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Factors related with development of treatment induced trismus in nasopharyngeal cancer patients

Year 2006, Volume: 21 Issue: 2, 57 - 62, 01.03.2006

Abstract

OBJECTIVES Our objective is to analyse the rate of trismus induced after treatment for nonmetastatic nasopharyngeal cancer patients and to assess the factors on development of it. METHODS The files of 292 patients with more than two years follow-up between November 1993-2001 were investigated retrospect ively. The patient related factors (gender, age), tumor related factors (stage, histopathological diagnosis, trismus at the time of diagnosis, cranial nerve involvement), tretment related factors (radiotherapy with or without concomittan chemotherapy, applying brachitherapy or not, total treatment time and radiotherapy dose, applying reirradiation or not) were registered and effect of these factors to formation of trismus was investigated. RESULTS The rate of trismus was found to be 8%. Two and five-year overall survival rates were 83% and 67.6%. Among investigated factors only two were found related with formation of radiation induced trismus: presence of trismus at the time of diagnosis (p=0.03) and treatment with reirradiation for recurrence (p=0.002). CONCLUSION In this study radiation induced trismus rate for nasopharyngeal cancer was similar to findings in literature. Trismus at the time of diagnosis and reirradiation are factors effecting the rate of observing this complication.

References

  • 1. Vissink A, Burlage FR, Spijkervet FK, Jansma J, Coppes RP. Prevention and treatment of the consequences of head and neck radiotherapy. Crit Rev Oral Biol Med 2003;14(3):213-25.
  • 2. Goldstein M, Maxymiw WG, Cummings BJ, Wood RE. The effects of antitumor irradiation on mandibular opening and mobility: a prospective study of 58 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88(3):365-73.
  • 3. CPT Jerry, K. Weldon, Jr. Nonsurgical cancer therapies: dental complications and patient management. Journal U.S. Army Medical Department March-April 1997. PB 8-97-3/4.
  • 4. Ozyar E, Cengiz M, Gurkaynak M, Atahan IL. Trismus as a presenting symptom in nasopharyngeal carcinoma. Radiother Oncol 2005;77(1):73-6.
  • 5. Zubizarreta PA, D'Antonio G, Raslawski E, Gallo G, Preciado MV, Casak SJ, et al. Nasopharyngeal carcinoma in childhood and adolescence: a single-institution experience with combined therapy. Cancer 2000;89(3):690-5.
  • 6. Huguenin PU, Taussky D, Moe K, Meister A, Baumert B, Lutolf UM, et al. Quality of life in patients cured from a carcinoma of the head and neck by radiotherapy: the importance of the target volume. Int J Radiat Oncol Biol Phys 1999;45(1):47-52.
  • 7. Wang CJ, Huang EY, Hsu HC, Chen HC, Fang FM, Hsiung CY. The degree and time-course assessment of radiation-induced trismus occurring after radiotherapy for nasopharyngeal cancer. Laryngoscope 2005;115(8):1458-60.
  • 8. Fang FM, Chiu HC, Kuo WR, Wang CJ, Leung SW, Chen HC, et al. Health-related quality of life for nasopharyngeal carcinoma patients with cancer-free survival after treatment. Int J Radiat Oncol Biol Phys 2002;53(4):959-68.
  • 9. Pow EH, McMillan AS, Leung WK, Kwong DL, Wong MC. Oral health condition in southern Chinese after radiotherapy for nasopharyngeal carcinoma: extent and nature of the problem. Oral Dis 2003;9(4):196-202.
  • 10. Schwarz E., Chiu GK, Leung WK. Oral health status of southern Chinese foloowing head and neck irradiation therapy: the impact of the target volume. Int J Radiat Oncol Biol Phys 1999;45(1):47-52.
  • 11. Hoppe RT, Goffinet DR, Bagshaw MA. Carcinoma of the nasopharynx. Eighteen years’ experience with megavoltage radiation therapy. Cancer 1976;37(6):2605-12.
  • 12. Lee AW, Law SC, Ng SH, Chan DK, Poon YF, Foo W, et al. Retrospective analysis of nasopharyngeal carcinoma treated during 1976-1985: late complications following megavoltage irradiation. Br J Radiol 1992;65(778):918-28.
  • 13.Choi KN, Rotman M, Aziz H, Sohn CK, Schulsinger A, Torres C, et al. Concomitant infusion cisplatin and hyperfractionated radiotherapy for locally advanced nasopharyngeal and paranasal sinus tumors. Int J Radiat Oncol Biol Phys 1997;39(4):823-9.
  • 14. Wu DH, Chen LH. Therapeutic effects of threedimensional conformal radiation therapy for locally recurrent nasopharyngeal carcinoma. [Article in Chinese] Di Yi Jun Yi Da Xue Xue Bao 2002;22(11):1028-9. [Abstract]
  • 15. Yeh SA, Tang Y, Lui CC, Huang YJ, Huang EY. Treatment outcomes and late complications of 849 patients with nasopharyngeal carcinoma treated with radiotherapy alone. Int J Radiat Oncol Biol Phys 2005;62(3):672-9.
  • 16. Teo PM, Leung SF, Chan AT, Leung TW, Choi PH, Kwan WH, et al. Final report of a randomized trial on altered-fractionated radiotherapy in nasopharyngeal carcinoma prematurely terminated by significant increase in neurologic complications. Int J Radiat Oncol Biol Phys 2000;48(5):1311-22.

Nazofarenks kanserli hastalarda geç yan etki olarak ortaya çıkan trismus gelişimine etkili faktörler

Year 2006, Volume: 21 Issue: 2, 57 - 62, 01.03.2006

Abstract

AMAÇ Çalışmada nazofarenks karsinomlu (NFK) hastalarda radyoterapi (RT) sonrası geç yan etki olarak ortaya çıkan trismus oranı araştırılarak gelişiminde etkili olabilecek faktörler ele alındı. GEREÇ VE YÖNTEM Aralık 1993-2003 tarihleri arasında NFK tanısıyla küratif olarak tedavi edilen 292 hasta çalışmaya alındı. Hastalara ait özellikler (cinsiyet, yaş), tümörlerine ait özellikler (evre, histopatolojik tanı, tanı anında trismus varlığı, kraniyal sinir tutulumu), tedaviye ait özellikler (radyoterapinin konkomittan olup olmaması, brakiterapi uygulanıp uygulanmaması, tedavi süresi ve dozu, ikinci seri ışınlama uygulanıp uygulanmaması) kaydedildi ve bu faktörlerin trismus gelişimine etkisi araştırıldı. BULGULAR İki ve beş yıllık genel sağkalım sırası ile %83 ve %67.6 olarak bulundu. Hastalarda takipte trismus görülme oranı %8 olarak saptandı. İncelenen faktörlerden sadece tanı anında trismus olması (p=0.03) ve hastalara birden fazla radyoterapi uygulanması (p=0.002) trismus gelişimini artırmaktadır. SONUÇ Bu çalışmada NFK tanılı hastalarda tedavi sonu trismus görülme oranı literatürle uyumlu bulundu. Hastalarda tanı anında trismus varlığı ve ikinci seri ışınlama uygulanması bu komplikasyonun görülme olasılığını artırmaktadır.

References

  • 1. Vissink A, Burlage FR, Spijkervet FK, Jansma J, Coppes RP. Prevention and treatment of the consequences of head and neck radiotherapy. Crit Rev Oral Biol Med 2003;14(3):213-25.
  • 2. Goldstein M, Maxymiw WG, Cummings BJ, Wood RE. The effects of antitumor irradiation on mandibular opening and mobility: a prospective study of 58 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;88(3):365-73.
  • 3. CPT Jerry, K. Weldon, Jr. Nonsurgical cancer therapies: dental complications and patient management. Journal U.S. Army Medical Department March-April 1997. PB 8-97-3/4.
  • 4. Ozyar E, Cengiz M, Gurkaynak M, Atahan IL. Trismus as a presenting symptom in nasopharyngeal carcinoma. Radiother Oncol 2005;77(1):73-6.
  • 5. Zubizarreta PA, D'Antonio G, Raslawski E, Gallo G, Preciado MV, Casak SJ, et al. Nasopharyngeal carcinoma in childhood and adolescence: a single-institution experience with combined therapy. Cancer 2000;89(3):690-5.
  • 6. Huguenin PU, Taussky D, Moe K, Meister A, Baumert B, Lutolf UM, et al. Quality of life in patients cured from a carcinoma of the head and neck by radiotherapy: the importance of the target volume. Int J Radiat Oncol Biol Phys 1999;45(1):47-52.
  • 7. Wang CJ, Huang EY, Hsu HC, Chen HC, Fang FM, Hsiung CY. The degree and time-course assessment of radiation-induced trismus occurring after radiotherapy for nasopharyngeal cancer. Laryngoscope 2005;115(8):1458-60.
  • 8. Fang FM, Chiu HC, Kuo WR, Wang CJ, Leung SW, Chen HC, et al. Health-related quality of life for nasopharyngeal carcinoma patients with cancer-free survival after treatment. Int J Radiat Oncol Biol Phys 2002;53(4):959-68.
  • 9. Pow EH, McMillan AS, Leung WK, Kwong DL, Wong MC. Oral health condition in southern Chinese after radiotherapy for nasopharyngeal carcinoma: extent and nature of the problem. Oral Dis 2003;9(4):196-202.
  • 10. Schwarz E., Chiu GK, Leung WK. Oral health status of southern Chinese foloowing head and neck irradiation therapy: the impact of the target volume. Int J Radiat Oncol Biol Phys 1999;45(1):47-52.
  • 11. Hoppe RT, Goffinet DR, Bagshaw MA. Carcinoma of the nasopharynx. Eighteen years’ experience with megavoltage radiation therapy. Cancer 1976;37(6):2605-12.
  • 12. Lee AW, Law SC, Ng SH, Chan DK, Poon YF, Foo W, et al. Retrospective analysis of nasopharyngeal carcinoma treated during 1976-1985: late complications following megavoltage irradiation. Br J Radiol 1992;65(778):918-28.
  • 13.Choi KN, Rotman M, Aziz H, Sohn CK, Schulsinger A, Torres C, et al. Concomitant infusion cisplatin and hyperfractionated radiotherapy for locally advanced nasopharyngeal and paranasal sinus tumors. Int J Radiat Oncol Biol Phys 1997;39(4):823-9.
  • 14. Wu DH, Chen LH. Therapeutic effects of threedimensional conformal radiation therapy for locally recurrent nasopharyngeal carcinoma. [Article in Chinese] Di Yi Jun Yi Da Xue Xue Bao 2002;22(11):1028-9. [Abstract]
  • 15. Yeh SA, Tang Y, Lui CC, Huang YJ, Huang EY. Treatment outcomes and late complications of 849 patients with nasopharyngeal carcinoma treated with radiotherapy alone. Int J Radiat Oncol Biol Phys 2005;62(3):672-9.
  • 16. Teo PM, Leung SF, Chan AT, Leung TW, Choi PH, Kwan WH, et al. Final report of a randomized trial on altered-fractionated radiotherapy in nasopharyngeal carcinoma prematurely terminated by significant increase in neurologic complications. Int J Radiat Oncol Biol Phys 2000;48(5):1311-22.
There are 16 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Enis Özyar This is me

Ebru Karakaya This is me

Ferah Yıldız This is me

İ. Lale Atahan This is me

Publication Date March 1, 2006
Published in Issue Year 2006 Volume: 21 Issue: 2

Cite

APA Özyar, E., Karakaya, E., Yıldız, F., Atahan, İ. L. (2006). Nazofarenks kanserli hastalarda geç yan etki olarak ortaya çıkan trismus gelişimine etkili faktörler. Türk Onkoloji Dergisi, 21(2), 57-62.
AMA Özyar E, Karakaya E, Yıldız F, Atahan İL. Nazofarenks kanserli hastalarda geç yan etki olarak ortaya çıkan trismus gelişimine etkili faktörler. Türk Onkoloji Dergisi. March 2006;21(2):57-62.
Chicago Özyar, Enis, Ebru Karakaya, Ferah Yıldız, and İ. Lale Atahan. “Nazofarenks Kanserli Hastalarda Geç Yan Etki Olarak Ortaya çıkan Trismus gelişimine Etkili faktörler”. Türk Onkoloji Dergisi 21, no. 2 (March 2006): 57-62.
EndNote Özyar E, Karakaya E, Yıldız F, Atahan İL (March 1, 2006) Nazofarenks kanserli hastalarda geç yan etki olarak ortaya çıkan trismus gelişimine etkili faktörler. Türk Onkoloji Dergisi 21 2 57–62.
IEEE E. Özyar, E. Karakaya, F. Yıldız, and İ. L. Atahan, “Nazofarenks kanserli hastalarda geç yan etki olarak ortaya çıkan trismus gelişimine etkili faktörler”, Türk Onkoloji Dergisi, vol. 21, no. 2, pp. 57–62, 2006.
ISNAD Özyar, Enis et al. “Nazofarenks Kanserli Hastalarda Geç Yan Etki Olarak Ortaya çıkan Trismus gelişimine Etkili faktörler”. Türk Onkoloji Dergisi 21/2 (March 2006), 57-62.
JAMA Özyar E, Karakaya E, Yıldız F, Atahan İL. Nazofarenks kanserli hastalarda geç yan etki olarak ortaya çıkan trismus gelişimine etkili faktörler. Türk Onkoloji Dergisi. 2006;21:57–62.
MLA Özyar, Enis et al. “Nazofarenks Kanserli Hastalarda Geç Yan Etki Olarak Ortaya çıkan Trismus gelişimine Etkili faktörler”. Türk Onkoloji Dergisi, vol. 21, no. 2, 2006, pp. 57-62.
Vancouver Özyar E, Karakaya E, Yıldız F, Atahan İL. Nazofarenks kanserli hastalarda geç yan etki olarak ortaya çıkan trismus gelişimine etkili faktörler. Türk Onkoloji Dergisi. 2006;21(2):57-62.