Abstract
Concurrent chemoradiation is becoming an increasingly popular treatment for patients with locally advanced head and neck cancer. The full extent of treatment related complications has not been completely documented in the literature. We present the case of a patient treated with definitive intensity modulated radiation therapy and concurrent carboplatin and fluorouracil for a locally advanced oral cavity and base of tongue cancer. The patient suffered acute grade 4 dermatitis and mucositis during treatment. One month after completion of treatment, the patient was found to have permanent adherence of the tongue to the buccal mucosa as a result of severe scar tissue formation. As more patients undergo chemoradiation for the treatment of locally advanced head and neck cancer, the full extent of treatment related complications are being identified. To our knowledge, this is the first report of chemoradiation for head and neck cancer resulting in adherence of the tongue to the buccal mucosa.
Highlights
A major paradigm shift has occurred over the past two decades in the treatment of locally advanced head and neck cancer
We report on a 74 year old woman with a locally advanced, oral cavity and base of tongue (BOT) cancer treated with definitive intensity modulated radiation therapy (IMRT) and concurrent chemotherapy (5-fluorouracil and carboplatin)
We believe that the adherence of the tongue to the buccal mucosa described in the is report is analogous to pharyngoesophageal strictures, which are known to occur in up to 50% of patients receiving head and neck radiation.[6]
Summary
A major paradigm shift has occurred over the past two decades in the treatment of locally advanced head and neck cancer. We report on a 74 year old woman with a locally advanced, oral cavity and base of tongue (BOT) cancer treated with definitive intensity modulated radiation therapy (IMRT) and concurrent chemotherapy (5-fluorouracil and carboplatin).
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