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The vicious circle of treatment-induced toxicities in locally advanced head and neck cancer and the impact on treatment intensity

Critical Reviews in Oncology/Hematology, Volume 116, August 2017, Pages 82–88

Abstract

The intensity of the available treatment approaches for locally-advanced head and neck cancer (HNC) is at the upper limit of tolerance of acute toxicities. Several factors including breakthrough cancer pain, mucositis, dysphagia, local and systemic infections, and nutritional problems are related to treatment intensity. Particularly, pain, as symptom directly associated with the disease or combined with other treatment-related factors, has a major impact on quality of life of HNC patients and ultimately can influence the efficacy of treatments in HNC. Here, a Multidisciplinary Board of Italian Experts has addressed these issues, with the aim to identify the unmet need and appropriate strategies for the maintenance of optimal treatment intensity in HNC.

Keywords: Head and neck cancer, Breakthrough cancer pain, Mucositis, Dysphagia, Concurrent chemoradiotherapy, Treatment intensity, Quality of life.

Footnotes

a Department of Head and Neck Medical Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy

b Genitourinary Unit, Division of Medical Oncology, European Institute of Oncology, Milan, Italy

c Department of Radio-Oncology, IRCCS AOU San Martino, IST, National Institute for Cancer Research, Genoa, Italy

d Oncology Unit, Azienda Ospedaliero-Universitaria Policlinico di Modena, Modena, Italy

e Director of Division of Palliative Care and Pain Therapy, European Institute of Oncology, Milan, Italy

f Departement of Anesthesia & Intensive care, University of L' Aquila, L'Aquila, Italy

g Institute of Radiotherapy, Università Cattolica del Sacro Cuore, Rome, Italy

h Radiation Oncology Centre, “S. Maria” Hospital, Terni, Italy

Corresponding author.