Late Morbidity (Dysphagia) in Head and Neck Cancer after Radiotherapy using various Treatment Techniques

Oropharyngeal Cancer (Chapter 2) Good tumor control but late-side effects occur e.g. dysphagia. Quality of Life: Dysphagia (Chapters 3-6) Dose-effects relationships in base of tongue, tonsillar fossa and nasopharyngeal cancer are found for swallowing problems. Quality of Lfe: Trismus (Chapter 7) Dose-effects relationships in base of tongue and tonsillar fossa are found for trismus problems. Brachytherapy (Chapters 8-10) Patient treated by brachyhterapy have better local control, disease-free survival and overal survival than those treated with EBRT. Also BT patients were found to have fewer swallowing problems compared with the non-BT group of patients. Hyperbaric Oxygen (Chapter 11) A great benefit for the quality of life of patients was seen in patients who were randomized for hyperbaric oxygen after radiotherapy. A significant difference of different aspects of quality of life was seen for H&N35 ‘swallowing problems’, H&N35 ‘sticky saliva’, H&N35 ‘dry mouth’, visual analogue scale (VAS) ‘Dry mouth’, PSS ‘eating in public’ and VAS ‘pain in mouth’ in favor of the hyperbaric oxygen group. Non-Rigid Registration / Atlas-Based Auto-Segmentation (Chapters 12-14) Non-rigid registration method is a powerful tool to accurately assess local shape and position changes in HNC patients. When using ABAS, edited auto-contours were somewhat more in concordance with the corresponding levels of this atlas as opposed to the originally contoured levels.

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