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  1. Article ; Online: An orthogonal matching pursuit optimization method for solving minimum-monitor-unit problems: Applications to proton IMPT, ARC and FLASH.

    Zhu, Ya-Nan / Zhang, Xiaoqun / Lin, Yuting / Lominska, Chris / Gao, Hao

    Medical physics

    2023  Volume 50, Issue 8, Page(s) 4710–4720

    Abstract: Background: The intensities (i.e., number of protons in monitor unit [MU]) of deliverable proton spots need to be either zero or meet a minimum-MU (MMU) threshold, which is a nonconvex problem. Since the dose rate is proportionally associated with the ... ...

    Abstract Background: The intensities (i.e., number of protons in monitor unit [MU]) of deliverable proton spots need to be either zero or meet a minimum-MU (MMU) threshold, which is a nonconvex problem. Since the dose rate is proportionally associated with the MMU threshold, higher-dose-rate proton radiation therapy (RT) (e.g., efficient intensity modulated proton therapy (IMPT) and ARC proton therapy, and high-dose-rate-induced FLASH effect needs to solve the MMU problem with larger MMU threshold, which however makes the nonconvex problem more difficult to solve.
    Purpose: This work will develop a more effective optimization method based on orthogonal matching pursuit (OMP) for solving the MMU problem with large MMU thresholds, compared to state-of-the-art methods, such as alternating direction method of multipliers (ADMM), proximal gradient descent method (PGD), or stochastic coordinate descent method (SCD).
    Methods: The new method consists of two essential components. First, the iterative convex relaxation (ICR) method is used to determine the active sets for dose-volume planning constraints and decouple the MMU constraint from the rest. Second, a modified OMP optimization algorithm is used to handle the MMU constraint: the non-zero spots are greedily selected via OMP to form the solution set to be optimized, and then a convex constrained subproblem is formed and can be conveniently solved to optimize the spot weights restricted to this solution set via OMP. During this iterative process, the new non-zero spots localized via OMP will be adaptively added to or removed from the optimization objective.
    Results: The new method via OMP is validated in comparison with ADMM, PGD and SCD for high-dose-rate IMPT, ARC, and FLASH problems of large MMU thresholds, and the results suggest that OMP substantially improved the plan quality from PGD, ADMM and SCD in terms of both target dose conformality (e.g., quantified by max target dose and conformity index) and normal tissue sparing (e.g., mean and max dose). For example, in the brain case, the max target dose for IMPT/ARC/FLASH was 368.0%/358.3%/283.4% respectively for PGD, 154.4%/179.8%/150.0% for ADMM, 134.5%/130.4%/123.0% for SCD, while it was <120% in all scenarios for OMP; compared to PGD/ADMM/SCD, OMP improved the conformity index from 0.42/0.52/0.33 to 0.65 for IMPT and 0.46/0.60/0.61 to 0.83 for ARC.
    Conclusions: A new OMP-based optimization algorithm is developed to solve the MMU problems with large MMU thresholds, and validated using examples of IMPT, ARC, and FLASH with substantially improved plan quality from ADMM, PGD, and SCD.
    MeSH term(s) Proton Therapy/methods ; Protons ; Radiotherapy Planning, Computer-Assisted/methods ; Radiotherapy, Intensity-Modulated/methods ; Algorithms ; Radiotherapy Dosage
    Chemical Substances Protons
    Language English
    Publishing date 2023-07-10
    Publishing country United States
    Document type Journal Article
    ZDB-ID 188780-4
    ISSN 2473-4209 ; 0094-2405
    ISSN (online) 2473-4209
    ISSN 0094-2405
    DOI 10.1002/mp.16577
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  2. Article: Stereotactic body radiotherapy for treatment of squamous cell carcinoma of the tongue associated with human papilloma virus: a case report.

    Rodgers, Brian / Neupane, Prakash / Lominska, Chris / Shnayder, Yelizaveta

    Frontiers in oncology

    2013  Volume 3, Page(s) 126

    Abstract: Stereotactic body radiotherapy (SBRT) has emerged as a treatment for recurrent squamous cell carcinoma of the head and neck in the field of prior radiation. We report a case of its use in an human papilloma virus (HPV) positive patient with squamous cell ...

    Abstract Stereotactic body radiotherapy (SBRT) has emerged as a treatment for recurrent squamous cell carcinoma of the head and neck in the field of prior radiation. We report a case of its use in an human papilloma virus (HPV) positive patient with squamous cell carcinoma of the right base of tongue. The patient had complete response to treatment and modest toxicities were noted. This represents encouraging results that SBRT is also useful for salvage in patients with HPV positive disease.
    Language English
    Publishing date 2013-05-17
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2649216-7
    ISSN 2234-943X
    ISSN 2234-943X
    DOI 10.3389/fonc.2013.00126
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  3. Article ; Online: Auranofin Protects Intestine against Radiation Injury by Modulating p53/p21 Pathway and Radiosensitizes Human Colon Tumor.

    Nag, Dhrubajyoti / Bhanja, Payel / Riha, Randal / Sanchez-Guerrero, Giselle / Kimler, Bruce F / Tsue, Terance T / Lominska, Chris / Saha, Subhrajit

    Clinical cancer research : an official journal of the American Association for Cancer Research

    2019  Volume 25, Issue 15, Page(s) 4791–4807

    Abstract: Purpose: The radiosensitivity of the normal intestinal epithelium is the major limiting factor for definitive radiotherapy against abdominal malignancies. Radiosensitizers, which can be used without augmenting radiation toxicity to normal tissue, are ... ...

    Abstract Purpose: The radiosensitivity of the normal intestinal epithelium is the major limiting factor for definitive radiotherapy against abdominal malignancies. Radiosensitizers, which can be used without augmenting radiation toxicity to normal tissue, are still an unmet need. Inhibition of proteosomal degradation is being developed as a major therapeutic strategy for anticancer therapy as cancer cells are more susceptible to proteasomal inhibition-induced cytotoxicity compared with normal cells. Auranofin, a gold-containing antirheumatoid drug, blocks proteosomal degradation by inhibiting deubiquitinase inhibitors. In this study, we have examined whether auranofin selectively radiosensitizes colon tumors without promoting radiation toxicity in normal intestine.
    Experimental design: The effect of auranofin (10 mg/kg i.p.) on the radiation response of subcutaneous CT26 colon tumors and the normal gastrointestinal epithelium was determined using a mouse model of abdominal radiation. The effect of auranofin was also examined in a paired human colonic organoid system using malignant and nonmalignant tissues from the same patient.
    Results: Both in the mouse model of intestinal injury and in the human nonmalignant colon organoid culture, auranofin pretreatment prevented radiation toxicity and improved survival with the activation of p53/p21-mediated reversible cell-cycle arrest. However, in a mouse model of abdominal tumor and in human malignant colonic organoids, auranofin inhibited malignant tissue growth with inhibition of proteosomal degradation, induction of endoplasmic reticulum stress/unfolded protein response, and apoptosis.
    Conclusions: Our data suggest that auranofin is a potential candidate to be considered as a combination therapy with radiation to improve therapeutic efficacy against abdominal malignancies.
    MeSH term(s) Animals ; Antirheumatic Agents/pharmacology ; Apoptosis ; Auranofin/pharmacology ; Cell Line, Tumor ; Cell Survival/drug effects ; Colonic Neoplasms/metabolism ; Colonic Neoplasms/pathology ; Colonic Neoplasms/radiotherapy ; Cyclin-Dependent Kinase Inhibitor p21/metabolism ; Endoplasmic Reticulum Stress/drug effects ; Humans ; Intestinal Mucosa/drug effects ; Intestinal Mucosa/injuries ; Intestinal Mucosa/metabolism ; Intestinal Mucosa/pathology ; Male ; Mice ; Mice, Inbred BALB C ; Mice, Inbred C57BL ; Protective Agents/pharmacology ; Radiation Injuries/pathology ; Radiation Injuries/prevention & control ; Radiation-Sensitizing Agents/pharmacology ; Tumor Suppressor Protein p53/metabolism ; Unfolded Protein Response/drug effects ; Xenograft Model Antitumor Assays
    Chemical Substances Antirheumatic Agents ; CDKN1A protein, human ; Cyclin-Dependent Kinase Inhibitor p21 ; Protective Agents ; Radiation-Sensitizing Agents ; TP53 protein, human ; Tumor Suppressor Protein p53 ; Auranofin (3H04W2810V)
    Language English
    Publishing date 2019-04-02
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 1225457-5
    ISSN 1557-3265 ; 1078-0432
    ISSN (online) 1557-3265
    ISSN 1078-0432
    DOI 10.1158/1078-0432.CCR-18-2751
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: CASTLE Thyroid Tumor: A Case Report and Literature Review.

    Lominska, Chris / Estes, Christopher Fleighton / Neupane, Prakash C / Shnayder, Y / TenNapel, Mindi J / O'Neil, Maura F

    Frontiers in oncology

    2017  Volume 7, Page(s) 207

    Abstract: Carcinoma showing thymus-like differentiation is a rare tumor of the thyroid gland, which is structurally similar to thymic tissue. Overall, it has a favorable prognosis. Radiotherapy has been shown to be an effective local treatment, but there have been ...

    Abstract Carcinoma showing thymus-like differentiation is a rare tumor of the thyroid gland, which is structurally similar to thymic tissue. Overall, it has a favorable prognosis. Radiotherapy has been shown to be an effective local treatment, but there have been reports of distant recurrence. It has been suggested that adding chemotherapy may decrease the risk of recurrence. Here, we present a case report of a patient with a large tumor and extrathyroidal extension. The patient was treated with surgery, radiotherapy, and cisplatin with acceptable toxicity. The patient is free of locally recurrent or distant disease at 3 years.
    Language English
    Publishing date 2017-09-13
    Publishing country Switzerland
    Document type Case Reports
    ZDB-ID 2649216-7
    ISSN 2234-943X
    ISSN 2234-943X
    DOI 10.3389/fonc.2017.00207
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  5. Article ; Online: Radiation-induced fibrosis: mechanisms and implications for therapy.

    Straub, Jeffrey M / New, Jacob / Hamilton, Chase D / Lominska, Chris / Shnayder, Yelizaveta / Thomas, Sufi M

    Journal of cancer research and clinical oncology

    2015  Volume 141, Issue 11, Page(s) 1985–1994

    Abstract: Purpose: Radiation-induced fibrosis (RIF) is a long-term side effect of external beam radiation therapy for the treatment of cancer. It results in a multitude of symptoms that significantly impact quality of life. Understanding the mechanisms of RIF- ... ...

    Abstract Purpose: Radiation-induced fibrosis (RIF) is a long-term side effect of external beam radiation therapy for the treatment of cancer. It results in a multitude of symptoms that significantly impact quality of life. Understanding the mechanisms of RIF-induced changes is essential to developing effective strategies to prevent long-term disability and discomfort following radiation therapy. In this review, we describe the current understanding of the etiology, clinical presentation, pathogenesis, treatment, and directions of future therapy for this condition.
    Methods: A literature review of publications describing mechanisms or treatments of RIF was performed. Specific databases utilized included PubMed and clinicaltrials.gov, using keywords "Radiation-Induced Fibrosis," "Radiotherapy Complications," "Fibrosis Therapy," and other closely related terms.
    Results: RIF is the result of a misguided wound healing response. In addition to causing direct DNA damage, ionizing radiation generates reactive oxygen and nitrogen species that lead to localized inflammation. This inflammatory process ultimately evolves into a fibrotic one characterized by increased collagen deposition, poor vascularity, and scarring. Tumor growth factor beta serves as the primary mediator in this response along with a host of other cytokines and growth factors. Current therapies have largely been directed toward these molecular targets and their associated signaling pathways.
    Conclusion: Although RIF is widely prevalent among patients undergoing radiation therapy and significantly impacts quality of life, there is still much to learn about its pathogenesis and mechanisms. Current treatments have stemmed from this understanding, and it is anticipated that further elucidation will be essential for the development of more effective therapies.
    MeSH term(s) DNA Damage/radiation effects ; Fibrosis ; Humans ; Inflammation/etiology ; Inflammation/metabolism ; Neoplasms/radiotherapy ; Radiation Injuries/etiology ; Radiation Injuries/physiopathology ; Radiation Injuries/therapy ; Radiotherapy/adverse effects ; Transforming Growth Factor beta/metabolism
    Chemical Substances Transforming Growth Factor beta
    Language English
    Publishing date 2015-11
    Publishing country Germany
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 134792-5
    ISSN 1432-1335 ; 0171-5216 ; 0084-5353 ; 0943-9382
    ISSN (online) 1432-1335
    ISSN 0171-5216 ; 0084-5353 ; 0943-9382
    DOI 10.1007/s00432-015-1974-6
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  6. Article: Quantitative clinical outcomes of therapy for head and neck lymphedema.

    Doke, Kaleigh N / Bowman, Laine / Shnayder, Yelizaveta / Shen, Xinglei / TenNapel, Mindi / Thomas, Sufi Mary / Neupane, Prakash / Yeh, Hung-Wen / Lominska, Chris E

    Advances in radiation oncology

    2018  Volume 3, Issue 3, Page(s) 366–371

    Abstract: Purpose: Head and neck surgery and radiation cause tissue fibrosis that leads to functional limitations and lymphedema. The objective of this study was to determine whether lymphedema therapy after surgery and radiation for head and neck cancer ... ...

    Abstract Purpose: Head and neck surgery and radiation cause tissue fibrosis that leads to functional limitations and lymphedema. The objective of this study was to determine whether lymphedema therapy after surgery and radiation for head and neck cancer decreases neck circumference, increases cervical range of motion, and improves pain scores.
    Methods and materials: A retrospective review of all patients with squamous cell carcinoma of the oral cavity, oropharynx, or larynx who were treated with high-dose radiation therapy at a single center between 2011 and 2012 was performed. Patients received definitive or postoperative radiation for squamous cell carcinoma of the oral cavity, oropharynx, or larynx. Patients were referred to a single, certified, lymphedema therapist with specialty training in head and neck cancer after completion of radiation treatment and healing of acute toxicity (typically 1-3 months). Patients underwent at least 3 months of manual lymphatic decongestion and skilled fibrotic techniques. Circumferential neck measurements and cervical range of motion were measured clinically at 1, 3, 6, 9, and 12 months after completion of radiation therapy. Pain scores were also recorded.
    Results: Thirty-four consecutive patients were eligible and underwent a median of 6 months of lymphedema therapy (Range, 3-12 months). Clinically measured total neck circumference decreased in all patients with 1 month of treatment. Cervical rotation increased by 30.2% on the left and 27.9% on the right at 1 month and continued to improve up to 44.6% and 55.3%, respectively, at 12 months. Patients undergoing therapy had improved pain scores from 4.3 at baseline to 2.0 after 1 month.
    Conclusions: Lymphedema therapy is associated with objective improvements in range of motion, neck circumference, and pain scores in the majority of patients.
    Language English
    Publishing date 2018-04-27
    Publishing country United States
    Document type Journal Article
    ISSN 2452-1094
    ISSN 2452-1094
    DOI 10.1016/j.adro.2018.04.007
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  7. Article ; Online: Stereotactic body radiation therapy for reirradiation of localized adenocarcinoma of the pancreas.

    Lominska, Chris E / Unger, Keith / Nasr, Nadim M / Haddad, Nadim / Gagnon, Greg

    Radiation oncology (London, England)

    2012  Volume 7, Page(s) 74

    Abstract: Background: Local control rates are poor in the treatment of pancreatic cancer. We investigated the role of hypofractionated stereotactic body radiation therapy (SBRT) for salvage or boost treatment after conventional doses of external beam radiation ... ...

    Abstract Background: Local control rates are poor in the treatment of pancreatic cancer. We investigated the role of hypofractionated stereotactic body radiation therapy (SBRT) for salvage or boost treatment after conventional doses of external beam radiation therapy.
    Methods: All patients treated with SBRT for pancreatic adenocarcinoma at Georgetown University from June 2002 through July 2007 were examined. Eligible patients had prior external beam radiation therapy to the pancreas. Treatment parameters and clinical and radiographic follow-up were evaluated.
    Results: Twenty-eight patients were identified who received SBRT after a median prior external beam radiotherapy dose of 50.4 Gy. The median patient age was 63 years old and the median follow-up was 5.9 months. Twelve of fourteen (85.7%) evaluable patients were free from local progression, with three partial responses and nine patients with stable disease. Toxicity consisted of one case of acute Grade II nausea/vomiting, and two cases of Grade III late GI toxicity. The median overall survival was 5.9 months, with 18% survival and 70% freedom from local progression at one year.
    Conclusions: Hypofractionated SBRT reirradiation of localized pancreatic cancer is a well-tolerated treatment. Most patients are free from local progression, albeit with limited follow-up, but overall survival remains poor.
    MeSH term(s) Adenocarcinoma/mortality ; Adenocarcinoma/radiotherapy ; Adenocarcinoma/surgery ; Adult ; Aged ; Aged, 80 and over ; Dose Fractionation, Radiation ; Female ; Humans ; Male ; Middle Aged ; Pancreatic Neoplasms/mortality ; Pancreatic Neoplasms/radiotherapy ; Pancreatic Neoplasms/surgery ; Radiation Dosage ; Radiosurgery/methods ; Radiotherapy, Adjuvant ; Retrospective Studies ; Survival Analysis
    Language English
    Publishing date 2012-05-18
    Publishing country England
    Document type Evaluation Study ; Journal Article
    ZDB-ID 2224965-5
    ISSN 1748-717X ; 1748-717X
    ISSN (online) 1748-717X
    ISSN 1748-717X
    DOI 10.1186/1748-717X-7-74
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  8. Article ; Online: Development and Characterization of an In Vitro Model for Radiation-Induced Fibrosis.

    Kumar, Dhruv / Yalamanchali, Sreeya / New, Jacob / Parsel, Sean / New, Natalie / Holcomb, Andrew / Gunewardena, Sumedha / Tawfik, Ossama / Lominska, Chris / Kimler, Bruce F / Anant, Shrikant / Kakarala, Kiran / Tsue, Terance / Shnayder, Yelizaveta / Sykes, Kevin / Padhye, Subhash / Thomas, Sufi Mary

    Radiation research

    2018  Volume 189, Issue 3, Page(s) 326–336

    Abstract: Radiation-induced fibrosis (RIF) is a major side effect of radiotherapy in cancer patients with no effective therapeutic options. RIF involves excess deposition and aberrant remodeling of the extracellular matrix (ECM) leading to stiffness in tissues and ...

    Abstract Radiation-induced fibrosis (RIF) is a major side effect of radiotherapy in cancer patients with no effective therapeutic options. RIF involves excess deposition and aberrant remodeling of the extracellular matrix (ECM) leading to stiffness in tissues and organ failure. Development of preclinical models of RIF is crucial to elucidate the molecular mechanisms regulating fibrosis and to develop therapeutic approaches. In addition to radiation, the main molecular perpetrators of fibrotic reactions are cytokines, including transforming growth factor-β (TGF-β). We hypothesized that human oral fibroblasts would develop an in vitro fibrotic reaction in response to radiation and TGF-β. We demonstrate here that fibroblasts exposed to radiation followed by TGF-β exhibit a fibrotic phenotype with increased collagen deposition, cell proliferation, migration and invasion. In this in vitro model of RIF (RIF
    MeSH term(s) Cell Movement/drug effects ; Cell Movement/radiation effects ; Cell Proliferation/drug effects ; Cell Proliferation/radiation effects ; Collagen/metabolism ; Curcumin/pharmacology ; Extracellular Matrix/metabolism ; Extracellular Matrix/radiation effects ; Fibroblasts/pathology ; Fibroblasts/radiation effects ; Fibrosis ; Gene Expression Regulation/drug effects ; Gene Expression Regulation/radiation effects ; Hepatocyte Growth Factor/genetics ; Humans ; Integrins/metabolism ; Pentoxifylline/pharmacology ; Radiation Injuries/pathology ; Transforming Growth Factor beta/pharmacology
    Chemical Substances Integrins ; Transforming Growth Factor beta ; Hepatocyte Growth Factor (67256-21-7) ; Collagen (9007-34-5) ; Curcumin (IT942ZTH98) ; Pentoxifylline (SD6QCT3TSU)
    Language English
    Publishing date 2018-01-19
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 80322-4
    ISSN 1938-5404 ; 0033-7587
    ISSN (online) 1938-5404
    ISSN 0033-7587
    DOI 10.1667/RR14926.1
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  9. Article ; Online: Stereotactic body radiation therapy for reirradiation of localized adenocarcinoma of the pancreas

    Lominska Chris E / Unger Keith / Nasr Nadim M / Haddad Nadim / Gagnon Greg

    Radiation Oncology, Vol 7, Iss 1, p

    2012  Volume 74

    Abstract: Abstract Background Local control rates are poor in the treatment of pancreatic cancer. We investigated the role of hypofractionated stereotactic body radiation therapy (SBRT) for salvage or boost treatment after conventional doses of external beam ... ...

    Abstract Abstract Background Local control rates are poor in the treatment of pancreatic cancer. We investigated the role of hypofractionated stereotactic body radiation therapy (SBRT) for salvage or boost treatment after conventional doses of external beam radiation therapy. Methods All patients treated with SBRT for pancreatic adenocarcinoma at Georgetown University from June 2002 through July 2007 were examined. Eligible patients had prior external beam radiation therapy to the pancreas. Treatment parameters and clinical and radiographic follow-up were evaluated. Results Twenty-eight patients were identified who received SBRT after a median prior external beam radiotherapy dose of 50.4 Gy. The median patient age was 63 years old and the median follow-up was 5.9 months. Twelve of fourteen (85.7%) evaluable patients were free from local progression, with three partial responses and nine patients with stable disease. Toxicity consisted of one case of acute Grade II nausea/vomiting, and two cases of Grade III late GI toxicity. The median overall survival was 5.9 months, with 18% survival and 70% freedom from local progression at one year. Conclusions Hypofractionated SBRT reirradiation of localized pancreatic cancer is a well-tolerated treatment. Most patients are free from local progression, albeit with limited follow-up, but overall survival remains poor.
    Keywords SBRT ; Reirradiation ; Radiotherapy ; Pancreatic cancer ; Medical physics. Medical radiology. Nuclear medicine ; R895-920 ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282
    Subject code 610 ; 616
    Language English
    Publishing date 2012-05-01T00:00:00Z
    Publisher BMC
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  10. Article ; Online: Quantitative clinical outcomes of therapy for head and neck lymphedema

    Kaleigh N. Doke, MD / Laine Bowman, MA, OTR / Yelizaveta Shnayder, MD / Xinglei Shen, MD / Mindi TenNapel, PhD / Sufi Mary Thomas, PhD / Prakash Neupane, MD / Hung-Wen Yeh, PhD / Chris E. Lominska, MD

    Advances in Radiation Oncology, Vol 3, Iss 3, Pp 366-

    2018  Volume 371

    Abstract: Purpose: Head and neck surgery and radiation cause tissue fibrosis that leads to functional limitations and lymphedema. The objective of this study was to determine whether lymphedema therapy after surgery and radiation for head and neck cancer decreases ...

    Abstract Purpose: Head and neck surgery and radiation cause tissue fibrosis that leads to functional limitations and lymphedema. The objective of this study was to determine whether lymphedema therapy after surgery and radiation for head and neck cancer decreases neck circumference, increases cervical range of motion, and improves pain scores. Methods and materials: A retrospective review of all patients with squamous cell carcinoma of the oral cavity, oropharynx, or larynx who were treated with high-dose radiation therapy at a single center between 2011 and 2012 was performed. Patients received definitive or postoperative radiation for squamous cell carcinoma of the oral cavity, oropharynx, or larynx. Patients were referred to a single, certified, lymphedema therapist with specialty training in head and neck cancer after completion of radiation treatment and healing of acute toxicity (typically 1-3 months). Patients underwent at least 3 months of manual lymphatic decongestion and skilled fibrotic techniques. Circumferential neck measurements and cervical range of motion were measured clinically at 1, 3, 6, 9, and 12 months after completion of radiation therapy. Pain scores were also recorded. Results: Thirty-four consecutive patients were eligible and underwent a median of 6 months of lymphedema therapy (Range, 3-12 months). Clinically measured total neck circumference decreased in all patients with 1 month of treatment. Cervical rotation increased by 30.2% on the left and 27.9% on the right at 1 month and continued to improve up to 44.6% and 55.3%, respectively, at 12 months. Patients undergoing therapy had improved pain scores from 4.3 at baseline to 2.0 after 1 month. Conclusions: Lymphedema therapy is associated with objective improvements in range of motion, neck circumference, and pain scores in the majority of patients.
    Keywords Medical physics. Medical radiology. Nuclear medicine ; R895-920 ; Neoplasms. Tumors. Oncology. Including cancer and carcinogens ; RC254-282
    Subject code 616 ; 610
    Language English
    Publishing date 2018-07-01T00:00:00Z
    Publisher Elsevier
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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