BC Cancer - Vancouver Centre, Vancouver, BC, Canada.
Univeristy of British Columbia, Vancouver, BC, Canada.
J Cancer Surviv. 2022 Oct;16(5):1117-1126. doi: 10.1007/s11764-021-01103-w. Epub 2021 Sep 20.
Adolescent and young adult (AYA) head and neck (H&N) cancer survivors are at risk of long-term complications. A cross-sectional study of survivors recalled for clinical evaluation was performed to evaluate late effects in this population.
Surviving patients who had been diagnosed with H&N cancer between the ages of 15 and 39 years and treated with radiation therapy (RT) in British Columbia between 1970 and 2010 were invited to participate in this study. Survivors were assessed in consultation by a radiation oncologist for a complete history and physical exam. Comprehensive data collection of subjective and objective late effects of RT and screening investigations were completed.
Of 36 AYA H&N participants, the majority were female (61%), and the most common tumour sites were thyroid (28%), oropharynx (17%), salivary gland (14%) and larynx (14%). Dental extractions post treatment was performed for 33% and dental implants for 17%. The majority (72%) reported xerostomia, 50% had dysphagia to solids and 25% hearing loss. Of the non-thyroid cancer patients who underwent RT to their neck, 45% developed hypothyroidism. There were 28% of participants with asymptomatic carotid stenosis and 27% with thyroid nodules; all were diagnosed after recall screening.
Survivors of AYA H&N cancer treated with RT reported numerous long-term complications. Comprehensive follow-up and screening guidelines should be established for this at-risk population.
AYA H&N cancer survivors and their primary care practitioners should be educated on screening recommendations and the risk of late effects.
青少年和年轻成人（AYA）头颈部（H＆N）癌症幸存者有发生长期并发症的风险。对接受临床评估的幸存者进行了一项回顾性研究，以评估该人群的晚期效应。
1970 年至 2010 年间，在不列颠哥伦比亚省接受过放射治疗（RT）的年龄在 15 至 39 岁之间被诊断患有 H＆N 癌症的幸存患者被邀请参加这项研究。由放射肿瘤学家对幸存者进行全面的病史和身体检查评估。完成了对 RT 和筛查调查的主观和客观晚期效应的综合数据收集。
在 36 名 AYA H＆N 参与者中，大多数为女性（61％），最常见的肿瘤部位为甲状腺（28％），口咽（17％），唾液腺（14％）和喉（14％）。治疗后进行了 33％的拔牙和 17％的牙种植。大多数（72％）报告有口干，50％有固体吞咽困难，25％有听力损失。在接受颈部 RT 的非甲状腺癌患者中，有 45％发生甲状腺功能减退。有 28％的参与者无症状颈动脉狭窄和 27％的甲状腺结节；所有这些都是在召回筛查后诊断出的。
接受 RT 治疗的 AYA H＆N 癌症幸存者报告了许多长期并发症。应针对高危人群制定全面的随访和筛查指南。
AYA H＆N 癌症幸存者及其初级保健医生应接受有关筛查建议和晚期效应风险的教育。
