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Case Reports
. 2016 Mar;57(2):169-73.
doi: 10.1093/jrr/rrv055. Epub 2015 Dec 18.

Early-onset dropped head syndrome after radiotherapy for head and neck cancer: dose constraints for neck extensor muscles

Koji Inaba  1 , Satoshi Nakamura  2 , Hiroyuki Okamoto  2 , Tairo Kashihara  2 , Kazuma Kobayashi  2 , Ken Harada  2 , Mayuka Kitaguchi  2 , Shuhei Sekii  2 , Kana Takahashi  2 , Naoya Murakami  2 , Yoshinori Ito  2 , Hiroshi Igaki  2 , Takashi Uno  3 , Jun Itami  2
Affiliations
Case Reports

Early-onset dropped head syndrome after radiotherapy for head and neck cancer: dose constraints for neck extensor muscles

Koji Inaba et al. J Radiat Res. 2016 Mar.

Abstract

Dropped head syndrome (DHS) is a famous but unusual late complication of multimodality treatment for head and neck carcinoma. We reported this early-onset complication and analyzed the dose to the neck extensor muscles. We examined the records of three patients with DHS after radiotherapy. The doses to the neck extensor muscles were compared between three patients with DHS and nine patients without DHS. The mean dose to the neck extensor muscles of the three patients with DHS were 58.5 Gy, 42.3 Gy and 60.9 Gy, while the dose was <50 Gy in all nine patients in the control group. The onset of this syndrome was 5 months, 6 months and 15 months. The early-onset DHS may have something to do with dose to the neck extensor muscles. The proposed dose to the neck extensor muscles might be <46 Gy (or at least <50 Gy).

Keywords: chemoradiotherapy; dose constraints to the neck extensor muscles; early-onset dropped head syndrome; radiotherapy; unusual complication.

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Figures

Fig. 1.
Fig. 1.
Dose–volume histogram of the neck extensor muscles of three patients with dropped head syndrome and nine patients without dropped head syndrome.
See this image and copyright information in PMC

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