Systematic Review of the Management of Fibrosis in Head and Neck Cancer Patients

Monday, October 13, 2025

2:42 PM - 2:48 PM EDT

Location: 127

Disclosure(s):

Pooja D. Reddy, BS:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Vanessa Helou, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Matthew E. Spector, MD:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Kevin J. Contrera, MD, MPH:

faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Introduction: An increasing number of patients are surviving after head and neck cancer (HNC) therapy; however, interventions to address long-term treatment effects have remained mostly unchanged. Radiation-related fibrosis can cause chronic pain, dysarthria, dysphagia, and cervical immobility. The aim of our study was to systematically review management options for head and neck fibrosis.

Methods: Medline, Embase.com, Web of Science, and Cochrane Library were searched and studies were included if they focused on radiation-induced fibrosis management in HNC patients. Data on demographics, intervention types, fibrosis symptoms, and quality of life outcomes were extracted, and a sample-weighted meta-analysis provided pooled estimates of treatment efficacy.

Results: Initial screening of 4078 titles narrowed to 147 full-text articles, of which eight met inclusion criteria. Among the eight studies analyzed, pharmacological interventions included pentoxifylline-tocopherol, pravastatin, amifostine, and topical superoxide dismutase (SOD). Pentoxifylline-tocopherol, pravastatin, and amifostine demonstrated a pooled fibrosis improvement rate of 47% (weighted sample size n=126), with pravastatin reducing fibrosis thickness in 35% of patients and pentoxifylline-tocopherol achieving up to 83% improvement. SOD did not show significant improvement over placebo and was therefore excluded from the pooled analysis. Procedural interventions included lipotransfer and microcurrent therapy and achieved a pooled effect size of 95% in symptom relief and functional improvement, with lipotransfer leading to physical improvements in 97% of patients and microcurrent therapy specifically enhancing cervical mobility in 92% of patients (n=64).

Conclusions: Improvements in HNC fibrosis after current treatments range from 35% to 97% of patients, with combination therapies offering the most promising results. Further research is needed to investigate and optimize long-term outcomes of these therapies.

Presenting Author(s)

Pooja D. Reddy, BS

Medical Student
University of Pittsburgh School of Medicine
Pittsburgh, Pennsylvania, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

PR

Purva Rumde, BS

University of Pittsburgh School of Medicine, United States

Disclosure information not submitted.
Vanessa Helou, MD

Postdoctoral Research Associate
Department of Otolaryngology, University of Pittsburgh
Pittsburgh, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
MK

Mary Klem, PhD, MLIS

University of Pittsburgh School of Medicine, United States

Disclosure information not submitted.
Matthew E. Spector, MD

Professor
Department of Otolaryngology-Head and Neck Surgery, University of Pittsburgh
Pittsburgh, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
Marci L. Nilsen, PhD, RN, CHPN, FAAN

Professor
University of Pittsburgh Department of Otolaryngology-Head & Neck Surgery
Pittsburgh, Pennsylvania, United States

Disclosure information not submitted.

Senior Author(s)

Kevin J. Contrera, MD, MPH

Assistant Professor
University of Pittsburgh
Pittsburgh, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.