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Toxicity of chemoradiotherapy in patients with head and neck tumors
TYLOVÁ, Pavla
Malignant ORL tumors represent about 5% of all malignant tumors. Especially smoking and alcohol consumption are major risk factors for tumor development. Among ORL tumors are usually classified those of oral cavity, tongue, nasal cavity, paranasal sinuses, pharynx and larynx. A standard therapy of locally advanced tumor stages of malignant head and neck tumors(T3, T4, N1-3, MO) consists in surgical treatment combined with radiotherapy alone or with radiotherapy with concomitant chemotherapy. A concomitant chemotherapy seems to be the perspective strategy in the treatment of advanced head and neck carcinoma stages. The primary tumor is recommended to be irradiated by a single dose of 2 Gy up to the total dose of 60{--}70 Gy. In case the tumor cannot be operated, the neoadjuvant chemotherapy (chemotherapy administered before irradiation) is indicated to prolong survival. Patients with a locally advanced tumor stage (stage III) show 5-year survival in 20-50 %. The aim of my work has been to evaluate the chemotherapy toxicity in head and neck tumor patients of the Department of Clinical and Radiation Oncology in České Budějovice and compare the toxicity data with those of the Hemato-Oncology Clinic of the University Hospital in Olomouc, the Department of Clinical and Radiation Oncology in Pardubice and the Department of Radiation and Oncology of the Faculty Hospital in Motol. I evaluated the changes in blood pictures at the beginning and the end of the treatment, mucositidis induction, infections of oral and nasal cavities, the necessity of treatment interruption or early termination, supportive treatment, antibiotic coverage and infusions. I studied head and neck tumor patients of stage III who underwent chemotherapy in years 2005-2008. Chemoradiotherapy toxicity which has been reported in professional literature does not differ from the toxicity I have found out within the group of 100 patients. The findings have been approximately comparable in tumor incidence between men and women, mucositis incidence and hematologic toxicity. There are some differences in antibiotic coverage and infusion administration among the departments.
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