Toxicity syndrome and early competing deaths in head-and-neck cancer undergoing radiation therapy: Observation and hypothesis

Radiotherapy (RT) and/or concurrent chemoradiation (CRT) is the mainstay for the treatment of locally advanced head-and-neck cancer (LAHNC). Sepsis remains a poorly understood and unrecognized event in head-and-neck cancer. The study aims to hypothesize a ‘toxicity syndrome’ leading to sepsis and su...

Full description

Saved in:
Bibliographic Details
Published inMedical hypotheses Vol. 143; p. 110145
Main Authors Muzumder, Sandeep, Srikantia, Nirmala
Format Journal Article
LanguageEnglish
Published United States Elsevier Ltd 01.10.2020
Subjects
Carcinoma, Squamous Cell - drug therapy
Chemoradiation
Chemoradiotherapy - adverse effects
Head and Neck Neoplasms - radiotherapy
Head-and-neck cancer
Humans
Mortality
Mucositis
Radiation therapy
Retrospective Studies
Sepsis
Toxicity syndrome
Head-and-neck cancer
Sepsis
Toxicity syndrome
Radiation therapy
Mortality
Chemoradiation
Online AccessGet full text

Cover

More Information
Summary:Radiotherapy (RT) and/or concurrent chemoradiation (CRT) is the mainstay for the treatment of locally advanced head-and-neck cancer (LAHNC). Sepsis remains a poorly understood and unrecognized event in head-and-neck cancer. The study aims to hypothesize a ‘toxicity syndrome’ leading to sepsis and subsequent sepsis-related deaths. A retrospective audit of all 125 LAHNC patients treated radically from January 2013 to June 2017 was conducted. A total of fifteen toxic deaths were reported. Thirteen deaths were attributed to sepsis. Individual toxicity for death was ascertained only for three cases. A toxicity syndrome namely ‘mucositis-dysphagia-aspiration-sepsis (MDAS) complex’ was proposed as the cause of death in the rest ten cases. The authors recommend the surveillance of the ‘MDAS complex’ for the prevention of early toxicity-related deaths in patients with LAHNC undergoing RT or CRT.
ISSN:0306-9877
1532-2777
DOI:10.1016/j.mehy.2020.110145