EFFECTS OF RADIOTHERAPY ON LOCALLY ADVANCED OR METASTATIC HEAD AND NECK SQUAMOUS CELL CARCINOMA: CASE SERIES

Introduction: The advanced head and neck squamous cell carcinoma (SCC) has symptomatology such as pain, cachexia, asthenia, bleeding, compression and psychological problems. Palliative radiotherapy (RT) associated with nursing interventions are strategies for alleviating these symptoms and improving quality of life. Objective: To describe seven cases of locally advanced or metastatic head and neck SCC and the response to RT. Methods: Data were obtained through anamnesis and physical examination, photographic record and medical record review. Results: Case 1. Patient with neck SCC for 5 month had a deep ulcer with pain and bad odor, with a larger diameter (LD) of 9.0 cm, staging 3. He underwent concomitant chemotherapy (QT) and RT with a total dose (TD) of 71.2Gy. After RT evolved with shallow ulcer, LD=4.0cm. Case 2. Patient with neck SCC had vegetative tumor, stage 3, with LD=6.1cm for one year. After previous QT, he underwent RT (TD=50Gy) and had improvement of the lesion which became shallow ulcer, LD=2.0cm. Case 3. Patient had neck SCC for 7 month with multilobulated tumor and pain, 1N staging and LD=10.0cm. He underwent simultaneous QT and RT (TD=50,4Gy). After treatment, the lesion evolved to infiltrated plaque, LD=5.0cm, with deep ulceration area and liquefaction necrosis. Case 4. Patient with prearicular SCC for 8 month had vegetative tumor, stage 3, with MD=8.0cm. He was treated only RT (TD=60Gy) and the lesion became shallow ulcer with LD=5.0cm. Case 5. Patient with tragus SCC for 4 month had painful vegetating nodule, staging 2 and LD=5.0cm. He was treated only RT (TD=40Gy) and the lesion evolved to shallow ulcer, LD=2.0cm. Case 6. Patient had neck SCC for 6 month with multilobulated tumor, stage 2, LD=5.0cm. He underwent simultaneous QT and RT (TD=70.2Gy) with improvement of the lesion which showed with infiltrated plaque, ulceration points and LD=3.0cm. Case 7. Patient had SCC in the temporal region for one year with painful and smelly vegetative tumor, satge 4 and LD=15.0cm. He was treated simultaneous QT and RT (TD=35Gy). The lesion evolved to ulcer, deep in the retroauricular region and more superficial in other areas, with LD=15.0cm. Conclusions: All patients had improvement of symptomatology after RT. This treatment is well indicated for palliation of locally advanced or metastatic tumors due to its high efficacy and fast remission of symptoms such as pain, bleeding, tumor volume and improved quality of life.

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Artikel online veröffentlicht:
23. Oktober 2019