Taylor Katherine J, Amdal Cecilie D, Bjordal Kristin, Astrup Guro L, Herlofson Bente B, Duprez Fréderic, Gama Ricardo R, Jacinto Alexandre, Hammerlid Eva, Scricciolo Melissa, Jansen Femke, Verdonck-de Leeuw Irma M, Fanetti Giuseppe, Guntinas-Lichius Orlando, Inhestern Johanna, Dragan Tatiana, Fabian Alexander, Boehm Andreas, Wöhner Ulrike, Kiyota Naomi, Krüger Maximilian, Bonomo Pierluigi, Pinto Monica, Nuyts Sandra, Silva Joaquim Castro, Stromberger Carmen, Specenier Pol, Tramacere Francesco, Bushnak Ayman, Perotti Pietro, Plath Michaela, Paderno Alberto, Stempler Noa, Kouri Maria, Grégoire Vincent, Tribius Silke, Singer Susanne
Institute of Medical Biostatistics, Epidemiology, and Informatics, University Medical Centre Mainz, Mainz, Germany.
Department of Oncology, Oslo University Hospital, Oslo, Norway.
Int J Cancer. 2025 Nov 15;157(10):2061-2070. doi: 10.1002/ijc.70033. Epub 2025 Jul 30.
Head and neck cancer (HNC) patients may experience toxicities as a result of their treatment modality. While acute toxicities have been well documented, the prevalence of toxicities at long-term follow-up of HNC survivors is less clear. As part of a multi-national, cross-sectional study, HNC survivors at least 5 years post-diagnosis were invited to undergo a toxicity examination. Using the Common Terminology Criteria for Adverse Events (version 5), 33 toxicities were assessed. From 2019 to 2021, 1094 survivors from 26 sites in 11 countries completed the assessment. Eighty-seven percent were from Europe, and most were survivors of oropharynx (35%), oral cavity (21%), or larynx cancer (19%). The majority had been diagnosed at stage III or IV (62%), and the median time since diagnosis was 8 years (range 5-36). Most had been treated with surgery and radiotherapy with or without chemotherapy (38%). Six percent had no toxicities, and 26% had only mild toxicities. 68% had at least one moderate or severe late toxicity. Overall, the most frequent late toxicities at any grade were dry mouth (67%), soft tissue fibrosis (52%), dysphagia (51%), and voice alterations (39%). Fistulae, neck and face edema, and osteonecrosis of the jaws were present in very few survivors. Our study shows that the majority of HNC survivors experience moderate or severe late toxicities, but that the problems are concentrated in a small group of specific toxicities. Understanding the problems experienced in the long term can help better inform newly diagnosed patients as well as inform survivorship follow-up initiatives.
头颈癌（HNC）患者可能会因其治疗方式而出现毒性反应。虽然急性毒性反应已有充分记录，但HNC幸存者长期随访时毒性反应的发生率尚不清楚。作为一项跨国横断面研究的一部分，邀请了诊断后至少5年的HNC幸存者接受毒性检查。使用《不良事件通用术语标准》（第5版）评估了33种毒性反应。2019年至2021年，来自11个国家26个地点的1094名幸存者完成了评估。87%来自欧洲，大多数是口咽癌（35%）、口腔癌（21%）或喉癌（19%）的幸存者。大多数患者诊断时为III期或IV期（62%），自诊断以来的中位时间为8年（范围5 - 36年）。大多数患者接受了手术和放疗，部分接受或未接受化疗（38%）。6%的患者没有毒性反应，26%的患者只有轻度毒性反应。68%的患者至少有一种中度或重度晚期毒性反应。总体而言，任何级别的最常见晚期毒性反应是口干（67%）、软组织纤维化（52%）、吞咽困难（51%）和声音改变（39%）。瘘管、颈部和面部水肿以及颌骨骨坏死在极少数幸存者中出现。我们的研究表明，大多数HNC幸存者经历中度或重度晚期毒性反应，但问题集中在一小部分特定的毒性反应上。了解长期存在的问题有助于更好地为新诊断的患者提供信息，并为幸存者随访计划提供参考。
