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

doi:10.1002/lio2.711

Dysphagia, hypothyroidism, and osteoradionecrosis after radiation therapy for head and neck cancer

Laryngoscope Investig Otolaryngol. 2021 Dec 10;7(1):108-116. doi: 10.1002/lio2.711. eCollection 2022 Feb.

Authors

Pihla Ranta¹, Eero Kytö¹, Linda Nissi², Ilpo Kinnunen¹, Tero Vahlberg³, Heikki Minn², Eeva Haapio¹, Lassi Nelimarkka⁴, Heikki Irjala¹

Affiliations

¹ Department of Otorhinolaryngology - Head and Neck Surgery Turku University and Turku University Hospital Turku Finland.
² Department of Oncology and Radiotherapy Turku University and Turku University Hospital Turku Finland.
³ Department of Clinical Medicine, Biostatistics Turku University and Turku University Hospital Turku Finland.
⁴ Department of Endocrinology, Division of Medicine Turku University and Turku University Hospital Turku Finland.

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.

Keywords: dysphagia/swallowing; neoplasia/malignancy; radiation therapy.