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A cross-sectional assessment of long-term effects in adolescent and young adult head and neck cancer survivors treated with radiotherapy

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Abstract

Purpose

Adolescent and young adult (AYA) head and neck (H&N) cancer survivors are at risk of long-term complications. A cross-sectional study of survivors recalled for clinical evaluation was performed to evaluate late effects in this population.

Methods

Surviving patients who had been diagnosed with H&N cancer between the ages of 15 and 39 years and treated with radiation therapy (RT) in British Columbia between 1970 and 2010 were invited to participate in this study. Survivors were assessed in consultation by a radiation oncologist for a complete history and physical exam. Comprehensive data collection of subjective and objective late effects of RT and screening investigations were completed.

Results

Of 36 AYA H&N participants, the majority were female (61%), and the most common tumour sites were thyroid (28%), oropharynx (17%), salivary gland (14%) and larynx (14%). Dental extractions post treatment was performed for 33% and dental implants for 17%. The majority (72%) reported xerostomia, 50% had dysphagia to solids and 25% hearing loss. Of the non-thyroid cancer patients who underwent RT to their neck, 45% developed hypothyroidism. There were 28% of participants with asymptomatic carotid stenosis and 27% with thyroid nodules; all were diagnosed after recall screening.

Conclusions

Survivors of AYA H&N cancer treated with RT reported numerous long-term complications. Comprehensive follow-up and screening guidelines should be established for this at-risk population.

Implications for Cancer Survivors

AYA H&N cancer survivors and their primary care practitioners should be educated on screening recommendations and the risk of late effects.

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Funding

This study was generously funded by Rob and Diane Milne through the BC Cancer Foundation and a BC Cancer Prospective Outcomes Support Initiative (POSI) grant.

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Authors and Affiliations

  1. BC Cancer - Vancouver Centre, Vancouver, BC, Canada

    Sarah Nicole Hamilton, Sara Mahdavi, Isabel Serrano Martinez, Narsis Afghari, Fuchsia Howard, Eric Tran & Karen Goddard

  2. Univeristy of British Columbia, Vancouver, BC, Canada

    Sarah Nicole Hamilton, Narsis Afghari, Eric Tran & Karen Goddard

  3. Vancouver, Canada

    Sarah Nicole Hamilton

Authors
  1. Sarah Nicole Hamilton
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Contributions

SH, ET, SD, KG, FH, and ISM contributed to the design and implementation of the study. SH and KG assessed the patients in consultation. NA performed the data analysis. All the authors contributed to the preparing and editing of the manuscript.

Corresponding author

Correspondence to Sarah Nicole Hamilton.

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Ethics approval

This study was approved by the BC Cancer and University of British Columbia Research Ethics Board.

Consent to participate

All participants consented to participate in this study, participation was voluntary.

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Not applicable,

Competing interests

The authors declare no competing interests.

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Hamilton, S.N., Mahdavi, S., Martinez, I.S. et al. A cross-sectional assessment of long-term effects in adolescent and young adult head and neck cancer survivors treated with radiotherapy. J Cancer Surviv 16, 1117–1126 (2022). https://doi.org/10.1007/s11764-021-01103-w

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  • DOI: https://doi.org/10.1007/s11764-021-01103-w

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