title: Cisplatin based chemoradiation late toxicities in head and neck squamous cell carcinoma patients.
abstract: BACKGROUND
  Cisplatin-based chemoradiation (CRT) offers head and neck squamous cell carcinoma (HNSCC) patients better overall survival when compared to radiation alone. However, it also increases acute and late toxicity (LT). Here we aimed to review the main aspects of diagnosis and treatment of long-term toxicities in HNSCC patients after CRT.
  
  
  METHODS
  We crossed-searched PubMed MeshTerms: Survivors, Deglutition Disorders, Xerostomia, Hypothyroidism, Cisplatin, Kidney, Hearing, and Osteoradionecrosis, with keywords: "Head and Neck Neoplasms" and "Chemoradiotherapy." A total of 5,541 publications were retrieved and 48 were selected for this systematic review.
  
  
  RESULTS
  Dysphagia (25%), xerostomia (40-80%, depending on the technique used), hypothyroidism (42%), ototoxicity (27%), and osteoradionecrosis (4%) were the most commonly reported LT and were related to compromised quality of life aspects in HNSCC patients. Concurrent cisplatin and higher radiation doses, especially to normal tissue, increased the rates of LT.
  
  
  CONCLUSIONS
  Late CRT toxicities were reported mostly in retrospective studies. Addressing these adverse effects as endpoints in future clinical trials is necessary to provide tools to prevent and treat them adequately, allowing better quality of life and survival results.
authors: Department of Medical Oncology, Instituto do Cancer do Estado de Sao Paulo, Sao Paulo, Brazil.
authors: Thomás Giollo
authors: TG
authors: Rivelli
authors: Department of Medical Oncology, Instituto do Cancer do Estado de Sao Paulo, Sao Paulo, Brazil.
authors: Milena Perez
authors: MP
authors: Mak
authors: Department of Medical Oncology, Instituto do Cancer do Estado de Sao Paulo, Sao Paulo, Brazil.
authors: Renata Eiras
authors: RE
authors: Martins
authors: Department of Nephrology, Instituto do Cancer do Estado de Sao Paulo, Sao Paulo, Brazil.
authors: Verônica Torres
authors: VT
authors: da Costa e Silva
authors: Department of Medical Oncology, Instituto do Cancer do Estado de Sao Paulo, Sao Paulo, Brazil.
authors: Gilberto
authors: G
authors: de Castro
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000628:therapy*; D059248:Chemoradiotherapy / Q000009:adverse effects* / Q000379:methods; D002945:Cisplatin / Q000009:adverse effects* / Q000627:therapeutic use; D006258:Head and Neck Neoplasms / Q000628:therapy*; D006801:Humans
chemical_list: D002945:Cisplatin