Postoperative radiation therapy for head and neck cancer in the setting of orocutaneous and pharyngocutaneous fistula

American Journal of Clinical Oncology
Valerie LauAllen M Chen

Abstract

Due to concerns of radiation-related toxicity and hindered wound healing, the presence of a fistulous tract from the aerodigestive airway to the skin is commonly considered a contraindication for the initiation of postoperative radiation therapy (RT). Seventeen patients with an orocutaneous (9 patients) or pharyngocutaneous (8 patients) fistula underwent postoperative RT for head and neck cancer to a median dose of 60 Gy (range, 60-70 Gy). The median time period from surgical resection to the first day of RT was 39 days (range, 23-77 days). All patients were irradiated over an open orocutaneous or pharyngocutaneous fistula using intensity-modulated (10 patients) or conventional (7 patients) techniques. The median size of the fistula at the initiation of RT was 2 cm (range, 0.5-5 cm). All 17 patients completed postoperative RT without any treatment breaks. However, 4 patients developed serious complications within 3 months after completion of treatment (1 osteomyelitis requiring intravenous antibiotics; 1 flap necrosis requiring surgical debridement; 1 oral commissure dihiscence requiring reconstruction; 1 tracheoesophageal fistula) resulting in a 24% rate of grade 3+ acute toxicity. Closure of the fistulous tract eventually occ...Continue Reading

References

Jul 1, 1967·Radiology·W E PowersL A Palmer
Mar 30, 1995·International Journal of Radiation Oncology, Biology, Physics·J D CoxT F Pajak
Apr 30, 1993·International Journal of Radiation Oncology, Biology, Physics·L J PetersR A Frankenthaler
May 1, 1997·Head & Neck·J H IsaacsJ T Parsons
Jul 1, 1997·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·M M Morris, S N Powell
Oct 13, 2001·International Journal of Radiation Oncology, Biology, Physics·K K AngL J Peters
Apr 19, 2002·The Oncologist·Brian H Chon, Jay S Loeffler
Oct 21, 2006·Radiation Oncology·Gabriela StuderChristoph Glanzmann
Nov 24, 2007·International Journal of Radiation Oncology, Biology, Physics·Jennifer Wo, Alphonse Taghian
Jan 1, 2008·International Journal of Radiation Oncology, Biology, Physics·Johnny KaoEric M Genden
May 29, 2008·Cancer·Alexander LinEdgar Ben-Josef

❮ Previous
Next ❯

Citations

Sep 8, 2016·Clinics in Plastic Surgery·Nidal Farhan Al DeekChung-Kan Tsao
May 3, 2019·Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery·Thomas ParzefallBoban M Erovic

❮ Previous
Next ❯

Related Concepts

Related Feeds

Antifungals

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.

Antifungals (ASM)

An antifungal, also known as an antimycotic medication, is a pharmaceutical fungicide or fungistatic used to treat and prevent mycosis such as athlete's foot, ringworm, candidiasis, cryptococcal meningitis, and others. Discover the latest research on antifungals here.