Pre and post radiotherpy care of head and neck cancer patients
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The expected changes on CT or MRI after treatment of a head and neck cancer are described; it is important not to confuse such expected changes with persisting or recurrent tumour, or a treatment complication. Post-treatment CT or MRI is of value when a recurrent tumour is suspected, to confirm the presence of such a lesion and to determine its extent; this is important information for determining the possibility of salvage therapy. More rarely, imaging may be of use in the differentiation between tumour recurrence and a treatment complication. In patients with a high-risk profile for tumour recurrence after treatment, imaging is of value for surveillance of the patient, as an adjunct to clinical follow-up. The baseline study should be obtained about 3 to 4 months after the end of therapy. There is evidence that tumour recurrences can be detect earlier by systematic follow-up imaging.
Keywords: Tumour recurrence, treatment complication, laryngeal necrosis, osteoradionecrosis, chondroradionecrosis, fistula
Introduction
After treatment of a head and neck cancer, a number of tissue changes become visible on CT and MR images of the neck. These expected alterations should be known, so that they are not misinterpreted as evidence of persistent or recurrent tumour.
Imaging may be used to monitor tumour response and to try to detect recurrent or persistent disease before it becomes clinically evident, possibly with a better chance for successful salvage.
Treatment complications, such as soft tissue or bone necrosis, are less frequent than tumour recurrences, but these conditions may be clinically sometimes difficult to distinguish. Although definitive distinction between necrosis and recurrent tumour may also radiologically be difficult, imaging findings may be helpful in guiding the choice of treatment and assessing the response to specific treatment.
Expected tissue changes after radiotherapy
After irradiation of a neck cancer, a number of tissue changes become visible on CT and MR images of the neck. Within the first 2 weeks after radiotherapy, there is an acute inflammatory reaction within the deep tissues. Increased permeability, due to detachment of the lining endothelial cells within small blood and lymphatic vessels, results in interstitial oedema. After this initial period of a few weeks, there is progressive thickening of the connective tissue. Endothelial proliferation is also seen, eventually resulting in complete obstruction of the vessels. The reduction in venous and lymphatic drainage results in further accumulation of interstitial fluid. Then the fibrosis becomes progressively more advanced, but the interstitial oedema may be reduced by formation of collateral capillary and lymphatic channels.
The changes visible on post-treatment CT and MR images depend on the radiation dose and rate, the irradiated tissue volume, and the time elapsed since the end of radiation therapy [1, 2]. Changes which may be seen include (Fig. 1(a)–(j)):
Thickening of the skin and platysma muscle.
Reticulation of the subcutaneous fat and the deep tissue fat layers.
Oedema in the retropharyngeal space.
Increased enhancement of the major salivary glands, followed by size reduction of these glands: post-irradiation sialadenitis.
Atrophy of lymphatic tissue, in both the lymph nodes and Waldeyer’s ring.
Thickening and increased enhancement of the pharyngeal walls.
Thickening of the laryngeal structures, with increased density of the fat in the pre-epiglottic and paralaryngeal spaces.
hope this helps plzz mark this as brainliest........
Keywords: Tumour recurrence, treatment complication, laryngeal necrosis, osteoradionecrosis, chondroradionecrosis, fistula
Introduction
After treatment of a head and neck cancer, a number of tissue changes become visible on CT and MR images of the neck. These expected alterations should be known, so that they are not misinterpreted as evidence of persistent or recurrent tumour.
Imaging may be used to monitor tumour response and to try to detect recurrent or persistent disease before it becomes clinically evident, possibly with a better chance for successful salvage.
Treatment complications, such as soft tissue or bone necrosis, are less frequent than tumour recurrences, but these conditions may be clinically sometimes difficult to distinguish. Although definitive distinction between necrosis and recurrent tumour may also radiologically be difficult, imaging findings may be helpful in guiding the choice of treatment and assessing the response to specific treatment.
Expected tissue changes after radiotherapy
After irradiation of a neck cancer, a number of tissue changes become visible on CT and MR images of the neck. Within the first 2 weeks after radiotherapy, there is an acute inflammatory reaction within the deep tissues. Increased permeability, due to detachment of the lining endothelial cells within small blood and lymphatic vessels, results in interstitial oedema. After this initial period of a few weeks, there is progressive thickening of the connective tissue. Endothelial proliferation is also seen, eventually resulting in complete obstruction of the vessels. The reduction in venous and lymphatic drainage results in further accumulation of interstitial fluid. Then the fibrosis becomes progressively more advanced, but the interstitial oedema may be reduced by formation of collateral capillary and lymphatic channels.
The changes visible on post-treatment CT and MR images depend on the radiation dose and rate, the irradiated tissue volume, and the time elapsed since the end of radiation therapy [1, 2]. Changes which may be seen include (Fig. 1(a)–(j)):
Thickening of the skin and platysma muscle.
Reticulation of the subcutaneous fat and the deep tissue fat layers.
Oedema in the retropharyngeal space.
Increased enhancement of the major salivary glands, followed by size reduction of these glands: post-irradiation sialadenitis.
Atrophy of lymphatic tissue, in both the lymph nodes and Waldeyer’s ring.
Thickening and increased enhancement of the pharyngeal walls.
Thickening of the laryngeal structures, with increased density of the fat in the pre-epiglottic and paralaryngeal spaces.
hope this helps plzz mark this as brainliest........
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Explanation:
About one half of people with oral cancer will live more than 5 years after they are diagnosed and treated. If the cancer is found early, before it has spread to other tissues, the cure rate is nearly 90%
About one half of people with oral cancer will live more than 5 years after they are diagnosed and treated. If the cancer is found early, before it has spread to other tissues, the cure rate is nearly 90%
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