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See <a href="https://exonpublications.com/index.php/exon/about/editorialTeam"><strong>here</strong></a> for more details.</p> <p><img src="https://exonpublications.com/public/site/images/cmorais/blank-10.png" alt="" width="10" height="10"></p> <p><img src="https://exonpublications.com/public/site/images/cmorais/blank-20.png" alt="" width="20" height="20"></p> <p><img src="https://exonpublications.com/public/site/images/bchapter/editors.png" alt="Open access books editors of Exon Publications" width="600" height="596"></p> en-US <p>Copyright of individual chapters belongs to the respective authors. The authors grant unrestricted publishing and distribution rights to the publisher. The electronic versions of the chapters are published under Creative Commons Attribution-NonCommercial 4.0 International (<a href="https://creativecommons.org/licenses/by-nc/4.0/" target="_blank" rel="noopener">CC BY-NC 4.0</a>). Users are allowed to share and adapt the chapters for any non-commercial purposes as long as the authors and the publisher are explicitly identified and properly acknowledged as the original source. The books in their entirety are subject to copyright by the publisher. The reproduction, modification, republication and display of the books in their entirety, in any form, by anyone, for commercial purposes are strictly prohibited without the written consent of the publisher.</p> books@exonpublications.com (Exon Editorial Office) admin@exonpublications.com (Peter Daniel) Fri, 28 Oct 2022 00:00:00 +1000 OJS 3.1.2.0 http://blogs.law.harvard.edu/tech/rss 60 Challenges in the Radiological Diagnosis of Osteoradionecrosis of the Jaw in Head and Neck Cancer Patients https://exonpublications.com/index.php/exon/article/view/osteoradionecrosis-radiological-diagnosis <p><strong>ABSTRACT</strong></p> <p>One of the most common and severe side effects of radiotherapy or concurrent chemo-radiotherapy&nbsp; for head and neck cancers&nbsp; is osteoradionecrosis of the jaws, which affects 2-22% patients. Correct diagnosis is crucial for the effective and timely management of osteoradionecrosis of the jaws. However, various stages of osteoradionecrosis of the jaws &nbsp;resemble osteomyelitis, medication-related osteonecrosis of the jaw, or tumor recurrences, challenging the diagnostic certainty. The clinical and radiological resemblance of osteoradionecrosis of the jaws &nbsp;to these non-radiotherapy-related conditions are the main contributors to this challenging situation. Nevertheless, it may be possible to avoid diagnostic roadblocks by using image analysis methods such as orthopantomography, computed tomography (CT), magnetic resonance imaging, bone scintigraphy, positron emission tomography, and single-photon emission CT (SPECT). There is no widely accepted consensus on the precise diagnosis of osteoradionecrosis of the jaws, although its general characteristics have been reported in the literature. The current chapter covers osteoradionecrosis of the jaws and its clinical and radiological features and provides information on relevant strategies to be used for an accurate diagnosis, with a specific emphasis on radiological and nuclear medicine techniques.</p> Busra Yilmaz, DDS, MSC, Efsun Somay, DDS, PHD, Ahmet Kucuk, MD, Berrin Pehlivan, MD, Ugur Selek, MD, Erkan Topkan, MD Copyright (c) 2022 Busra Yilmaz, DDS, MSC, Efsun Somay, DDS, PHD, Ahmet Kucuk, MD, Berrin Pehlivan, MD, Ugur Selek, MD, Erkan Topkan, MD https://creativecommons.org/licenses/by-nc/4.0 https://exonpublications.com/index.php/exon/article/view/osteoradionecrosis-radiological-diagnosis Fri, 28 Oct 2022 00:00:00 +1000 Definitions of Radiation-induced Trismus in Head and Neck Cancer: Current Concepts and Controversies https://exonpublications.com/index.php/exon/article/view/trismus <p><strong>ABSTRACT</strong></p> <p>Radiation-induced trismus is a devastating side effect of radiotherapy in patients with head and neck cancers. It hampers daily activities like eating, speaking, chewing, swallowing, and oral hygiene routines. Radiation induced trismus also negatively affects social interactions, psychological wellbeing, and lowers the quality of life of patients. The most common method for determining radiation-induced trismus is to measure the ‘maximum mouth opening’. Different cut-off values for maximum mouth opening have been employed in studies that assessed radiation-induced trismus, including 40 mm, 35 mm, 30 mm, and 20 mm. The impact and prevalence of radiation-induced trismus are not fully understood because there is no common and reliable objective measure to determine cut-off values of maximum mouth opening. Additionally, regardless of the pretreatment measures, a standard cut-off is applied to all patients, where a change may be substantial for one patient but not necessarily for another. These discrepancies may cause certain patients' conditions to be overstated or understated, misdirecting their prophylactic or therapeutic interventions. This chapter highlights the current concepts and controversies of the definitions of radiation-induced trismus, and the possible challenges in managing radiation-induced trismus because of the varied definitions.</p> Efsun Somay, DDS, PHD, Ahmet Kucuk, MD, Busra Yilmaz, DDS, MSC, Berrin Pehlivan, MD, Ugur Selek, MD, Erkan Topkan, MD Copyright (c) 2022 Efsun Somay, DDS, PHD, Ahmet Kucuk, MD, Busra Yilmaz, DDS, MSC, Berrin Pehlivan, MD, Ugur Selek, MD, Erkan Topkan, MD https://creativecommons.org/licenses/by-nc/4.0 https://exonpublications.com/index.php/exon/article/view/trismus Fri, 28 Oct 2022 00:00:00 +1000 Assessment of the Impact of Osteoradionecrosis on Quality-of-Life Measures in Patients with Head and Neck Cancer https://exonpublications.com/index.php/exon/article/view/quality-of-life-osteoradionecrosis <p><strong>ABSTRACT</strong></p> <p>Osteoradionecrosis of the jaws is a serious complication of radiotherapy that frequently results in facial deformity, pain, fracture, devitalized bone, fistulas, dysesthesia or anesthesia, trismus, difficulty chewing, swallowing, and localized or systemic infections. Osteoradionecrosis is defined as "a potentially severe, delayed radiation-induced injury characterized by bone necrosis, failure to heal, and exposed bone for at least three months in the absence of primary tumor progression or recurrence, or metastatic disease". The incidence rate of osteonecrosis among patients with head and neck cancers treated with radiotherapy or concurrent chemo radiotherapy is 2-22%. Although the incidence of osteoradionecrosis of the jaws has decreased as a result of recent improvements in radiotherapy procedures, it is still a very challenging task to predict, prevent, and treat osteoradionecrosis of the jaws and its consequences on patients' quality of life. Despite the negative impacts of osteoradionecrosis of the jaws on sufferers' physical appearance and functioning, and social relationships, there is a paucity of research on the quality-of-life that is specific to this condition. This chapter provides a summary of the available data on the physical, social, and emotional effects of osteoradionecrosis of the jaws as determined by general or head and neck cancer-specific quality of life surveys, which may be used to evaluate and treat such patients in radiation oncology and dentistry practices.</p> Efsun Somay, DDS, PHD, Busra Yilmaz, DDS, MSC, Erkan Topkan, MD, Ahmet Kucuk, MD, Berrin Pehlivan, MD, Ugur Selek, MD Copyright (c) 2022 Efsun Somay, DDS, PHD, Busra Yilmaz, DDS, MSC, Erkan Topkan, MD, Ahmet Kucuk, MD, Berrin Pehlivan, MD, Ugur Selek, MD https://creativecommons.org/licenses/by-nc/4.0 https://exonpublications.com/index.php/exon/article/view/quality-of-life-osteoradionecrosis Fri, 28 Oct 2022 00:00:00 +1000 Combined Stereotactic Radiosurgery and Immune Checkpoint Inhibitors for the Treatment of Brain Metastasis https://exonpublications.com/index.php/exon/article/view/treatment-brain-metastasis <p><strong>ABSTRACT</strong></p> <p>Metastasis of solid tumors to the brain occurs in about 30% of cases. Surgery and whole-brain radiotherapy have been the standard treatments with very limited success rates. As a result of the unsatisfactory local control and long-term survival outcomes, stereotactic radiosurgery has been used as an alternative to surgery and whole-brain radiotherapy, or to improve the outcomes in conjunction with other treatments. However, stereotactic radiosurgery does not produce the desired survival results despite the striking increases in local control rates, primarily because of deaths attributed to extracranial systemic disease progression or unavoidably fatal distant brain recurrences. Lately, immunotherapy has become a part, or mainstay, of treatment algorithms for many cancer types. Several authors have proposed the integration of stereotactic radiosurgery and immunotherapy for the treatment of brain metastasis. This chapter evaluates the efficacy and safety of combining novel immunotherapeutics with traditional stereotactic radiosurgery for the treatment of brain metastasis.</p> Ahmet Kucuk, MD, Erkan Topkan, MD, Nulifer Kılıc Durankus, MD, Sukran Senyurek, MD, Eyub Yasar Akdemir, MD, Duygu Sezen, MD, Yasemin Bolukbasi, MD, Ugur Selek, MD, Berrin Pehlivan, MD Copyright (c) 2023 Ahmet Kucuk, MD, Erkan Topkan, MD, Nulifer Kılıc Durankus, MD, Sukran Senyurek, MD, Eyub Yasar Akdemir, MD, Duygu Sezen, MD, Yasemin Bolukbasi, MD, Ugur Selek, MD, Berrin Pehlivan, MD https://creativecommons.org/licenses/by-nc/4.0 https://exonpublications.com/index.php/exon/article/view/treatment-brain-metastasis Tue, 03 Jan 2023 00:00:00 +1000 Preoperative Radiosurgical Management of Brain Metastases: Evidence and Challenges https://exonpublications.com/index.php/exon/article/view/preoperative-radiosurgery-brain-metastasis <p><strong>ABSTRACT</strong></p> <p>About 30% of all adult patients with solid tumors will develop brain metastases. The prognosis of patients with brain metastasis is poor, with a median overall survival of 4–7 months. Nevertheless, with efficient systemic and local therapies, some specific patient groups may experience longer survival times. Currently, the options for the management of brain metastasis include surgery, systemic chemotherapy, targeted therapies, stereotactic radiosurgery (SRS), postoperative stereotactic radiosurgery, whole-brain radiotherapy (WBRT), and their combination variants. Given the severe neurotoxic effects of WBRT, increased risk of radionecrosis, leptomeningeal dissemination after postoperative SRS, and the ineligibility of certain patients for SRS during the postoperative period (usually first 21 days), an active search for alternative treatment strategies for such patients ensued. It has been suggested that novel preoperative stereotactic radiosurgery, which has a lower risk of radionecrosis and leptomeningeal dissemination, would provide at least equivalent local control rates in this regard. The purpose of the current chapter is to outline the justification and available evidence for the novel preoperative stereotactic radiosurgery in the management of brain metastasis while accepting the paucity of related literature.</p> Erkan Topkan, MD, Ahmet Kucuk, MD, Sukran Senyurek, MD, Duygu Sezen, MD, Nulifer Kılıc Durankus, MD, Eyub Yasar Akdemir, MD, Yasemin Bolukbasi, MD, Berrin Pehlivan, MD, Ugur Selek, MD Copyright (c) 2023 Erkan Topkan, ahmet kucuk, sukran senyurek, duygu sezen, Nulifer Kılıc Durankus, Eyub Yasar Akdemir, Yasemin Bolukbasi, berrin pehlivan, ugur selek https://creativecommons.org/licenses/by-nc/4.0 https://exonpublications.com/index.php/exon/article/view/preoperative-radiosurgery-brain-metastasis Tue, 10 Jan 2023 00:00:00 +1000