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Observational Study
. 2024 Dec 30;33(1):64.
doi: 10.1007/s00520-024-09128-4.

Impact of radiotherapy-related late toxicities of skin and soft tissue in the neck on quality of life in head and neck cancer patients: a multi-institutional observational study in Japan

Takuya Higashino  1 , Masashi Wakabayashi  2 , Sadamoto Zenda  3 , Yoshichika Yasunaga  4 , Jun Araki  4 , Takashi Mukaigawa  5 , Tetsuro Onitsuka  6 , Masahiro Nakagawa  7 , Atsumori Hamahata  8 , Keigo Narita  9 , Masaki Arikawa  10 , Keisuke Takanari  11 , Hideki Kadota  12 , Daisuke Yanagisawa  13 , Kentaro Tanaka  14 , Hiroshi Matsumoto  15 , Yoshihiro Kimata  15 , Shimpei Miyamoto  16 , Minoru Sakuraba  17 , Kenichiro Kawai  18 , Yasunobu Terao  19 , Ikuo Hyodo  20 , Katsuhiro Ishida  21 , Kotaro Yoshimura  22
Affiliations
Observational Study

Impact of radiotherapy-related late toxicities of skin and soft tissue in the neck on quality of life in head and neck cancer patients: a multi-institutional observational study in Japan

Takuya Higashino et al. Support Care Cancer. .

Abstract

Purpose: This multi-institutional observational study aimed to assess the incidence, severity, and impact of radiotherapy-related late toxicities of the cervical skin and soft tissue in head and neck cancer patients. We also explored patient interest in fat grafting as a potential treatment for skin and soft tissue sequelae.

Methods: This study was conducted across 19 institutions in Japan. The study involved head and neck cancer patients who received ≥ 60 Gy of cervical radiotherapy concomitant with a history of neck dissection and were free of cancer recurrence ≥ 3 years after the final treatment. Consenting outpatients completed a self-administered questionnaire to collect data on symptom severity and the attending outpatient physicians reported data on demographics and treatments in a case report form.

Results: A total of 222 patients were enrolled. The incidence proportion of late cervical skin and soft tissue toxicities was 96%, with 32% of patients reporting their symptoms as severe, and 69% of patients reporting an impact on quality of life (QOL). An interest in or consideration of fat grafting was reported by 34% of patients, with a greater desire among those with severe symptoms.

Conclusion: This study elucidated the incidence, severity, and life impact of late toxicities affecting the cervical skin and soft tissue after radiotherapy for head and neck cancer. These late toxicities were highly prevalent and significantly impacted QOL. There is a substantial demand for new treatments, such as fat grafting, to address these complications and enhance the QOL for survivors of head and neck cancer.

Keywords: Head and neck neoplasms; Mesenchymal stem cell transplantation; Morbidity; Neck dissection; Quality of life; Radiotherapy.

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Conflict of interest statement

Declarations. Ethics approval: In accordance with the Declaration of Helsinki, the study protocol was approved by the National Cancer Center Institutional Review Board (2022–214) on October 24, 2022, prior to the first inclusion in National Cancer Center Hospital East on November 14, 2022, and subsequently approved by all participating institutions. Ethical approval was obtained from institutional ethics boards before patient recruitment. Consent to participate: Informed consent was obtained from all individual participants included in the study. Competing interests: The authors declare no competing interests.

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