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Crit Rev Oncol Hematol. 2016 Jan;97:131-42. doi: 10.1016/j.critrevonc.2015.08.010. Epub 2015 Aug 12.

Oral toxicity management in head and neck cancer patients treated with chemotherapy and radiation: Dental pathologies and osteoradionecrosis (Part 1) literature review and consensus statement.

Author information

1
Radiation Oncology Department, Spedali Civili Hospital, Brescia University, Italy. Electronic address: michela.buglione@unibs.it.
2
Radiation Oncology Department, Spedali Civili Hospital, Brescia University, Italy. Electronic address: rcnero@gmail.com.
3
Department of Oral Diagnosis, Oral Medicine & Oral Pathology, Spedali Civili Hospital, Brescia University, Italy. Electronic address: fedric81@gmail.com.
4
Department of Diagnostic Imaging, Spedali Civili Hospital, Brescia University, Italy. Electronic address: lara.sottocornola@gmail.com.
5
Radiation Oncology Department, Spedali Civili Hospital, Brescia University, Italy. Electronic address: marta.maddalo@gmail.com.
6
Medical Oncology Department, Spedali Civili Hospital, Brescia University, Italy. Electronic address: lucia.vassalli@libero.it.
7
Medical Oncology Department, Spedali Civili Hospital, Brescia University, Italy. Electronic address: salvatore.grisanti@tin.it.
8
Department of Oral Diagnosis, Oral Medicine & Oral Pathology, Spedali Civili Hospital, Brescia University, Italy. Electronic address: stefano.salgarello@unibs.it.
9
Radio-Oncology Department, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. Electronic address: Ester.Orlandi@istitutotumori.mi.it.
10
Department of Oral Diagnosis, Oral Medicine & Oral Pathology, Spedali Civili Hospital, Brescia University, Italy. Electronic address: corrado.paganelli@unibs.it.
11
Department of Oral Diagnosis, Oral Medicine & Oral Pathology, Spedali Civili Hospital, Brescia University, Italy. Electronic address: alessandra.majorana@unibs.it.
12
Department of Oral Diagnosis, Oral Medicine & Oral Pathology, Spedali Civili Hospital, Brescia University, Italy. Electronic address: giorgio.gastaldi@unibs.it.
13
Head and Neck Medical Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy. Electronic address: paolo.bossi@istitutotumori.mi.it.
14
Medical Oncology Department, Spedali Civili Hospital, Brescia University, Italy. Electronic address: alfredo.berruti@gmail.com.
15
Radiation oncology department, Ospedale S. Maria della Misericordia, Azienda ULSS 18, 45100 Rovigo, Italy. Electronic address: pavanato.giovanni@azisanrovigo.it.
16
ENT Clinic and Head and Neck Department, Spedali Civili Hospital, Brescia University, Italy. Electronic address: piero.nicolai@unibs.it.
17
Department of Diagnostic Imaging, Spedali Civili Hospital, Brescia University, Italy. Electronic address: roberto.maroldi@unibs.it.
18
Department of General Dental Sciences, University of Alabama at Birmingham, USA. Electronic address: ABarasch@winthrop.org.
19
Radiation Oncology Department, AO. S. Croce e Carle, Cuneo, Italy. Electronic address: elviorussi@gmail.com.
20
Department of Oral and Maxillofacial Surgery, Academic Medical Center Amsterdam, University of Amsterdam, Amsterdam, The Netherlands; Department of Medical Dental Interaction, Academic Center for Dentistry Amsterdam, University of Amsterdam and VU University, Amsterdam, The Netherlands. Electronic address: j.e.raberdurlacher@amc.uva.nl.
21
Division of Hematology/Oncology, Department of Medicine, Vanderbilt University, Nashville, TN, USA. Electronic address: barbara.murphy@vanderbilt.edu.
22
Radiation Oncology Department, Spedali Civili Hospital, Brescia University, Italy. Electronic address: stefano.magrini@unibs.it.

Abstract

Radiotherapy alone or in combination with chemotherapy and/or surgery is the typical treatment for head and neck cancer patients. Acute side effects (such as oral mucositis, dermatitis, salivary changes, taste alterations, etc.), and late toxicities in particular (such as osteo-radionecrosis, hypo-salivation and xerostomia, trismus, radiation caries etc.), are often debilitating. These effects tend to be underestimated and insufficiently addressed in the medical community. A multidisciplinary group of head and neck cancer specialists met in Milan with the aim of reaching a consensus on clinical definitions and management of these toxicities. The Delphi Appropriateness method was used for developing the consensus, and external experts evaluated the conclusions. This paper contains 10 clusters of statements about the clinical definitions and management of head and neck cancer treatment sequels (dental pathologies and osteo-radionecroses) that reached consensus, and offers a review of the literature about these topics. The review was split into two parts: the first part dealt with dental pathologies and osteo-radionecroses (10 clusters of statements), whereas this second part deals with trismus and xerostomia.

KEYWORDS:

Caries; Dental pathology; Head and neck cancer; Osteo-radionecrosis; Radionecrosis; Radiotherapy

[Indexed for MEDLINE]

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