez grado 3 en la sexta evaluación, permaneciendo hasta la octava. No hubo diferencia estadísticamente significativa en los grupos evaluados. Conclusión: Hubo equivalencia en la efectividad del uso de crema de manzanilla en relación con la crema de caléndula en la prevención de la radiodermatitis aguda en pacientes con cáncer de cabeza y cuello sometidos a radioterapia


Subject(s)
Humans , Male , Female , Radiodermatitis/prevention & control , Calendula/drug effects , Chamomile/drug effects , Head and Neck Neoplasms/radiotherapy , Double-Blind Method
3.
J. appl. oral sci ; 29: e20200854, 2021. tab, graf
Article in English | LILACS | ID: biblio-1286917

ABSTRACT

Abstract Hyposalivation and sensation of dry mouth (xerostomia) are one of the most common adverse effects in the treatment of patients with head and neck cancer. Objective: This study evaluates the prevalence of late hyposalivation and associated factors in survivors of squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx treated with radiotherapy with or without concomitant chemotherapy. Methodology: A cross-sectional study was conducted with 88 patients who had concluded radiotherapy at least three months before the study, at a referral center for the treatment of head and neck cancer in the Southern region of Brazil. Hyposalivation was evaluated based on the stimulated salivary flow rate using the spitting method. Multivariate analysis using binary logistic regression was performed to determine the associations between hyposalivation and clinical and demographic variables. Results: Hyposalivation was found in 78.41% of the sample and the mean radiation dose was 63.01 Gy (±9.58). In the crude model of the multivariate analysis, hyposalivation was associated with higher doses of radiation (p=0.038), treatment with concomitant radiotherapy and chemotherapy (p=0.005), and time elapsed since the end of radiotherapy (p=0.025). In the adjusted model of the multivariate analysis, hyposalivation was only associated with dose and time elapsed. Patient who received higher doses of radiation had a 4.25-fold greater chance of presenting hyposalivation, whereas a longer time elapsed since the end of radiotherapy exerted a 75% protective effect against the occurrence of hyposalivation. Conclusion: Hyposalivation is a highly prevalence late-onset side effect of radiotherapy in patients treated for head and neck cancer, with a greater chance of occurrence among those who received higher doses of radiation and those who ended therapy less than 22 months before our study. Concomitant chemotherapy and radiotherapy does not seem to increase the chances of hyposalivation compared to radiotherapy alone.


Subject(s)
Humans , Xerostomia/etiology , Xerostomia/epidemiology , Head and Neck Neoplasms/radiotherapy , Brazil/epidemiology , Prevalence , Cross-Sectional Studies , Survivors
4.
Braz. oral res. (Online) ; 35: e079, 2021. tab, graf
Article in English | LILACS, BBO | ID: biblio-1278593

ABSTRACT

Abstract Head and neck radiotherapy causes quantitative and qualitative changes in saliva. The objective of this case-control study was to evaluate the salivary biomarkers associated with bone remodeling and tissue repair in patients submitted to radiotherapy for head and neck cancer treatment, compared with non-irradiated individuals. Total unstimulated saliva was collected for ELISA assay analysis of receptor activator for nuclear factor κ B (RANK) and its ligand (RANK-L), osteoprotegerin, matrix metalloproteinase-9/ tissue inhibitor of metalloproteinase-2, vascular endothelial growth factor, and epidermal growth factor. Statistics were performed, and revealed that salivary RANK (p = 0.0304), RANK-L (p = 0.0005), matrix metalloproteinase-9/ tissue inhibitor of metalloproteinase-2 (p = 0.0067), vascular endothelial growth factor (p = 0.0060), and epidermal growth factor (p < 0.0001) were reduced in patients, compared with the control group. Osteoprotegerin did not differ between the groups (p = 0.3765). Salivary biomarkers did not differ according to radiotherapy completion time (p > 0.05). In conclusion, the lower output of the salivary molecules - essential for bone remodeling and tissue repair - may disrupt tissue homeostasis and play a role in the pathogenesis of the radiotherapy-induced deleterious effects in the oral cavity.


Subject(s)
Humans , Bone Remodeling , Head and Neck Neoplasms/radiotherapy , Saliva , Case-Control Studies , Tissue Inhibitor of Metalloproteinase-2 , Vascular Endothelial Growth Factor A , Epidermal Growth Factor , RANK Ligand
5.
Rev. enferm. UFSM ; 11: e58, 2021. tab, ilus
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1282664

ABSTRACT

Objetivo: descrever o impacto da radiodermatite na estética corporal em pacientes com câncer de cabeça e pescoço submetidos à radioterapia. Método: estudo exploratório descritivo, do tipo série de casos, realizado no ambulatório de radioterapia de um hospital de ensino. Foram incluídos dez pacientes com câncer de cabeça e pescoço que foram submetidos à radioterapia no período de 2015 a 2017. A coleta dos dados foi realizada com instrumento construído para esse fim e por meio de registro fotográfico. Os dados foram analisados de forma descritiva, apresentando-se o cálculo da frequência. Resultados: todos os pacientes apresentaram sinais característicos de radiodermatite, principalmente os sinais clínicos de epilação (nos homens), hiperpigmentação e descamação seca, que afetam a estética corporal. Conclusão: a estética corporal dos pacientes acompanhados foi alterada em decorrência dos sinais clínicos da radiodermatite. Destaca-se a importância de avaliar essas alterações em pacientes com câncer de cabeça e pescoço submetidos à radioterapia.


Objective: to describe the impact of radiodermatitis on body aesthetics in patients with head and neck cancer undergoing radiotherapy. Method: this is an exploratory descriptive case series study conducted at the radiotherapy outpatient clinic of a teaching hospital. Ten patients with head and neck cancer who underwent radiotherapy from 2015 to 2017 were included. Data collection was performed with an instrument designed for this purpose and through photographic record. Data was analyzed descriptively, presenting the calculation of frequency. Results: all patients presented characteristic signs of radiodermatitis, mainly the clinical signs of epilation (in men), hyperpigmentation and dry scaling, which affect body aesthetics. Conclusion: the body aesthetics of the followed patients was altered as a result of the clinical signs of radiodermatitis. It is important to evaluate these changes in patients with head and neck cancer undergoing radiotherapy.


Objetivo: describir impacto de la radiodermatitis en la estética corporal en pacientes con cáncer de cabeza y cuello sometidos a radioterapia. Método: estudio exploratorio descriptivo, del tipo serie de casos, realizado en ambulatorio de radioterapia de un hospital de enseñanza. Incluidos diez pacientes con cáncer de cabeza y cuello que fueron sometidos a radioterapia entre 2015 y 2017. Recolecta de datos fue realizada con instrumento construido para ese fin y mediante registro fotográfico. Los datos fueron analizados de manera descriptiva, presentándose el cálculo de la frecuencia. Resultados: todos los pacientes presentaron síntomas característicos de radiodermatitis, principalmente síntomas clínicos de epilación (en los hombres), hiperpigmentación y descamación seca, que afectan la estética corporal. Conclusión: la estética corporal de los pacientes acompañados fue alterada en decurso de los síntomas clínicos de la radiodermatitis. Se destaca la importancia de evaluar esas alteraciones en pacientes con cáncer de cabeza y cuello sometidos a radioterapia.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Young Adult , Radiodermatitis/psychology , Body Image/psychology , Head and Neck Neoplasms/radiotherapy
6.
Article in English | WPRIM | ID: wpr-878416

ABSTRACT

Oral squamous cell carcinoma (OSCC) is the most frequent tumour in head and neck malignant. The current treatment is mainly based on surgery therapy, radiation therapy and chemical therapy. Meanwhile, there are many a defect in the treatment. For example, there are many defects in radiotherapy. Radioactive salivatitis is the most common. In addition, there are a series of changes such as dry mouth, oral mucositis, rampant dental caries, and radioactive osteomyelitis of jaw, which cause swallowing, chewing problems, and taste dysfunction. Currently, the research on radioactive salivatitis is progressing rapidly, but its mechanism is more complication. This paper review aims to summarize the research progress in this field.


Subject(s)
Carcinoma, Squamous Cell , Dental Caries , Head and Neck Neoplasms/radiotherapy , Humans , Mouth Neoplasms , Radiation Injuries , Salivary Glands , Xerostomia/etiology
7.
Rev. otorrinolaringol. cir. cabeza cuello ; 80(3): 367-375, set. 2020. tab
Article in Spanish | LILACS | ID: biblio-1144902

ABSTRACT

Resumen En adultos, una masa cervical detectada mediante examen físico o un estudio de imagen puede ser la única manifestación de un cáncer proveniente de cabeza y cuello. Un retraso en el diagnóstico repercute en el pronóstico de la enfermedad, por lo que debe haber un alto índice de sospecha. Las metástasis cervicales con primario desconocido (MCCPD) son tumores metastásicos en los que el estudio diagnóstico no logró identificar el sitio primario del cáncer, con una histología predominantemente de tipo escamosa. Según algunos estudios, el origen más frecuente resultó ser la orofaringe, incluyendo amígdala palatina y base de lengua. Factores de riesgo conocidos son edades avanzadas, consumo de tabaco y de alcohol. Actualmente, la infección por el virus del papiloma humano (VPH) está teniendo un rol cada vez más importante como factor de riesgo, formando parte de entre 20%-25% de los cánceres de cabeza y cuello. Al enfrentarse a un paciente con masa cervical es importante realizar una completa anamnesis y examen físico acucioso para detectar cualquier elemento sugerente de malignidad. Se debe complementar con nasofibroscopía para visualizar estructuras que no alcanzan a evaluarse en el examen habitual. También se puede orientar la búsqueda del primario desconocido en base a los patrones de drenaje linfático. Dentro del estudio complementario se puede comenzar con una tomografía computada (TC) y se puede considerar también el ultrasonido o un PET/TC. Si con esto aún no se logra definir el primario, continuar con una punción aspirativa con aguja fina (PAAF), luego biopsia core que consiste en tomar una muestra del centro de la lesión guiada por ecografía, si fuese necesario, incluyendo inmunohistoquímica para VPH; ambos estudios histológicos son preferibles en vez de una biopsia abierta debido al menor riesgo de diseminación y complicaciones. El siguiente paso incluye estudio endoscópico y biopsias bajo anestesia. El tratamiento de los pacientes con MCCPD, va a depender de factores relacionados con el estadio de la enfermedad: desde cirugía o radioterapia (RT) únicas, cirugía más RT, y en algunos casos quimioterapia. Se recomienda seguimiento clínico frecuente durante los primeros años y con imágenes dentro de los 6 primeros meses postratamiento.


Abstract In adults, a cervical mass detected by physical examination or an imaging study may be the only manifestation of cancer from the head and neck. A delay in the diagnosis affects the prognosis of the disease, so there must be a high index of suspicion. Cervical metastases from unknown primary tumor (CUP) are metastatic tumors in which the diagnostic study failed to identify the primary site of cancer, with predominantly squamous histology. According to some studies, the most frequent origin was the oropharynx, including palatine tonsil and tongue base. Known risk factors are advanced ages, tobacco and alcohol consumption. Currently, human papilloma virus (HPV) infection is playing an increasingly important role as a risk factor, being the cause of between 20-25% of cancers of the head and neck. When confronting a patient with cervical mass it is important to carry out a complete anamnesis and a thorough physical examination to detect any element suggestive of malignancy. Physical examination could be complemented with a flexible nasal endoscopic to evaluate structures that can not be evaluated in the habitual examination. The search for the unknown primary can also be oriented based on lymphatic drainage patterns. Within the complementary evaluations, one can start with a study of images such as computed tomography (CT) or magnetic resonance imaging (MRI) with contrast, and also could consider ultrasound or PET/CT. If the primary can not be defined yet, fine needle aspiration (FNAP) can be the next choice and then a core biopsy that consisting of taking a sample from the center of the ultrasound-guided lesion, if necessary, including immunohistochemistry for HPV; both histological studies are preferable to an open biopsy because of the lower risk of complications. The next step searching for the primary includes endoscopic study and biopsies under anesthesia. Regarding to the management of patients with CUP, it will depend on factors related to the stage of the disease: from surgery or radiotherapy (RT) only, surgery and RT, and in some cases chemotherapy. Frequent clinical follow-up is recommended during the first years and images within the first 6 months after treatment.


Subject(s)
Humans , Neoplasms, Unknown Primary/pathology , Carcinoma, Squamous Cell/secondary , Head and Neck Neoplasms/pathology , Neoplasms, Unknown Primary , Neoplasms, Unknown Primary/radiotherapy , Carcinoma, Squamous Cell/radiotherapy , Carcinoma, Squamous Cell/diagnostic imaging , Tomography, X-Ray Computed , Biopsy, Fine-Needle , Head and Neck Neoplasms/radiotherapy , Head and Neck Neoplasms/diagnostic imaging , Neck
8.
Vaccimonitor (La Habana, Print) ; 29(1)ene.-abr. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1094636

ABSTRACT

En Cuba, el cáncer es la segunda causa de muerte con 24.902 defunciones en el 2018; de ellas, 795 fueron por tumores de laringe y 826 por tumores de labio, cavidad bucal y faringe. El anticuerpo monoclonal nimotuzumab (CIMAher®) está registrado como tratamiento combinado con radioterapia o quimioterapia para el cáncer de células escamosas de cabeza y cuello estadios avanzados. Del mismo se conoce su efectividad y perfil de seguridad, no así el impacto económico que acarrearía la incorporación del mismo al Sistema Nacional de Salud (SNS) cubano; de forma tal de asignar y reajustar presupuestos en la esfera de medicamentos. Por tanto, se hizo necesario realizar un análisis de impacto presupuestario, con el objetivo de estimar el impacto financiero de la incorporación del nimotuzumab (CIMAher®) al paquete de beneficios del SNS cubano. Se tomaron los datos de prevalencia e incidencia de la enfermedad en los estadios III/IV. Se estableció un escenario actual con la terapia radio/quimioterapia secuencial y una tasa de penetración de 100%. El escenario futuro fue radio/quimioterapia secuencial + nimotuzumab (CIMAher®) con tasa anual de penetración 20, 40, 60, 80 y 100 por ciento. La perspectiva fue desde el SNS y un horizonte temporal de 5 años (2019-2023). El análisis de impacto presupuestal mostró que, desde perspectiva, horizonte y tasa de penetración establecidos, el SNS debe invertir aproximadamente de 10 a 65 millones de pesos cubanos (CUP); cifras menores al presupuesto destinado a salud pública(AU)


In Cuba, cancer is the second cause of death with 24,902 deaths in 2018; 795 were due to laryngeal tumors and 826 due to tumors of the lip, oral cavity and pharynx. The monoclonal antibody nimotuzumab (CIMAher®) is registered as a combined treatment with radiotherapy or chemotherapy for advanced squamous cell carcinoma of the head and neck. Its effectiveness and safety profile are known, but not their economic impact into the Cuban National Health System (NHS); in order to allocate and readjust budgets in the field of medicines. Therefore, it was necessary to perform a budget impact analysis in order to estimate the financial impact of the incorporation of nimotuzumab (CIMAher®) into the benefits package of the Cuban NHS. Data on prevalence and incidence of the disease in stages III / IV were taken into account. The current scenario was with the therapy radio/sequential chemotherapy and penetration rate of 100 percent. The future scenario was radio/sequential chemotherapy + nimotuzumab (CIMAher®) and annual penetration rate of 20, 40, 60, 80 and 100 percent. The perspective was from the NHS and a time horizon of five years (2019-2023). The budget impact analysis showed that from an established perspective, horizon and penetration rate, the NHS must invest 10-65 million Cuban pesos (CUP) approximately; lower values than the budget allocated to Public Health(AU)


Subject(s)
Reference Drugs , Analysis of the Budgetary Impact of Therapeutic Advances , Head and Neck Neoplasms/drug therapy , Head and Neck Neoplasms/radiotherapy , Head and Neck Neoplasms/epidemiology , Cuba
9.
Rev. Assoc. Med. Bras. (1992) ; 66(3): 380-384, Mar. 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1136199

ABSTRACT

SUMMARY INTRODUCTION Radiotherapy (RT) plays an important role in the treatment of patients with head and neck neoplasia, and is frequently used as postoperative adjuvant therapy. This study aimed to review the literature about timing factors that may influence the clinical outcomes of patients with advanced head and neck neoplasia treated with adjuvant RT. RESULTS Timing factors such as total treatment time, length of adjuvant RT, and the absence of interruptions during RT may influence the clinical outcome of these patients. CONCLUSIONS In the same way that certain tumor factors can affect the prognosis of patients with squamous cell carcinoma of the head and neck, some therapeutic timing factors are also prognostic factors and therefore, must be carefully orchestrated in order to avoid loss at therapeutic outcomes for these patients.


RESUMO INTRODUÇÃO A radioterapia (RT) tem importante papel no tratamento dos pacientes com neoplasia de cabeça e pescoço, sendo frequentemente utilizada como terapia adjuvante a fim de diminuir a probabilidade de recorrência local. O presente estudo tem o objetivo de realizar uma revisão da literatura para avaliar os fatores terapêuticos temporais que possam ter influência sobre os desfechos clínicos dos pacientes com neoplasia avançada de cabeça e pescoço tratados com RT adjuvante. RESULTADOS As variáveis terapêuticas, como o tempo total do tratamento, a duração da RT e a ausência de interrupções durante o tratamento radioterápico são capazes de impactar o resultado clínico dos pacientes. CONCLUSÕES Da mesma forma que determinados fatores tumorais podem afetar o prognóstico de pacientes com carcinoma de células escamosas de cabeça e pescoço, alguns fatores terapêuticos temporais também constituem fatores prognósticos e, portanto, devem ser rigorosamente orquestrados a fim de se evitarem prejuízos sobrepostos para esses pacientes.


Subject(s)
Humans , Squamous Cell Carcinoma of Head and Neck/radiotherapy , Head and Neck Neoplasms/radiotherapy , Time Factors , Survival Rate , Combined Modality Therapy , Radiotherapy, Adjuvant , Disease-Free Survival , Squamous Cell Carcinoma of Head and Neck/surgery , Head and Neck Neoplasms/surgery
10.
Rev. bras. cancerol ; 66(1)20200129.
Article in Portuguese | LILACS | ID: biblio-1095028

ABSTRACT

Introdução: A presença de um nutricionista no setor de radioterapia objetiva a recuperação e a manutenção do estado nutricional dos pacientes. Objetivo: Comparar os resultados do aconselhamento nutricional diário com o aconselhamento nutricional semanal em pacientes com câncer de cabeça, pescoço e esôfago em tratamento radioterápico. Método: Foram selecionados 29 pacientes para o estudo e separados aleatoriamente em dois grupos. O grupo intervenção recebeu aconselhamento nutricional diariamente. O grupo padrão recebeu aconselhamento nutricional semanalmente. De ambos os grupos, foram aferidos peso corporal, circunferência braquial ou de panturrilha, avaliação subjetiva global produzida pelo próprio paciente (ASG-PPP) e cálculo do recordatório alimentar diário. Resultados: A maioria dos participantes era do sexo masculino (80%), com média de idade de 62,7 ± 26 anos. A terapia nutricional oral foi necessária para 48% dos indivíduos e, ao final do tratamento, 60% estavam em uso de nutrição enteral. A perda de peso média no grupo intervenção foi de 1,89 ± 2,58 Kg comparada à perda média de peso no grupo padrão de 9,92 ± 6,68 Kg (p=0,017). Metade dos pacientes do grupo intervenção, que iniciaram o tratamento categorizados pela ASG-PPP em A, finalizou o tratamento nessa mesma categoria (41,7%). Mais de 40% dos pacientes do grupo intervenção alcançaram as necessidades calóricas durante cinco semanas do tratamento. Conclusão: Encontraram-se resultados significativos para menor perda de peso em pacientes com aconselhamento nutricional diário que podem futuramente ser precursores de diretrizes que orientem e direcionem profissionais a condutas específicas aos pacientes com esse perfil.


Introduction: The presence of a nutritionist in the radiotherapy sector intends to recover and maintain the nutritional status of the patients. Objective: To compare the results of daily nutritional counseling with weekly nutritional advising for patients with head, neck and esophagus cancer in radiotherapy treatment. Method: 29 patients were assigned to the study and randomly divided into two groups. The intervention group received nutritional advice daily. The standard group received weekly nutritional counseling. For both groups, body weight, calf or calf circumference, global subjective evaluation produced by the patient (ASG-PPP) and calculation of the daily dietary recall were measured. Results: The majority of the participants were male (80%), mean age 62.7 ± 26 years. Oral nutrition therapy was required treatment 60% were in use of enteral nutrition. The mean weight loss in the intervention group was 1.89 ± 2.58 kg compared to the mean weight loss in the standard group of 9.92 ± 6.68 kg (p <0.001). Half of the patients in the intervention group who began treatment categorized by ASG-PPP in A, finished treatment in the same category (41.7%). More than 40% of patients in the intervention group achieved caloric needs during five weeks of treatment. Conclusion: This study found significant results for lower weight loss in patients with daily nutritional counseling. These results may in the future be precursors of guidelines that steer and direct professionals to specific conducts to patients with this profile.


Introducción: La presencia de un nutricionista en el sector de radioterapia intenciona la recuperación y mantenimiento del estado nutricional de los pacientes. Objetivo: Comparar los resultados del asesoramiento nutricional diario con el asesoramiento nutricional semanal en pacientes con cáncer de cabeza, cuello y esófago en tratamiento radioterápico. Método: Fueron seleccionados 29 pacientes para el estudio y separados aleatoriamente en dos grupos. El grupo de intervención recibió asesoramiento nutricional diariamente. El grupo estándar recibió asesoramiento nutricional semanalmente. De ambos grupos se evaluaron peso corporal, circunferencia braquial o de pantorrilla, evaluación subjetiva global producida por el propio paciente (ASG-PPP) y cálculo del recordatorio alimentario diario. Resultados: La mayoría de los participantes eran del sexo masculino (80%), con una media de edad de 62,7 ± 26 años. La terapia nutricional oral fue necesaria para el 48% de los individuos y al final del tratamiento el 60% estaban en uso de nutrición enteral. La pérdida de peso media en el grupo de intervención fue de 1,89 ± 2,58 Kg comparada con la pérdida media de peso en el grupo estándar de 9,92 ± 6,68 Kg (p<0,001). La mitad de los pacientes del grupo intervención que iniciaron el tratamiento categorizados por la ASG-PPP en A, finalizaron el tratamiento en esa misma categoría (41,7%). Más del 60% de los pacientes del grupo de intervención alcanzaron las necesidades calóricas durante cinco semanas del tratamiento. Conclusión: Este estudio encontró resultados significativos para una menor pérdida de peso en pacientes con asesoramiento nutricional diario. Estos resultados pueden en el futuro ser precursores de pautas que orientan y dirigen profesionales a conductas específicas a los pacientes con este perfil.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Esophageal Neoplasms/radiotherapy , Nutritional Status , Head and Neck Neoplasms/radiotherapy , Body Weight , Esophageal Neoplasms/diet therapy , Counseling/methods , Head and Neck Neoplasms/diet therapy
11.
Clinics ; 75: e1615, 2020. tab, graf
Article in English | LILACS | ID: biblio-1133376

ABSTRACT

OBJECTIVE: This study aimed to evaluate the effect of the delay to initiate postoperative radiation therapy (RT) on locoregional control to head and neck squamous cell carcinoma patients. METHODS: Retrospective cohort study that included patients submitted to surgery followed by adjuvant RT (with/without chemotherapy). The time interval between surgery and RT was dichotomized by the receiver operating characteristics curve method at 92 days. Other possible sources of heterogeneity with potential impact on locoregional control were explored by regressive analysis. RESULTS: A total of 168 patients were evaluated. The median time for locoregional recurrence (LRR) was 29.7 months. The relapse-free survival rates were 66.4% and 75.4% for patients who initiated RT more than and within 92 postoperative days (p=0.377), respectively. Doses lower than 60Gy were associated with worse rates of locoregional control (HR=6.523; 95%CI:2.266-18.777, p=0.001). Patients whose total treatment time (TTT) was longer than 150 days had LRR rate of 41.8%; no patient with TTT inferior to 150 days had relapses (p=0.001). CONCLUSIONS: The interval between surgery and RT did not show influence on locoregional control rates. However, doses <60Gy and the total treatment time >150 days were associated with lower locoregional control rates.


Subject(s)
Humans , Head and Neck Neoplasms/surgery , Head and Neck Neoplasms/radiotherapy , Neoplasm Recurrence, Local , Postoperative Period , Survival Rate , Retrospective Studies
12.
Rev. cuba. pediatr ; 91(4): e789, oct.-dic. 2019. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1093731

ABSTRACT

Introducción: Los tumores malignos de cabeza y cuello incluyen varios subtipos histológicos y el pronóstico depende de su ubicación anatómica. Objetivo: Describir las características clínicas y el tratamiento de pacientes pediátricos con tumores malignos de cabeza y cuello. Métodos: Estudio descriptivo, longitudinal y retrospectivo realizado en el servicio de Oncopediatría del Instituto Nacional de Oncología y Radiobiología, desde el 1ro. de enero de 2005 al 31 de diciembre de 2017. Se registraron variables demográficas, clínicas y terapéuticas. Se identificaron los pacientes a partir de las bases de datos del registro hospitalario del citado instituto. Se seleccionaron todos los pacientes con tumores de cabeza y cuello que tuvieron diagnóstico histológico. Resultados: Se identificaron 73 pacientes, con ligero predominio del sexo femenino (60,3 por ciento), con una edad media de 12 años (rango entre 0 y 18 años). El tipo histológico más frecuente fue el carcinoma tiroideo (35,6 por ciento), seguido de los rabdomiosarcomas (27,3 por ciento). El tratamiento más utilizado fue la cirugía (38,3 por ciento) seguido de la combinación de cirugía más radioterapia y quimioterapia (22,0 por ciento). Conclusiones: El tumor maligno de cabeza y cuello más frecuente en pacientes pediátricos es el carcinoma tiroideo. El tratamiento de elección es la resección total, acompañado de radioterapia y quimioterapia, dependiendo del tipo histológico y la etapa clínica(AU)


Introduction: Malignant tumors of the head and neck include several histological subtypes and the prognosis depends on their anatomical location. Objective: To describe the clinical characteristics and treatment of patients diagnosed with malignant head and neck tumors. Methods: A descriptive, longitudinal and retrospective study was carried out from January 1, 2005 to December 31, 2017 at the Oncopediatrics service in the National Institute of Oncology and Radiobiology, according to demographic, clinical and therapeutic variables. Patients were identified from the databases of the hospital registry of the above mentioned institute. All patients with head and neck tumors that had a histological diagnosis were selected. Results: 73 patients were identified, with a slight predominance of females (60.3 percent), with a mean age of 12 years (range between 0 and 18 years). The most frequent histological type was thyroid carcinoma (35.6 percent), followed by rhabdomyosarcomas (27.3 percent). The most used treatment was surgery (38.3 percent) followed by the combination of surgery plus radiotherapy and chemotherapy (22 percent). Conclusions: Tumors of the head and neck are infrequent. The treatment of choice is total resection, accompanied by radiotherapy and chemotherapy, depending on the histological type and the clinical stage(AU)


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Head and Neck Neoplasms/surgery , Head and Neck Neoplasms/drug therapy , Epidemiology, Descriptive , Retrospective Studies , Longitudinal Studies , Head and Neck Neoplasms/radiotherapy
13.
Int. j. odontostomatol. (Print) ; 13(4): 428-432, dic. 2019. graf
Article in English | LILACS | ID: biblio-1056479

ABSTRACT

ABSTRACT: Radiotherapy applies ionizing radiation at predetermined doses for a limited period of time in order to destroy tumors. The oral cavity, which has a high rate of cell renewal, is affected by the side effects of radiotherapy including osteoradionecrosis (ORN). This condition occurs due to irradiated bone tissue that becomes devitalized and exposed in the oral cavity. Conservative therapies are recommended for ORN lesions that are not extensive or in an early stage. Surgical intervention is necessary for extensive areas affected by necrosis. This study reports a case of ORN in the left mandibular body which resulted in a pathological fracture. The treatment consisted of segmental mandibulectomy and the use of a reconstruction plate. Also, low-level laser therapy around bone exposure was performed. After surgery, the patient underwent 6 months of follow-up and was satisfied with the outcome. However, the patient died before control of ORN was achieved due to a heart attack.


RESUMEN: La radioterapia aplica radiación ionizante a dosis predeterminadas durante un período de tiempo limitado para destruir tumores. La cavidad oral, que tiene una alta tasa de renovación celular, se ve afectada por los efectos secundarios de la radioterapia, incluida la osteorradionecrosis (ORN). Esta condición se produce debido al tejido óseo irradiado que se desvitaliza y expone en la cavidad oral. Se recomiendan terapias conservadoras para las lesiones de ORN que no son extensas o en una etapa temprana. La intervención quirúrgica es necesaria para áreas extensas afectadas por necrosis. Este estudio reporta un caso de ORN en el cuerpo mandibular izquierdo que resultó en una fractura patológica. El tratamiento consistió en mandibulectomía segmentaria y el uso de una placa de reconstrucción. Además, se realizó una terapia con láser de bajo nivel alrededor de la exposición ósea. Después de la cirugía, el paciente se sometió a 6 meses de seguimiento y quedó satisfecho con el resultado. Sin embargo, el paciente falleció antes de que se lograra el control de ORN debido a un ataque cardíaco.


Subject(s)
Humans , Male , Adult , Osteoradionecrosis/diagnosis , Osteoradionecrosis/therapy , Mandibular Diseases/therapy , Mandibular Osteotomy/methods , Head and Neck Neoplasms/radiotherapy , Radiography, Dental/methods , Radiography, Panoramic , Mandible/surgery
14.
Rev. méd. Chile ; 147(7): 928-931, jul. 2019. graf
Article in Spanish | LILACS | ID: biblio-1058623

ABSTRACT

Lhermitte phenomenon is a neurological symptom described as a sensation of electric shock that radiates from the back towards the extremities, which appears when a patient flexes the neck. A transient myelopathy as a late complication of radiotherapy is associated with this symptom. It appears two to four months after treatment and disappears spontaneously. We report a 45 years old female with a neck malignant melanoma treated with surgery and adjuvant radiotherapy. She experienced the Lhermitte phenomenon that was triggered by heat. This phenomenon must be differentiated from the Uhthoff phenomenon.


Subject(s)
Humans , Male , Middle Aged , Pain/etiology , Skin Neoplasms/diagnosis , Radiotherapy, Adjuvant/adverse effects , Head and Neck Neoplasms/diagnosis , Hot Temperature/adverse effects , Melanoma/diagnosis , Skin Neoplasms/surgery , Skin Neoplasms/radiotherapy , Diagnosis, Differential , Head and Neck Neoplasms/surgery , Head and Neck Neoplasms/radiotherapy , Melanoma/surgery , Melanoma/radiotherapy
15.
Rev. otorrinolaringol. cir. cabeza cuello ; 79(2): 229-239, jun. 2019.
Article in Spanish | LILACS | ID: biblio-1014442

ABSTRACT

RESUMEN Los análogos del platino, como el cisplatino, y la radioterapia son usados de forma individual y en conjunto para el tratamiento de diversas neoplasias en población adulta y pediátrica. Sin embargo, el uso de estos tratamientos puede generar ototoxicidad, especialmente cuando son usados de forma combinada para neoplasias que comprometen cabeza y cuello, manifestándose principalmente como una hipoacusia progresiva e irreversible que compromete la calidad de vida. Diversos mecanismos han sido propuestos para explicar el daño en las estructuras auditivas generado por estos tratamientos, incluyendo la producción de especies reactivas del oxígeno y la inflamación, desencadenando muerte celular. Si bien distintas estrategias otoprotectoras han sido probadas en humanos, es aún incierta su efectividad y seguridad en combinación con los tratamientos oncológicos. El objetivo de la siguiente revisión es proporcionar una visión general y actualizada de la ototoxicidad inducida por quimio-radioterapia basada en platinos, discutiendo sus bases, características clínicas, potenciales tratamientos y estrategias preventivas que se han desarrollado en los últimos años.


ABSTRACT Platinum analogues, such as cisplatin, and radiotherapy are used separately or in combination to treat several neoplasms in pediatric and adult populations. Nonetheless, the use of these treatments may lead to ototoxicity, especially when these treatments are concomitantly used to treat head and neck cancers, which can manifest as progressive and irreversible hearing loss that decreases quality of life. Several mechanisms have been proposed in order to explain the damage to the auditory structures induced by these treatment modalities, including: reactive oxygen species production and inflammation, leading to cell death. Although several otoprotective strategies have been attempted in humans, their effectiveness and security are unclear. The objective of this review is to provide an updated and general overview on platinum-based chemoradio-therapy induced ototoxicity, discussing its basis, clinical features, potential treatments and preventive strategies developed in recent years.


Subject(s)
Humans , Cisplatin/adverse effects , Chemoradiotherapy/adverse effects , Ototoxicity/etiology , Ototoxicity/prevention & control , Head and Neck Neoplasms/drug therapy , Head and Neck Neoplasms/radiotherapy , Hearing Loss, Sensorineural/etiology
16.
Rev. pesqui. cuid. fundam. (Online) ; 11(3): 785-791, abr.-maio 2019.
Article in English, Portuguese | LILACS, BDENF | ID: biblio-987479

ABSTRACT

Objective: The study's purpose has been to summarize the knowledge about primary studies that investigated radiotherapy experiences from the perspective of head and neck cancer patients. Methods: It is an integrative literature review. Results: The final sample consisted of 13 studies that were published from 1998 to 2015. Through the studies thematic analysis were identified four major themes, as follows: "physical consequences of radiotherapy", "psychological and emotional repercussions of radiotherapy", "lack of information about the treatment and posture of the health professional regarding the treatment adverse effects" and "support networks". Conclusion: The studies showed that the radiotherapy treatment had important negative repercussions in the patients' life regarding the reactions and readjustments, and also the roles played family wise, all due to the treatment. There was also an important knowledge gap on the subject, then demonstrating the need for new studies with a qualitative approach, aiming to better understand this experience, therefore, producing care improvement


Objetivo: Sintetizar o conhecimento de estudos primários que investigaram a experiência da radioterapia, na perspectiva do paciente com câncer de cabeça e pescoço. Método: Revisão integrativa da literatura. Resultados: Amostra final composta por 13 estudos publicados entre 1998 a 2015. Pela análise temática dos estudos foram identificados quatro temas maiores: "repercussões físicas da radioterapia", "repercussões psicológicas e emocionais da radioterapia", "falta de informação sobre o tratamento e a postura do profissional de saúde perante os efeitos adversos do tratamento" e "redes de apoio". Conclusão: Os estudos evidenciaram que o tratamento radioterápico trouxe repercussões negativas importantes na vida dos pacientes frente às reações e rearranjos na vida e nos papéis desempenhados dentro da família, decorrentes do tratamento. Verificou-se também uma lacuna importante de conhecimento sobre a temática, demonstrando a necessidade de novos estudos, com abordagem qualitativa, para melhor compreensão desta experiência, refletindo em aprimoramento da assistência


Objetivo: Sintetizar el conocimiento de estudios primarios que investigaron la experiencia de la radioterapia, en la perspectiva del paciente con cáncer de cabeza y cuello. Método: Revisión integrativa de la literatura. Resultados: La muestra final consistió en 13 estudios publicados entre 1998 y 2015. En el análisis temático de los estudios se identificaron cuatro temas más grandes: "repercusiones físicas de la radioterapia", "repercusiones psicológicas y emocionales de la radioterapia", "falta de información sobre el tratamiento y la la postura del profesional de la salud ante los efectos adversos del tratamiento y las redes de apoyo. Conclusión: Los estudios evidenciaron que el tratamiento radioterápico trajo repercusiones negativas importantes en la vida de los pacientes frente a las reacciones y reajustes en la vida y en los papeles desempeñados dentro de la familia, derivados del tratamiento. Se verificó también una laguna importante de conocimiento sobre la temática, demostrando la necesidad de nuevos estudios, con abordaje cualitativo, para una mejor comprensión de esta experiencia, reflejando en el perfeccionamiento de la asistencia


Subject(s)
Humans , Male , Female , Head and Neck Neoplasms/nursing , Head and Neck Neoplasms/psychology , Head and Neck Neoplasms/radiotherapy , Radiotherapy/adverse effects , Radiotherapy/nursing
17.
Rev. cuba. estomatol ; 56(1): e1495, ene.-mar. 2019. graf
Article in Portuguese | LILACS | ID: biblio-1003872

ABSTRACT

Introdução: Pacientes submetidos à radioterapia para tratamento de neoplasias malignas na região de cabeça e pescoço são propensos a desenvolver complicações orais como a cárie de radiação, que evolui rapidamente e é altamente destrutiva.É reconhecido que o seu desenvolvimento está associado a alterações pós-radioterápicas nas glândulas salivares maiores, o que resulta em hipossalivação e alteração nos constituintes salivares. No entanto, tem sido aceito que danos diretos causados pela radiação à estrutura dentária podem acelerar a progressão da cárie e estudos têm demonstrado alterações morfológicas e físicas em dentes humanos após radioterapia. Objetivo: Propõe-se apresentar um caso de cárie de radiação e os efeitos diretos da radioterapia na estrutura dentária. Relato de caso: Paciente masculino, 60 anos de idade, com queixa principal de fragilidade dentária; relatou história de carcinoma epidermóide em língua há 18 meses e que o protocolo de tratamento aplicado foi quimioterapia (38 sessões), radioterapia (38 sessões) e cirurgia. Ao exame físico, dentre as alterações observadas, destacou-se a presença de regiões cervicais dentárias enegrecidas com coroas bastante fragilizadas em todos os dentes remanescentes, características de cárie de radiação. Foi realizado um tratamento atraumático, que está em acompanhamento. Conclusões: A cárie de radiação tem como principal fator etiológico alterações salivares qualitativas e quantitativas. A discussão sobre os efeitos diretos da radioterapia sobre a estrutura dentária ainda é bastante polêmica na literatura odontológica. Desta forma, sugere-se que mais estudos sejam realizados de forma sistemática, de maneira mais completa e padronizada(AU)


Introducción: Los pacientes sometidos a radioterapia para el tratamiento de tumores malignos en la cabeza y el cuello son propensos a desarrollar complicaciones bucales, tales como caries de radiación que evoluciona rápidamente y es altamente destructiva. Se reconoce que el desarrollo se asocia con cambios posradioterapia en las glándulas salivales, que resulta en hiposalivación y el cambio en los componentes salivales. Sin embargo, se ha aceptado que los daños por radiación directa a la estructura dental puede acelerar la progresión de la caries y los estudios han demostrado cambios morfológicos y físicos en los dientes humanos después de la radioterapia. Objetivo: presentar un caso de caries de radiación y los efectos directos de la radiación en la estructura dental. Presentación del caso: Paciente masculino de 60 años de edad, se quejaba de fragilidad dental, con historia notificada de carcinoma de células escamosas en la lengua hace 18 meses y con protocolo de tratamiento aplicado de quimioterapia (38 sesiones), terapia de radiación (38 sesiones) y cirugía. En el examen físico, de los cambios observados, se destacó la presencia de regiones cervicales dentarias negruzcas con coronas bastante frágiles en todos los dientes restantes, características de caries de radiación. El tratamiento atraumático se realizó y el paciente está bajo observación. Conclusiones: los cambios cuantitativos y cualitativos salivales actúa como el factor causal principal de la caries por radiación. La discusión acerca de los efectos directos de la radiación sobre la estructura del diente es todavía muy controvertido en la literatura dental. Por lo tanto, se sugiere que se realicen estudios adicionales de manera sistemática, más completa y estandarizada(AU)


Introduction: Patients undergoing radiotherapy as treatment for malignant head and neck tumors are prone to develop oral complications such as radiation caries, which evolves rapidly and is highly destructive. Such development is known to be caused by post-radiotherapy alterations in salivary glands resulting in hyposalivation and changes in salivary components. However, it has been accepted that damage by direct radiation to the dental structure may hasten the progress of caries development, and studies have shown the morphological and physical changes occurring in human teeth after radiotherapy. Objective: Present a case of radiation caries and the direct effects of radiation on dental structure. Case presentation: A 60-year-old male patient complains of dental fragility. The patient was diagnosed with squamous-cell carcinoma of the tongue 18 months ago and indicated chemotherapy (38 sessions), radiotherapy (38 sessions) and surgery. Physical examination revealed among other changes the presence of blackish cervical areas with quite fragile crowns in all remaining teeth, which are characteristic of radiation caries. Non-traumatic treatment was performed and the patient is now under observation. Conclusions: Salivary quantitative and qualitative changes are the main cause of radiation caries. Discussion about the direct effects of radiation on dental structure is still quite controversial in the literature on the topic. It is therefore suggested to conduct further studies in a more systematic, complete and standardized manner(AU)


Subject(s)
Humans , Male , Middle Aged , Dental Caries Susceptibility/radiation effects , Mouth Diseases/complications , Tongue Neoplasms/drug therapy , Head and Neck Neoplasms/radiotherapy
18.
CoDAS ; 31(4): e20180176, 2019. tab, graf
Article in Portuguese | LILACS | ID: biblio-1019721

ABSTRACT

RESUMO Objetivo Analisar os efeitos da eletroestimulação sobre o fluxo salivar de pacientes com hipossalivação induzida por radioterapia em região de cabeça e pescoço. Estratégia de pesquisa Utilizaram-se as bases de dados Medline (via Pubmed), Cochrane Library, Scopus e Lilacs. Critérios de seleção Foram selecionados os ensaios clínicos que avaliaram objetivamente o fluxo salivar, publicados nos últimos 10 anos em português, inglês ou espanhol. Análise dos dados Para avaliação metodológica dos estudos, foi utilizada a escala PEDro. Resultados A estratégia de busca resultou em 21 publicações, sendo que 17 foram excluídas, selecionando-se assim 4 artigos. Os estudos incluídos contaram com um total de 212 participantes, sendo que todos demonstraram aumento do fluxo salivar, tanto por meio do método de eletroacupuntura quanto pela estimulação aplicada diretamente sobre as glândulas salivares. A pontuação obtida por meio da escala PEDro foi baixa, evidenciando qualidade metodológica baixa e com consideráveis riscos de viés. Conclusão os estudos incluídos demonstram o potencial clínico da TENS no aumento do fluxo salivar de pacientes com câncer de cabeça e pescoço tratados com RT.


ABSTRACT Purpose To analyze the effects of electrical stimulation on the salivary flow of head and neck cancer patients with radiotherapy-induced hyposalivation. Research strategies Searches were made in the Medline (via Pubmed), Cochrane Library, Scopus and Lilacs databases. Selection criteria Selection included clinical trials that evaluated salivary flow objectively, published in the last 10 years in either Portuguese, English or Spanish. Data analysis The PEDro scale was used for the methodological evaluation of the studies. Results The search strategy resulted in 21 publications, 17 of which were excluded, hence there were 4 articles left. The included studies had a total of 212 participants, all of whom had an increase in salivary flow, both through the electroacupuncture method and direct application on the salivary glands. The score obtained through the PEDRo scale was low, evidencing questionable methodological quality and risk of bias. Conclusion The included studies demonstrate the clinical potential of TENS to increase the salivary flow of head and neck cancer patients treated with RT.


Subject(s)
Humans , Radiotherapy/adverse effects , Xerostomia/therapy , Electric Stimulation , Xerostomia/etiology , Clinical Trials as Topic , Head and Neck Neoplasms/radiotherapy
19.
Int. arch. otorhinolaryngol. (Impr.) ; 23(2): 172-177, 2019. ilus, tab
Article in English | LILACS | ID: biblio-1015180

ABSTRACT

Introduction: Acute carotid blowout syndrome (aCBS) is a severe complication of head and neck cancer (HNC). It can be defined as a rupture of the extracranial carotid arteries, or one of their branches, that causes life-threatening hemorrhage, and which nowadays can be treated with urgent endovascular intervention. Objective: We retrospectively evaluate the endovascular management of aCBS and its outcome in years of survival. Methods: Retrospectively, we describe our experience with endovascular control of aCBS in patients treated for HNC. We review the characteristics, pathology, endovascular treatment and morbidity and assess the gain in life years. Results: Nine individuals were included in this study. Four patients had been previously diagnosed with laryngeal squamous cell carcinoma (SCC), one with paranasal SCC, one with nasopharyngeal carcinoma and three with oral or maxillary adenocarcinoma. All subjects underwent radiotherapy and surgical excision to different extents. Twelve endovascular procedures were performed for injuries to the internal carotid artery (n = 3; 25%), external carotid artery (n = 1; 7%) or one of their branches (n = 8; 67%). Deconstructive methods were used in nine procedures, and three procedures were mainly reconstructive with deployment of covered stents. Total control of bleeding was achieved in all individuals with no intraprocedural complications. Conclusion: Endovascular therapy is an effective alternative for the management of exsanguinating CBS. In our series, this palliative therapy increased the overall patient survival by an estimated 9 months (AU)


Subject(s)
Middle Aged , Aged , Carotid Artery Injuries/surgery , Endovascular Procedures , Angiography , Reconstructive Surgical Procedures , Carotid Artery Injuries/etiology , Balloon Occlusion , Head and Neck Neoplasms/complications , Head and Neck Neoplasms/pathology , Head and Neck Neoplasms/radiotherapy
20.
Braz. j. otorhinolaryngol. (Impr.) ; 84(3): 344-350, May-June 2018. tab
Article in English | LILACS | ID: biblio-951827

ABSTRACT

Abstract Introduction: Internal lymphedema is one of the sequelae of head and neck cancer treatment that can lead to varying degrees of swallowing, speech, and respiration alterations. The Radiotherapy Edema Rating Scale, developed by Patterson et al., is a tool used to evaluate pharyngeal and laryngeal edema. Objective: To translate into Brazilian Portuguese, to culturally adapt and test this scale in patients undergoing treatment for head and neck cancer. Methods: The process followed the international guidelines and translation steps by two head and neck surgeons and back-translation performed independently by two North-American natives. The final version of the test was evaluated based on the assessment of 18 patients by two head and neck surgeons and two speech therapists using the scales in Brazilian Portuguese. Results: The translation and cultural adaptation were satisfactorily performed by the members of the committee in charge. Conclusion: The translation and adaptation into Brazilian Portuguese of the Radiotherapy Edema Rating Scale was successfully performed and showed to be easy to apply.


Resumo Introdução: O linfedema interno é uma das sequelas do tratamento para o câncer de cabeça e pescoço, pode levar a alterações de grau variado na deglutição, voz e respiração. A Escala do Edema da Radioterapia (Radiotherapy Edema Rating Scale), elaborada por Patterson et al., é uma ferramenta de avaliação do edema de faringe e laringe. Objetivo: Traduzir, para o português brasileiro, adaptar culturalmente e testar essa escala em pacientes submetidos ao tratamento para o câncer de cabeça e pescoço. Método: O processo seguiu as diretrizes internacionais e as etapas de tradução por dois cirurgiões de cabeça e pescoço e a retrotradução de forma independente por dois nativos norte-americanos. O teste da versão final para avaliação foi realizado a partir da avaliação de 18 pacientes por dois médicos cirurgiões de cabeça e pescoço e duas fonoaudiólogas por meio da aplicação das escalas em português. Resultados: A tradução e a adaptação cultural foram executadas satisfatoriamente pelos membros do comitê responsável. Conclusão: A tradução e adaptação da Escala do Edema da Radioterapia para o português foi bem-sucedida e de fácil aplicação.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Surveys and Questionnaires , Head and Neck Neoplasms/radiotherapy , Lymphedema/etiology , Radiotherapy/adverse effects , Translations , Brazil , Reproducibility of Results , Cultural Characteristics , Neck , Neoplasm Staging
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