Over 500,000 new cases of head and neck cancer are diagnosed globally each year. The incidence has continued to rise in the United States, Canada, Western Europe, and Scandinavia since the 1980s . More than 90% of head and neck cancer is squamous cell carcinoma , which is amenable to a combination of surgery, intensity-modulated radiation therapy (IMRT), and/or chemotherapy.
Mucosal cells experience high mitotic activity and are susceptible to the harmful effects of radiotherapy. Radiation exposure to the oral cavity and pharyngeal mucosa can...
Description of activity and work performed
Both the World Health Organization (WHO) and Radiation Therapy Oncology Group (RTOG) have classified RIOM into a set of four major clinical stages [Table 1] [3,4,5]. The RTOG grading symptom is utilized more in the clinical setting .
Macroscopic signs of RIOM [Fig. 2] appear on non-keratinized surfaces (e.g. tongue, buccal mucosa, soft palate), initially as erythema, and can progress to desquamation approximately one month after the beginning of radiotherapy. Corresponding radiographic findings would show mucosal edema and swelling of the epiglottis. Patients may report...
Conclusion and recommendations
RIOM has pleomorphic features and can be a debilitating, chronic condition. Post-RT healing is contingent on a variety of patient-dependent factors. Risk factors, including age, concurrent chemotherapy with radiation, prior periodontal disease, and/or diabetes impairs wound healing and increases the risk and severity of RIOM. This process may occur weeks, even years, after radiation treatment. Because there is no gold standard for surveillance and frequency of post-radiotherapy follow-up, the radiologist can serve a valuable role in the multidisciplinary care for a head & neck cancer...
R. T. Le; Jacksonville/US - nothing to disclose D. Rao; Jacksonville/US - nothing to disclose F. Behzadi; Vancouver/CA - nothing to disclose P. Fiester; Jacksonville/US - nothing to disclose
World Health Organization. Locally Advanced Squamous Carcinoma of the Head and Neck. https://www.who.int/selection_medicines/committees/expert/20/applications/HeadNeck.pdf. Published 2014. Accessed December 5, 2019.
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Mukherji SK, Mancusco AA, Kotzur IM, et al. Radiographic appearance...