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World J Clin Oncol. May 10, 2014; 5(2): 93-102
Published online May 10, 2014. doi: 10.5306/wjco.v5.i2.93
Relationship between head and neck cancer therapy and some genetic endpoints
Eliana Maria Minicucci, Glenda Nicioli da Silva, Daisy Maria Fávero Salvadori
Eliana Maria Minicucci, Departamento de Dermatologia e Radioterapia, Faculdade de Medicina de Botucatu, Univ. Estadual Paulista, UNESP, Botucatu, SP 18618-000, Brazil
Glenda Nicioli da Silva, Departamento de Análises Clínicas, Escola de Farmácia, Univ. Federal de Ouro Preto, UFOP, Ouro Preto, 35400-000, Brazil
Daisy Maria Fávero Salvadori, Departamento de Patologia, Faculdade de Medicina de Botucatu, Univ. Estadual Paulista, UNESP, Botucatu, SP 18618-000, Brazil
Author contributions: Minicucci EM and da Silva GN collected the literature and drafted the first version of the manuscript; Salvadori DMF did a critical reading of the manuscript and included additional literature.
Correspondence to: Daisy Maria Fávero Salvadori, PhD, Departamento de Patologia, Faculdade de Medicina de Botucatu, Univ. Estadual Paulista, UNESP, Botucatu Distrito de Rubião Júnior, s/nº, Botucatu, SP 18618-000, Brazil. dfavero@fmb.unesp.br
Telephone: +55-14-38807210 Fax: +55-14-38807210
Received: December 17, 2013
Revised: February 22, 2014
Accepted: March 13, 2014
Published online: May 10, 2014
Abstract

Head and neck cancer (HNC) is the sixth most common human malignancy worldwide. The main forms of treatment for HNC are surgery, radiotherapy (RT) and chemotherapy (CT). However, the choice of therapy depends on the tumor staging and approaches, which are aimed at organ preservation. Because of systemic RT and CT genotoxicity, one of the important side effects is a secondary cancer that can result from the activity of radiation and antineoplastic drugs on healthy cells. Ionizing radiation can affect the DNA, causing single and double-strand breaks, DNA-protein crosslinks and oxidative damage. The severity of radiotoxicity can be directly associated with the radiation dosimetry and the dose-volume differences. Regarding CT, cisplatin is still the standard protocol for the treatment of squamous cell carcinoma, the most common cancer located in the oral cavity. However, simultaneous treatment with cisplatin, bleomycin and 5-fluorouracil or treatment with paclitaxel and cisplatin are also used. These drugs can interact with the DNA, causing DNA crosslinks, double and single-strand breaks and changes in gene expression. Currently, the late effects of therapy have become a recurring problem, mainly due to the increased survival of HNC patients. Herein, we present an update of the systemic activity of RT and CT for HNC, with a focus on their toxicogenetic and toxicogenomic effects.

Keywords: Chemotherapy, Head and neck cancer, Radiotherapy, Toxicogenetic, Toxicogenomic

Core tip: The main therapies for head and neck cancer (HNC) are surgery, radiotherapy (RT) and chemotherapy. Considering that both RT and chemotherapeutical drugs can interact with the DNA, one of the important, late-occurring complications is a therapy-related secondary tumor resulting from the genotoxic effects of the therapy on the healthy cells. This review presents an update of the toxicogenetic and toxicogenomic effects of HNC treatments, highlighting the main mechanisms evolved in the secondary damage caused by RT and chemotherapies.