Acute oro-facial complications of head and neck cancer patients on radiotherapy in Lagos University Teaching Hospital

Abstract

Background: Radiotherapy is a critical component in management of head and neck cancer patients, as cancer cells and normal surrounding tissues are damaged by radiation, resultingin several oral complications. This study aims to evaluate various acute oro-facial complications experienced by head and neck cancer patients receiving radiotherapy.

Methodology: One hundred and thirty three adult patients with head and neck cancer treated at the Lagos University Teaching Hospital Radiotherapy Department between October 2011 and November 2012 were studied. Information collected included; socio-demographic data, characteristics of primary disease, treatment characteristics, and associated acute oro-facial complications. Clinical findings at first visit, weekly for 4-6 weeks and 2 weeks post radiotherapy were also recorded.

Results: Of the 133 patients in this study, 82(61.7%) were males and 51(38.3%) were females with a male to female ratio of 1.6:1. Majority of patients 58(43.6%) were in the 6th decade of life and mean age of patients was 48.0 ±14.9 years. Nasopharyngeal region 36(27.1%) was the most commonsite of primary tumour, followed by maxillary antrum 25(18.8%) while cervical lymph nodes 1(0.8%) was the least common site. Squamous cell carcinoma was by far the most common histologicaltype of cancer observed 88(66.2%) and only 6(4.5%)patients received pre-radiotherapy dental care. Radiotherapy formed the primary modality of treatment in 99(74.4%) patients and facio-cervical field was the most common 30(22.6%) treatment field of irradiation. Of the 114 study participants without treatment interruptions; almost all 112(98.2%) and 108(94.7%)experienced odynophagia and oral mucositis respectively. Other acute complications were; taste dysfunction 84(73.7%), xerostomia83(72.8%)andoral candidiasis 9(7.9%).

Conclusion: A high incidence of acute oro-facial complications such as; oral mucositis, odynophagia, xerostomia and taste dysfunction were observed in patients undergoing radiotherapy for head and neck cancer. Up to 3 oro-facial complications occurred simultaneously, and they usually persist for over 2 weeks after completion of treatment.

Keywords: Acute complications, oro-facial complication, head and neck cancer, radiotherapy