Table 4 Grade 4 and 5 severe adverse events
Primary site | Primary stage | Initial treatment | Primary response | Second diagnosis | Interval between first and second diagnosis (months) | Life time accumulated dose | Toxicity description | Interval between second radiation and toxicity (months) |
|---|---|---|---|---|---|---|---|---|
Oropharynx cancer | T4N2b | Concurrent Platinum-based chemotherapy + radiation 70/35 Gy | Complete | Local recurrence | 17.7 | 134 Gy | Carotid rupture | 6 months |
Causing death | ||||||||
Maxillary cancer | T3N2 | Radiation 74/32 Gy | Complete | Second primary, oropharynx cancer | 51.8 | 144 Gy | 1 – osteonecrosis, fractured mandible, disabling; 2 – skin fistula with bone exposed to air | 24 months |
Oropharynx cancer | T2N1 | Surgical resection followed by adjuvant radiation of 60 Gy | Complete | Locoregional recurrence | 29 | 120 Gy | Mucositis, 5 × 6 cm ulceration causing bleeding, leading to death | 5 months |