Adverse reactions of radiotherapy for head and neck cancers. Treatment of radiation reactions in the oral cavity
Magdalena Czerżyńska1, Paulina Orłow2, Magdalena Choromańska3
Due to painless nature and poorly specific symptoms, such as hoarseness or sore throat, head and neck cancers are usually diagnosed when the disease is locally advanced. A typical patient is older than 50 years. Low social awareness concerning the occurrence of these cancers and rare appointments with specialist physicians escalate the problem. As a result, patients usually seek medical advice when the disease is advanced and prognosis poor. The risk of these cancers increases by regular consumption of weak alcoholic beverages, cigarette smoking and infection with human papilloma virus. The head and neck location, which is a richly vascularised and innervated anatomic region, necessitates the application of highly specialised treatment, i.e. intensitymodulated radiation therapy. Radiation reactions can be divided into early (acute) and late (chronic) based on the time of occurrence. Early reactions include inflammation and fibrosis of the oral mucosa. Late reactions are more troublesome and persistent. They include: mandible necrosis or permanent impairment of salivary gland secretory function. The most common adverse effects of radiotherapy include mucositis. Patients irradiated for head and neck cancers usually suffer from persistent oral mucosa dryness that requires particular care and hygiene. Preventive measures in patients undergoing radiotherapy include: systematic plaque removal, using high-fluoride agents for oral hygiene, following a low-sugar diet and regular dental check-ups.