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\begin{document}

\title{The Impact of Smoking, Alcohol Use, Recurrent Disease, and Age on the
Development of Neck Fibrosis in Head and Neck Cancer Patients Following
Radiation Therapy}



\author[1]{Connor Pratson}%
\author[1]{Michael Larkins}%
\author[1]{Brandon Karimian}%
\author[1]{Caitrin Curtis}%
\author[1]{Pamela Leppera}%
\author[1]{Brian Brodish}%
\author[1]{Andrew Ju}%
\affil[1]{East Carolina University}%


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  \date{May 26, 2024}


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\begin{abstract}
Objectives This study investigates the incidence of neck fibrosis in
head and neck cancer (HNC) patients following radiotherapy with respect
to patient age, treatment characteristics, history of alcohol and
tobacco use, and disease recurrence. Design A retrospective review of
all patients being treated for HNC at a rural tertiary care center
between 2013 and 2017 was performed. Participants 90 patients being
treated for HNC, aged 19 to 99 years. Main outcome measures Incidence
and Grade of head and neck fibrosis. Correlation with treatment/patient
characteristics was performed using Chi-squared and Mann-Whitney U tests
for univariate analysis and multiple logistic regression for
multivariate analysis. Results Factors associated with an increased
incidence of fibrosis included smoking during radiotherapy (p
\textless{} 0.001), alcohol use (p = 0.026), recurrent disease (p =
0.042), and age less than 60 (p \textless{} 0.001) on univariate
analysis. Factors associated with increased grade of fibrosis in HNC
patients included recurrent HNC (p = 0.033), alcohol use (p = 0.013),
patient age younger than 60 years (p = 0.018), smoking during
radiotherapy (p \textless{} 0.001), and non-Caucasian race (p = 0.012).
Conclusions Identification and intervention directed at patients who
possess risk factors associated with fibrosis prior to treatment has the
potential to improve the long-term quality of life for HNC patients.%
\end{abstract}%



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