Radiation-induced Trismus and Related Measures of Patient Life Quality | Chapter 2 | Current Innovations in Medicine and Medical Science Vol. 2

 Radiation therapy (RT) and concurrent chemoradiotherapy (CCRT), with or without surgery, are the established current standard treatment modalities for patients with head and neck cancers (HNC). Radiation-induced trismus (RIT), a serious side effect of RT or CCRT, can affect 5% to 69% of HNC patients, depending on the primary tumor, its spread to neighboring tissues, and the stage of the disease. RIT is typically described as having a maximum mouth opening of ≤ 35, which can manifest as early as three months of therapy or as late as 12 to 48 months after RT or CCRT. The victims of RIT may experience considerable negative impacts on their quality of life (QoL) measurement domains of everyday activities, speech, chewing, eating, drinking, malnutrition, dehydration, halitosis, oral hygiene, pain, aesthetic appearance, emotional, sexual and economic. Given the underappreciated nature of RIT and its detrimental effects in HNC patients undergoing RT or C-CRT, the goal of this chapter was to provide a concise review of the physical, social, emotional, sexual, and economic implications of RIT and their impact on QoL measures, as well as the available evaluation methods for health professionals working in related medical fields.

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, Faculty of Medicine, Baskent University, 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, School of Medicine, Koc University, Istanbul, Turkey 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/CIMMS-V2/article/view/8215

Radiation- Induced Trismus: A Concise Review of Pathogenesis, Prevention and Management | Chapter 1 | Current Practice in Medical Science Vol. 8

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