This document summarizes the management of head and neck radiotherapy patients. It discusses that squamous cell carcinoma makes up 90% of head and neck cancers, with a 50% 5-year survival rate. It occurs most commonly in the tongue, skin, throat, and soft palate. Treatment is based on staging of disease, age, comorbidities and involves options like radiation therapy, surgery, or no treatment. Radiation therapy can involve external beam, brachytherapy, or implants. It discusses acute and chronic side effects like mucositis, xerostomia, trismus, osteoradionecrosis and their management. It emphasizes the need for dental consultation and treatment before and after radiation due

1. MANAGEMENT OF HEAD & NECK RADIOTHERAPY PATIENTS Dr. Gillian Soskin General Medicine D344/QP344

2. Head & Neck Cancer Diagnosis

4. Radiation Treatment Centres In Ontario Sudbury Ottawa Kingston Toronto London Windsor

9. Treatment Options +/- +/- +/- +/- OR

16. Radiation Therapy Au grain or Iridium Implants

18. How much radiation? 1 “rad” = 1 centiGray (cGy) 200 cGy per day 5 days per week 1000 cGy per week

19. How much radiation? Total dose ranges from 6000 cGy – 7000 cGy 6 – 7 WEEKS of treatment

30. 4 minutes once a day EVERY DAY for the rest of your life!!

35. TREATMENT: 1. Nystatin 100,000 u/ml oral suspension 5 mL (1 tsp.) P.O. qid Swish for 1 min. and swallow ** If another organism or systemic infection is suspected, alert the medical oncologist immediately ** CANDIDIASIS

59. Hyperbaric Oxygen Therapy Prior to HBO

60. Hyperbaric Oxygen Therapy During HBO

61. Hyperbaric Oxygen Therapy Following HBO