Follow-up/Toxicity Flashcards
What is Frey syndrome, and from what does it result?
Auriculotemporal nerve syndrome (gustatory sweating or redness and sweating on the cheek area when the pt eats, sees, or thinks about or talks about certain kinds of food). It is a postop complication of parotidectomy.
What is 1st bite syndrome, and from what does it result?
First bite syndrome is a rare complication of Sg involving the infratemporal fossa, parapharyngeal space or removal of the deep lobe of the parotid gland. It is characterized by facial pain after the 1st bite of each meal which usually subsides after subsequent bites. It is believed to be caused by autonomic dysfunction of salivary myoepithelial cells.
What are some possible Tx sequelae from RT for parotid cancers?
The main concerning sequelae are related to the ear. Acute effects include otitis externa or media with mild hearing loss. Late effects include dry cerumen, otitis media, and hearing loss. ORN of the temporal bone (parotid cancer) is uncommon as is mandibular ORN. Since Tx is mostly unilat, xerostomia is mild.
Above which RT doses can salivary gland function be compromised, resulting in xerostomia?
The parotid is the most sensitive gland d/t a large component of serous glands which are highly radiosensitive. There is no dose threshold. Min doses to effect parotid function start at ∼14 Gy. Based on older data, mean doses of 26–30 Gy are still used as planning goals with IMRT, although doses as high as 40 Gy can still allow some recovery. The doses that result in damage to other salivary glands have not been well studied.
What is the general follow-up for pts with salivary gland neoplasms?
Per 2018 NCCN guidelines, H&P (q1–3 mos for yr 1, q2–6 mos for yr 2, q4–8 mos for yrs 3–5, and q12 mos thereafter), chest imaging if clinically indicated, and TSH q6–12 mos if neck RT
