One of the most challenging side effects of anti-cancer therapy for patients with head and neck tumours is trismus (HNC). High-dose radiotherapy (RT), also known as radiation-induced trismus, has a high risk of inducing trismus in the temporomandibular joint, pterygoid, and temporalis or masseter muscles (RIT). Fibrosis in skeletal muscles, synovial fluid, extracellular matrix, and articular cartilage is thought to result from tissue hypoxia and inflammation brought on by RT, which are important factors in the development of RIT. The most frequently mentioned risk factors for RIT are age, cigarette and alcohol use, poor oral hygiene, tumour location, tumour size, advanced T-stage, and hereditary factors. Perineural invasion, tumour location near the masticatory apparatus, initial maximum mouth opening restriction, large RT volumes, and high masticatory apparatus doses are all present. After HNC radiation, up to 42% of patients may experience RIT. The goal of the current review is to discuss the available data regarding the pathogenesis, risk factors, preventive measures, and therapeutic approaches of RIT, a severe late side effect of RT or chemoradiotherapy that lowers the quality of life of patients by interfering with daily oral functions like chewing, eating, drinking, and speaking. The current review also focuses on the potential role of pre-existing systemic or local inflammation, as well as RT-induced inflammation, as a cause of RIT in HNC patients receiving RT or chemoradiotherapy, which may open a new window for RIT prevention and treatment given the growing body of evidence indicating that chronic inflammation is one of the major causes of RIT.
Author (s) Details
Efsun Somay
Department of Oral and Maxillofacial
Surgery, Faculty of Dentistry, Baskent University, Ankara, Turkey.
Busra Yilmaz
Department of Oral and Maxillofacial
Radiology, Faculty of Dentistry, Baskent University, Ankara, Turkey.
Erkan Topkan
Department of Radiation Oncology, Baskent
University Faculty of Medicine, Adana, Turkey.
Ahmet Kucuk
Department of Radiation Oncology, Mersin
City Hospital, Mersin, Turkey.
Berrin Pehlivan
Department of Radiation Oncology,
Bahcesehir University, Istanbul, Turkey.
Ugur Selek
Department of Radiation Oncology, Koc
University School of Medicine, Istanbul, Turkeya and Department of Radiation
Oncology, MD Anderson Cancer Center, The University of Texas, Houston, TX, USA.
Please see the link here:- https://stm.bookpi.org/CPMS-V8/article/view/7790
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