Skip to main content
Top
Published in: Supportive Care in Cancer 7/2019

01-07-2019 | Original Article

Documentation and incidence of late effects and screening recommendations for adolescent and young adult head and neck cancer survivors treated with radiotherapy

Authors: Sarah Nicole Hamilton, Omair Arshad, Jaime Kwok, Eric Tran, A. Fuchsia Howard, Isabel Serrano, Karen Goddard

Published in: Supportive Care in Cancer | Issue 7/2019

Login to get access

Abstract

Purpose

A retrospective review of adolescent and young adult (AYA) head and neck cancer (HNC) patients treated with radiation therapy (RT) at British Columbia Cancer  was performed to determine the incidence of late toxicities, the documented late side effects discussed and the screening recommendations provided at the time of transfer of care to primary care providers (PCPs).

Methods

Charts (n = 162) were reviewed for all patients 15 to 35 years at diagnosis with HNC treated with RT from 1960 to 2010 who survived > 5 years after diagnosis.

Results

A discussion regarding the risk of long-term side effects was documented in the initial consultation for 85% of patients. The majority of patients (78%) developed > 1 documented late effect. The most common were xerostomia (44%), skin changes (28%), neck fibrosis (22%), nasal crusting (16%), epistaxis (16%), and dental decay (14%). In all, 20% were currently followed or were followed until they died. Of the 80% transferred to their PCP, 14% had a formal discharge summary. For those discharged from British Columbia Cancer, documented recommendations included regular dental care (34%) and screening for hypothyroidism (5%) and second malignancy (4%).

Conclusions

The majority of AYA HNC patients treated with RT developed late side effects, and most PCPs were not sent a discharge summary outlining screening recommendations for delayed late effects.

Implications for cancer survivors

AYA HNC survivors treated with RT are at high risk for late effects and would benefit from a survivorship care plan outlining these risks and screening recommendations.
Literature
1.
go back to reference Bleyer A, Viny A, Barr R. Introduction. In: Cancer epidemiology in older adolescents and young adults 15 to 29 years of age, including SEER incidence and survival: 1975–2000. National Cancer Institute, NIH Pub Bleyer A, Viny A, Barr R. Introduction. In: Cancer epidemiology in older adolescents and young adults 15 to 29 years of age, including SEER incidence and survival: 1975–2000. National Cancer Institute, NIH Pub
2.
go back to reference Ramphal R, Aubin S, Czaykowski P, et al. Adolescent and young adult cancer: principles of care. Curr Oncol 2016;23(3) Ramphal R, Aubin S, Czaykowski P, et al. Adolescent and young adult cancer: principles of care. Curr Oncol 2016;23(3)
3.
go back to reference Bleyer A, Barr R, Hayes-Lattin B et al (2008) The distinct biology of cancers in adolescents and young adults. Nat Rev Cancer 8:288–298CrossRefPubMed Bleyer A, Barr R, Hayes-Lattin B et al (2008) The distinct biology of cancers in adolescents and young adults. Nat Rev Cancer 8:288–298CrossRefPubMed
4.
go back to reference Salsman JM, Garcia SF, Yanez B, Sanford SD, Snyder MA, Victorson D (2014) Physical, emotional and social health differences between post treatment young adults with cancer and matched controls. Cancer 120(15):2247–2254CrossRefPubMedPubMedCentral Salsman JM, Garcia SF, Yanez B, Sanford SD, Snyder MA, Victorson D (2014) Physical, emotional and social health differences between post treatment young adults with cancer and matched controls. Cancer 120(15):2247–2254CrossRefPubMedPubMedCentral
5.
go back to reference Tai E, Buchanan N, Townsend J, Fairley T, Moore A, Richardson LC (2012) Health status of adolescent and young adult cancer survivors. Cancer 118(19):4884–4891CrossRefPubMedPubMedCentral Tai E, Buchanan N, Townsend J, Fairley T, Moore A, Richardson LC (2012) Health status of adolescent and young adult cancer survivors. Cancer 118(19):4884–4891CrossRefPubMedPubMedCentral
6.
go back to reference Baker KS et al (2017) Adolescent and young adult cancer survivors: late effects of treatment. In: Bleyer A (ed) Cancer in adolescents and young adults. Springer International Publishing, pp 687–710 Baker KS et al (2017) Adolescent and young adult cancer survivors: late effects of treatment. In: Bleyer A (ed) Cancer in adolescents and young adults. Springer International Publishing, pp 687–710
7.
go back to reference Modh A, Gayar OH, Elshaikh MA, Paulino AC, Siddiqui F (2018) Pediatric head and neck squamous cell carcinoma: patient demographics, treatment trends and outcomes. Int J Pediatr Otorhinolaryngol 106:21–25CrossRefPubMed Modh A, Gayar OH, Elshaikh MA, Paulino AC, Siddiqui F (2018) Pediatric head and neck squamous cell carcinoma: patient demographics, treatment trends and outcomes. Int J Pediatr Otorhinolaryngol 106:21–25CrossRefPubMed
8.
go back to reference Shiboski CH, Schmidt BL, Jordan RC (2005) Tongue and tonsil carcinoma: increasing trends in the U.S. population ages 20–44 years. Cancer 103(9):1843–1849CrossRefPubMed Shiboski CH, Schmidt BL, Jordan RC (2005) Tongue and tonsil carcinoma: increasing trends in the U.S. population ages 20–44 years. Cancer 103(9):1843–1849CrossRefPubMed
10.
go back to reference Hammerlid E, Taft C (2001) Health-related quality of life in long-term head and neck cancer survivors: a comparison with general population norms. Br J Cancer 84(2):149–1576CrossRefPubMedPubMedCentral Hammerlid E, Taft C (2001) Health-related quality of life in long-term head and neck cancer survivors: a comparison with general population norms. Br J Cancer 84(2):149–1576CrossRefPubMedPubMedCentral
12.
go back to reference Nathan PC, Daugherty CK, Wroblewski KE, Kigin ML, Stewart TV, Hlubocky FJ, Grunfeld E, del Giudice ME, Ward LAE, Galliher JM, Oeffinger KC, Henderson TO (2013) Family physician preferences and knowledge gaps regarding the care of adolescent and young adult survivors of childhood cancer. J Cancer Surviv 7:275–282CrossRefPubMed Nathan PC, Daugherty CK, Wroblewski KE, Kigin ML, Stewart TV, Hlubocky FJ, Grunfeld E, del Giudice ME, Ward LAE, Galliher JM, Oeffinger KC, Henderson TO (2013) Family physician preferences and knowledge gaps regarding the care of adolescent and young adult survivors of childhood cancer. J Cancer Surviv 7:275–282CrossRefPubMed
13.
go back to reference Simcock R, Simo R (2016) Follow-up and survivorship in head and neck Cancer. Clin Oncol (R Coll Radiol) 28(7):451–458CrossRef Simcock R, Simo R (2016) Follow-up and survivorship in head and neck Cancer. Clin Oncol (R Coll Radiol) 28(7):451–458CrossRef
14.
go back to reference Murphy BA, Deng J (2015) Advances in supportive care for late effects of head and neck cancer. J Clin Oncol 33(29):3314–3321CrossRefPubMed Murphy BA, Deng J (2015) Advances in supportive care for late effects of head and neck cancer. J Clin Oncol 33(29):3314–3321CrossRefPubMed
15.
go back to reference Rapidis AD, Dijkstra PU, Roodenburg JL, Rodrigo JP, Rinaldo A, Strojan P, Takes RP, Ferlito A (2015) Trismus in patients with head and neck cancer: etiopathogenesis, diagnosis and management. Clin Otolaryngol 40(6):516–526CrossRefPubMed Rapidis AD, Dijkstra PU, Roodenburg JL, Rodrigo JP, Rinaldo A, Strojan P, Takes RP, Ferlito A (2015) Trismus in patients with head and neck cancer: etiopathogenesis, diagnosis and management. Clin Otolaryngol 40(6):516–526CrossRefPubMed
16.
go back to reference Hudson MM, Ness KK, Gurney JG, Mulrooney DA, Chemaitilly W, Krull KR, Green DM, Armstrong GT, Nottage KA, Jones KE, Sklar CA, Srivastava DK, Robison LL (2013) Clinical ascertainment of health outcomes among adults treated for childhood cancer. JAMA 309(22):2371–2381CrossRefPubMedPubMedCentral Hudson MM, Ness KK, Gurney JG, Mulrooney DA, Chemaitilly W, Krull KR, Green DM, Armstrong GT, Nottage KA, Jones KE, Sklar CA, Srivastava DK, Robison LL (2013) Clinical ascertainment of health outcomes among adults treated for childhood cancer. JAMA 309(22):2371–2381CrossRefPubMedPubMedCentral
18.
go back to reference Jawad H, Hodson NA, Nixon PJ (2015) A review of dental treatment of head and neck cancer patients, before, during and after radiotherapy: part 1. Br Dent J 218(2):65–68CrossRefPubMed Jawad H, Hodson NA, Nixon PJ (2015) A review of dental treatment of head and neck cancer patients, before, during and after radiotherapy: part 1. Br Dent J 218(2):65–68CrossRefPubMed
19.
go back to reference Jereczek-Fossa BA, Alterio D, Jassem J, Gibelli B, Tradati N, Orecchia R (2004) Radiotherapy-induced thyroid disorders. Cancer Treat Rev 30(4):369–384CrossRefPubMed Jereczek-Fossa BA, Alterio D, Jassem J, Gibelli B, Tradati N, Orecchia R (2004) Radiotherapy-induced thyroid disorders. Cancer Treat Rev 30(4):369–384CrossRefPubMed
20.
go back to reference Chu CN, Chen SW, Bai LY, Mou CH, Hsu CY, Sung FC (2011) Increase in stroke risk in patients with head and neck cancer: a retrospective cohort study. Br J Cancer 105(9):1419–1423CrossRefPubMedPubMedCentral Chu CN, Chen SW, Bai LY, Mou CH, Hsu CY, Sung FC (2011) Increase in stroke risk in patients with head and neck cancer: a retrospective cohort study. Br J Cancer 105(9):1419–1423CrossRefPubMedPubMedCentral
21.
go back to reference Plummer C, Henderson RD, O'Sullivan JD, Read SJ (2011) Ischemic stroke and transient ischemic attack after head and neck radiotherapy: a review. Stroke 42(9):2410–2418CrossRef Plummer C, Henderson RD, O'Sullivan JD, Read SJ (2011) Ischemic stroke and transient ischemic attack after head and neck radiotherapy: a review. Stroke 42(9):2410–2418CrossRef
22.
go back to reference Lee DH, Roh JL, Baek S, Jung JH, Choi SH, Nam SY, Kim SY (2013) Second cancer incidence, risk factor, and specific mortality in head and neck squamous cell carcinoma. Otolaryngol Head Neck Surg 149(4):579–586CrossRefPubMed Lee DH, Roh JL, Baek S, Jung JH, Choi SH, Nam SY, Kim SY (2013) Second cancer incidence, risk factor, and specific mortality in head and neck squamous cell carcinoma. Otolaryngol Head Neck Surg 149(4):579–586CrossRefPubMed
23.
go back to reference Kong L, Lu JJ, Hu C, Guo X, Wu Y, Zhang Y (2006) The risk of second primary tumors in patients with nasopharyngeal carcinoma after definitive radiotherapy. Cancer 107(6):1287–1293CrossRefPubMed Kong L, Lu JJ, Hu C, Guo X, Wu Y, Zhang Y (2006) The risk of second primary tumors in patients with nasopharyngeal carcinoma after definitive radiotherapy. Cancer 107(6):1287–1293CrossRefPubMed
24.
go back to reference Atienza JA, Dasanu CA (2012) Incidence of second primary malignancies in patients with treated head and neck cancer: a comprehensive review of literature. Curr Med Res Opin 28(12):1899–1909CrossRefPubMed Atienza JA, Dasanu CA (2012) Incidence of second primary malignancies in patients with treated head and neck cancer: a comprehensive review of literature. Curr Med Res Opin 28(12):1899–1909CrossRefPubMed
25.
go back to reference Smits-Seemann RR, Kaul S, Zamora ER, Wu YP, Kirchhoff AC (2017) Barriers to follow-up care among survivors of adolescent and young adult cancer. J Cancer Surviv 11(1):126–132CrossRef Smits-Seemann RR, Kaul S, Zamora ER, Wu YP, Kirchhoff AC (2017) Barriers to follow-up care among survivors of adolescent and young adult cancer. J Cancer Surviv 11(1):126–132CrossRef
26.
go back to reference Ramsay JM, Mann K, Kaul S, Zamora ER, Smits-Seemann RR, Kirchhoff AC (2018) Follow-up care provider preferences of adolescent and young adult cancer survivors. J Adolesc Young Adult Oncol. 7(2):204–209CrossRefPubMedPubMedCentral Ramsay JM, Mann K, Kaul S, Zamora ER, Smits-Seemann RR, Kirchhoff AC (2018) Follow-up care provider preferences of adolescent and young adult cancer survivors. J Adolesc Young Adult Oncol. 7(2):204–209CrossRefPubMedPubMedCentral
27.
go back to reference Giuliani M, McQuestion M, Jones J, Papadakos J, Le LW, Alkazaz N, Cheng T, Waldron J, Catton P, Ringash J (2016) Prevalence and nature of survivorship needs in patients with head and neck cancer. Head Neck 38(7):1097–1103CrossRefPubMed Giuliani M, McQuestion M, Jones J, Papadakos J, Le LW, Alkazaz N, Cheng T, Waldron J, Catton P, Ringash J (2016) Prevalence and nature of survivorship needs in patients with head and neck cancer. Head Neck 38(7):1097–1103CrossRefPubMed
28.
go back to reference Zullig LL, Ramos K, Berkowitz C, Miller JJ, Dolor RJ, Koontz BF, Yousuf Zafar S, Hutch Allen D, Tenhover JA, Bosworth HB (2018) Assessing key stakeholders’ knowledge, needs, and preferences for head and neck cancer survivorship care plans. J Cancer Educ. https://doi.org/10.1007/s13187-018-1345-5 Zullig LL, Ramos K, Berkowitz C, Miller JJ, Dolor RJ, Koontz BF, Yousuf Zafar S, Hutch Allen D, Tenhover JA, Bosworth HB (2018) Assessing key stakeholders’ knowledge, needs, and preferences for head and neck cancer survivorship care plans. J Cancer Educ. https://​doi.​org/​10.​1007/​s13187-018-1345-5
Metadata
Title
Documentation and incidence of late effects and screening recommendations for adolescent and young adult head and neck cancer survivors treated with radiotherapy
Authors
Sarah Nicole Hamilton
Omair Arshad
Jaime Kwok
Eric Tran
A. Fuchsia Howard
Isabel Serrano
Karen Goddard
Publication date
01-07-2019
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 7/2019
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-018-4559-5

Other articles of this Issue 7/2019

Supportive Care in Cancer 7/2019 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine