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

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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.

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References

  1. 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. Ramphal R, Aubin S, Czaykowski P, et al. Adolescent and young adult cancer: principles of care. Curr Oncol 2016;23(3)

  3. Bleyer A, Barr R, Hayes-Lattin B et al (2008) The distinct biology of cancers in adolescents and young adults. Nat Rev Cancer 8:288–298

    Article  CAS  PubMed  Google Scholar 

  4. 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):2247–2254

    Article  PubMed  PubMed Central  Google Scholar 

  5. 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):4884–4891

    Article  PubMed  PubMed Central  Google Scholar 

  6. 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. 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 106:21–25

    Article  PubMed  Google Scholar 

  8. 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):1843–1849

    Article  PubMed  Google Scholar 

  9. Challapalli SD, Simpson MC, Adjei Boakye E, Pannu JS, Costa DJ, Osazuwa-Peters N (2018) Head and neck squamous cell carcinoma in adolescents and young adults: survivorship patterns and disparities. J Adolesc Young Adult Oncol 7:472–479. https://doi.org/10.1089/jayao.2018.0001

    Article  PubMed  Google Scholar 

  10. 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):149–1576

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Children’s Oncology Group (2013) Long-term follow-up guidelines for survivors of childhood, adolescent and young adult cancers. Version 4.0. Children’s Oncology Group, Monrovia http://www.survivorshipguidelines.org

    Google Scholar 

  12. 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 7:275–282

    Article  PubMed  Google Scholar 

  13. Simcock R, Simo R (2016) Follow-up and survivorship in head and neck Cancer. Clin Oncol (R Coll Radiol) 28(7):451–458

    Article  CAS  Google Scholar 

  14. Murphy BA, Deng J (2015) Advances in supportive care for late effects of head and neck cancer. J Clin Oncol 33(29):3314–3321

    Article  CAS  PubMed  Google Scholar 

  15. 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):516–526

    Article  CAS  PubMed  Google Scholar 

  16. 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):2371–2381

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Adolescents and young adult (AYA) oncology. National Comprehensive Cancer Network (NCCN). https://www.nccn.org/

  18. 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):65–68

    Article  CAS  PubMed  Google Scholar 

  19. Jereczek-Fossa BA, Alterio D, Jassem J, Gibelli B, Tradati N, Orecchia R (2004) Radiotherapy-induced thyroid disorders. Cancer Treat Rev 30(4):369–384

    Article  CAS  PubMed  Google Scholar 

  20. 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):1419–1423

    Article  PubMed  PubMed Central  Google Scholar 

  21. 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):2410–2418

    Article  Google Scholar 

  22. 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):579–586

    Article  PubMed  Google Scholar 

  23. 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):1287–1293

    Article  PubMed  Google Scholar 

  24. 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):1899–1909

    Article  PubMed  Google Scholar 

  25. 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):126–132

    Article  Google Scholar 

  26. 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):204–209

    Article  PubMed  PubMed Central  Google Scholar 

  27. 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):1097–1103

    Article  PubMed  Google Scholar 

  28. 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

  29. Berkowitz C, Allen DH, Tenhover J, Zullig LL, Ragsdale J 3rd, Fischer JE, Pollak KI, Koontz BF (2017) Knowledge and preferences of primary care providers in delivering head and neck cancer survivorship care. J Cancer Educ. https://doi.org/10.1007/s13187-017-1250-3

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Authors and Affiliations

  1. British Columbia Cancer, Vancouver, BC, Canada

    Sarah Nicole Hamilton, Eric Tran, Isabel Serrano & Karen Goddard

  2. Univeristy of British Columbia, 600 W 10th Ave, Vancouver, BC, V5K 4E6, Canada

    Sarah Nicole Hamilton, Omair Arshad, Jaime Kwok, Eric Tran, A. Fuchsia Howard & Karen Goddard

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  1. Sarah Nicole Hamilton
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  2. Omair Arshad
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  3. Jaime Kwok
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  4. Eric Tran
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Corresponding author

Correspondence to Sarah Nicole Hamilton.

Ethics declarations

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This study was approved by the BC Cancer research ethics review board. As a retrospective study, informed consent was not required.

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The authors declare that they have no conflict of interest.

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Hamilton, S.N., Arshad, O., Kwok, J. et al. Documentation and incidence of late effects and screening recommendations for adolescent and young adult head and neck cancer survivors treated with radiotherapy. Support Care Cancer 27, 2609–2616 (2019). https://doi.org/10.1007/s00520-018-4559-5

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  • DOI: https://doi.org/10.1007/s00520-018-4559-5

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