Higashino Takuya, Wakabayashi Masashi, Zenda Sadamoto, Yasunaga Yoshichika, Araki Jun, Mukaigawa Takashi, Onitsuka Tetsuro, Nakagawa Masahiro, Hamahata Atsumori, Narita Keigo, Arikawa Masaki, Takanari Keisuke, Kadota Hideki, Yanagisawa Daisuke, Tanaka Kentaro, Matsumoto Hiroshi, Kimata Yoshihiro, Miyamoto Shimpei, Sakuraba Minoru, Kawai Kenichiro, Terao Yasunobu, Hyodo Ikuo, Ishida Katsuhiro, Yoshimura Kotaro
Department of Plastic and Reconstructive Surgery, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba, 277-8577, Japan.
Biostatistics Division, Center for Research Administration and Support, National Cancer Center Hospital East, Kashiwa, Japan.
Support Care Cancer. 2024 Dec 30;33(1):64. doi: 10.1007/s00520-024-09128-4.
This multi-institutional observational study aimed to assess the incidence, severity, and impact of radiotherapy-related late toxicities of the cervical skin and soft tissue in head and neck cancer patients. We also explored patient interest in fat grafting as a potential treatment for skin and soft tissue sequelae.
This study was conducted across 19 institutions in Japan. The study involved head and neck cancer patients who received ≥ 60 Gy of cervical radiotherapy concomitant with a history of neck dissection and were free of cancer recurrence ≥ 3 years after the final treatment. Consenting outpatients completed a self-administered questionnaire to collect data on symptom severity and the attending outpatient physicians reported data on demographics and treatments in a case report form.
A total of 222 patients were enrolled. The incidence proportion of late cervical skin and soft tissue toxicities was 96%, with 32% of patients reporting their symptoms as severe, and 69% of patients reporting an impact on quality of life (QOL). An interest in or consideration of fat grafting was reported by 34% of patients, with a greater desire among those with severe symptoms.
This study elucidated the incidence, severity, and life impact of late toxicities affecting the cervical skin and soft tissue after radiotherapy for head and neck cancer. These late toxicities were highly prevalent and significantly impacted QOL. There is a substantial demand for new treatments, such as fat grafting, to address these complications and enhance the QOL for survivors of head and neck cancer.
这项多机构观察性研究旨在评估头颈癌患者颈部皮肤和软组织放疗相关晚期毒性的发生率、严重程度及影响。我们还探讨了患者对脂肪移植作为皮肤和软组织后遗症潜在治疗方法的兴趣。
本研究在日本的19个机构开展。研究纳入了接受≥60 Gy颈部放疗且有颈部清扫史、最终治疗后≥3年无癌症复发的头颈癌患者。同意参与的门诊患者完成一份自行填写的问卷，以收集症状严重程度的数据，主治门诊医生通过病例报告表报告人口统计学和治疗数据。
共纳入222例患者。颈部皮肤和软组织晚期毒性的发生率为96%，32%的患者报告症状严重，69%的患者报告对生活质量（QOL）有影响。34%的患者报告对脂肪移植感兴趣或考虑过，症状严重的患者意愿更强。
本研究阐明了头颈癌放疗后影响颈部皮肤和软组织的晚期毒性的发生率、严重程度及对生活的影响。这些晚期毒性非常普遍，对生活质量有显著影响。对于新的治疗方法，如脂肪移植，有大量需求以解决这些并发症并提高头颈癌幸存者的生活质量。
