Radiation-induced trismus in head and neck cancer patients.
OBJECTIVE
To determine the incidence of trismus in patients who had previously received curative doses of radiation therapy (RT) for head and neck cancer. In addition, we assessed if trismus was associated with quality of life deficits and radiation toxicity.


METHODS
Between February, 2005 and December, 2006, 40 patients with histologically confirmed head and neck cancer who had received curative doses of RT to the area(s) of the masticatory muscles and/or the ligaments of the temporomandibular joint (TMJ) were enrolled in this study. Differences in trismus incidence were compared between cancer treatment modalities [i.e., RT vs RT/chemotherapy (CT) and conventional RT vs intensity modulated RT]. Quality of life (QOL) was measured by using four questions from the EORTC QLQ-C30 that address pain and difficulty opening the jaw. Scores regarding impaired eating as a result of decreased range of motion of the mouth were derived from the Modified Common Toxicity Criteria (CTCAE Version 3.0).


RESULTS
Trismus was identified in 45% of subjects who had received curative doses of RT. No differences were noted in the incidence of trismus between RT and RT/CT or between conventional RT and intensity modulated RT (IMRT). Those with trismus demonstrated more QOL deficits than the non-trismus group.


CONCLUSIONS
Curative doses of RT for head and neck cancer result in trismus in a high percentage of patients, independent of other treatment modalities. Trismus has a negative impact on quality of life in this population.
Louise Kent
M
M
Department of Oral Medicine, Carolinas Medical Center, Charlotte, NC 28203, USA. marielouise.kent@carolinashealthcare.org
Brennan
Michael T
MT
Noll
Jenene L
JL
Fox
Philip C
PC
Burri
Stuart H
SH
Hunter
Jane C
JC
Lockhart
Peter B
PB
D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D016009:Chi-Square Distribution; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D011878:Radiotherapy / Q000009:adverse effects*; D050397:Radiotherapy, Intensity-Modulated / Q000009:adverse effects; D012189:Retrospective Studies; D018709:Statistics, Nonparametric; D014313:Trismus / Q000453:epidemiology / Q000209:etiology*