Change search
ReferencesLink to record
Permanent link

Direct link
Radiation-induced trismus in the ARTSCAN head and neck trial
Department of Clinical Sciences, Otorhinolaryngology, Lund University, Lund, Sweden ; Department of Otorhinolaryngology, Kirkenes Hospital, Kirkenes , Norway Correspondence: P. Nilsson, Department of Oncology and Radiation Physics, Skåne University Hospital, Lund University, Lund, Sweden.
Umeå University, Faculty of Medicine, Department of Clinical Sciences, Otorhinolaryngology.
Department of Oncology and Radiation Physics, Skåne University Hospital, Lund University, Lund, Sweden.
Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
Show others and affiliations
2014 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 53, no 5, 620-627 p.Article in journal (Refereed) Published
Abstract [en]

Trismus, a well-known sequelae after treatment of head and neck cancer, decreases a patient's oral function and quality of life. The main objectives of this study were to: 1) investigate the long-term prevalence of radiation-induced trismus in patients treated for head and neck cancer according to two different fractionation schedules; and 2) model a dose-response relationship for trismus. MATERIAL AND METHODS: Patients were recruited from the Swedish ARTSCAN trial, a prospective randomised multicentre study comparing conventional and accelerated fractionation. A total of 124 patients agreed to a clinical ENT examination 21-127 months (median 66 months) after beginning radiation therapy. Trismus-related scores were assessed using the EORTC H&N35 Quality of Life questionnaire. The TheraBite(®) range of motion scale was used to measure maximal interincisal distance. The dose-response relationship for structures important for mastication and the temporomandibular joints was investigated by normal tissue complication probability modelling. RESULTS: No significant differences in patient-reported trismus or maximal interincisal distance were found between the two trial arms. Patient-reported moderate to high scores regarding trismus increased from 3% at the start of radiation therapy to 25% at the long-term follow-up. Maximal interincisal distance correlated significantly with patient-reported scores of trismus. The best dose-response fit to the endpoint data was found for the dose to the ipsilateral masseter. CONCLUSIONS: Trismus is a persistent complication after radiotherapy with 3D-conformal radiation therapy. We found no difference between the severity and prevalence of trismus between conventional and accelerated fractionation, but a significant correlation between the absorbed dose to the mastication structures and opening of the mouth. Further prospective studies may determine whether a reduced dose to structures important for mastication using intensity-modulated radiation therapy will reduce problems with trismus.

Place, publisher, year, edition, pages
Informa Healthcare, 2014. Vol. 53, no 5, 620-627 p.
National Category
Cancer and Oncology
URN: urn:nbn:se:umu:diva-87737DOI: 10.3109/0284186X.2014.892209ISI: 000334740000007PubMedID: 24669774OAI: diva2:710690
Available from: 2014-04-08 Created: 2014-04-08 Last updated: 2014-05-28Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Gärskog, OlaLevring Jäghagen, EvaZackrisson, Björn
By organisation
OtorhinolaryngologyDepartment of OdontologyOncology
In the same journal
Acta Oncologica
Cancer and Oncology

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 144 hits
ReferencesLink to record
Permanent link

Direct link