CLINICAL STUDY OF POST RADIOTHERAPY COMPLICATIONS IN HEAD AND NECK CARCINOMA

Introduction: Radiation therapy (RT) is often used to treat head and neck cancer (HNC). RT can damage blood vessels that nourish muscles, nerves, and bones resulting in a progressive “radiation fibrosis syndrome”, which causes a variety of complications. The likelihood and severity of complications depends on a number of factors, including the total dose of radiation delivered, over what time it was delivered and what parts of the head and neck received radiation. The side effects of RT for HNC are divided into early (acute) and long-term (chronic) effects. Early side effects occur during the course of therapy and during the immediate post therapy period (approximately 2–3 weeks after the completion of a course of RT). Late effects can manifest any time thereafter, from weeks to years later. Materials and methods:The study was conducted at Cancer Treatment Hospital and is a single center prospective study. A signed informed consent, ECOG performance status = 0-3, no distant metastases (M0) were included in the study. Informed consent forms were obtained from the patients. Patients particulars were noted, a thorough history of the disease. Any history of addiction to smoking, alcohol, opium and tobacco consumption was taken. History of diabetes melllitus was noted. A complete physical examination with assessment of ECOG performance score, oral assessment, primary tumor size and regional lymph nodes was carried out for all the patients in the study. Routine investigations like CBC, RFT, TSP, DSP, CXR-PA view, ECG were noted and ECHO was done where required. Mucositis was determined weekly while the patient was on chemo-radiation or radiation. Results were displayed as mean ± standard deviation or percentage. Results:Most of the patients presented with chief complaint of non healing ulcer in the oral cavity along with the neck swelling (192 patients). Neck swelling was the one of the chief complaint in 178 patients of the series. Facial disfigurement was complained by 24 patients, loss of the appetite was observed by 96 patients and 62 were having complaints of the weight loss. 178 patients presented with the complaint of the difficulty in swallowing. Restriction of the movement of tongue was seen in 106 patients. Conclusion:It was observed in the present study that mucositis was the one of the chief complication. More than 50% of the patients had nutritional deficiencies in the form of anemia and hypoproteinemia due to oral mucositis.Oral evaluation includin