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Chapter 084. Head and Neck Cancer (Part 6)

Chemoprevention β-Carotene and cis-retinoic acid can lead to the regression of leukoplakia. However, cis-retinoic acid does not reduce the incidence of second primaries Treatment Complications Complications from treatment of head and neck cancer are usually correlated to the extent of surgery and exposure of normal tissue structures to radiation. Currently, the extent of surgery has been limited or completely replaced by chemotherapy and radiation therapy as the primary approach. Acute complications of radiation include mucositis and dysphagia. Long-term complications include xerostomia, loss of taste, decreased tongue mobility, second malignancies, dysphagia, and neck fibrosis. The complications of chemotherapy vary with the regimen. | Chapter 084. Head and Neck Cancer Part 6 Chemoprevention 0-Carotene and m-retinoic acid can lead to the regression of leukoplakia. However m-retinoic acid does not reduce the incidence of second primaries Treatment Complications Complications from treatment of head and neck cancer are usually correlated to the extent of surgery and exposure of normal tissue structures to radiation. Currently the extent of surgery has been limited or completely replaced by chemotherapy and radiation therapy as the primary approach. Acute complications of radiation include mucositis and dysphagia. Long-term complications include xerostomia loss of taste decreased tongue mobility second malignancies dysphagia and neck fibrosis. The complications of chemotherapy vary with the regimen used but usually include myelosuppression mucositis nausea and vomiting and nephrotoxicity with cisplatin . The mucosal side effects of therapy can lead to malnutrition and dehydration. Many centers address issues of dentition before starting treatment and some place feeding tubes to assure control of hydration and nutrition intake. About 50 of patients develop hypothyroidism from the treatment thus thyroid function should be monitored. Salivary Gland Tumors Most benign salivary gland tumors are treated with surgical excision and patients with invasive salivary gland tumors are treated with surgery and radiation therapy. Neutron radiation may be particularly effective. These tumors may recur regionally adenoidcystic carcinoma has a tendency to recur along the nerve tracks. Distant metastases may occur as late as 10a 20 years after the initial diagnosis. For metastatic disease therapy is given with palliative intent usually chemotherapy with doxorubicin and or cisplatin. Further Readings Adelstein DJ et al An intergroup phase III comparison of standard radiation therapy and two schedules of concurrent chemoradiotherapy in patients with unresectable squamous cell head and neck cancer. J Clin Oncol 21 92 2003