Fat transfer treatment for management of radiotherapy-induced fibrosis
Research type
Research Study
Full title
Application of fat transfer treatment for the management of symptoms in radiotherapy-induced fibrosis in head and neck cancer patients.
IRAS ID
168077
Contact name
Nicholas Kalavrezos
Contact email
Sponsor organisation
Research & Development, University College London Hospitals
Duration of Study in the UK
3 years, 0 months, 1 days
Research summary
Fat transfer is an established treatment for restoring volume deficits in patients treated for Trauma, Congenital Deformities or Head and Neck Cancer. Published studies have documented that head and neck cancer patients who have undergone radiotherapy (or combination surgery/radiotherapy treatment in the pre- or post- operative setting) may develop subcutaneous fat attenuation and subsequent fibrosis. This is manifested in the head and neck as skin tethering to the underlying neck musculature with subsequent stiffness and limitation of neck movements. In some patients this may also be associated with pain and discomfort during movement. Functionally and aesthetically, these can have a profound impact on patient quality of life leading to social and professional deprivation despite the successful outcome of the cancer treatment. Fat transfer is currently used mainly to improve facial asymmetry. Improvements in skin texture, tethering to underlying tissues, range of motion and reduced requirement for chronic analgesia have additionally been reported. This treatment effect may occur as a by-product of volume-restoring fat transfer and has been noticed in a group of our own patients who previously suffered similar debilitating symptoms of radiotherapy-induced fibrosis. We therefore propose a pilot study to trial fat transfer specifically as a treatment for radiotherapy-induced fibrosis in Head and Neck Cancer patients. We endeavour to address the needs of all such patients with symptoms of radiotherapy-induced fibrosis, who have been cancer-free for at least twelve months following treatment completion. We will employ a structured clinical assessment of these patients before fat transfer in order to identify specific clinical, mechanical and aesthetic needs. Following treatment, we will re-assess the clinical, mechanical and aesthetic properties described and investigate changes to the skin and subcutaneous microcirculation using laser doppler and thermographic imaging in order to identify potential mechanisms underlying any changes noted.
REC name
East of England - Cambridge South Research Ethics Committee
REC reference
15/EE/0127
Date of REC Opinion
9 Apr 2015
REC opinion
Unfavourable Opinion