The relationship between oral health and radiation-induced mucositis among patients with head and neck cancer

Eun-Young Park; Hae-ok Sohn; Yun-Sook Jung; Eun-Kyoung Lee; Eun-kyong Kim

doi:10.11149/jkaoh.2018.42.2.34

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Park, Sohn, Jung, Lee, and Kim: The relationship between oral health and radiation-induced mucositis among patients with head and neck cancer

Original Article

Journal of Korean Academy of Oral Health 2018; 42(2): 34-39.

Published online: 28 June 2018

DOI: https://doi.org/10.11149/jkaoh.2018.42.2.34

The relationship between oral health and radiation-induced mucositis among patients with head and neck cancer

Eun-Young Park^1,^#, Hae-ok Sohn^2,^#, Yun-Sook Jung³, Eun-Kyoung Lee², Eun-kyong Kim³

¹Department of Dentistry, Yeungnam University Medical Center, Korea.

²Department of Dentistry, Kyungpook National University Chilgok Hospital, Daegu, Korea.

³Department of Dental Hygiene, College of Science & Technology, Kyungpook National University, Sangju, Korea.

Corresponding Author: Eun-kyong Kim. Department of Dental Hygiene, College of Science & Technology, Kyungpook National University, 2559 Gyeongsangdero, Sangju 37224, Korea. Tel: +82-54-530-1423, Fax: +82-54-530-1429, jinha01@naver.com

Equal contributor:

#These authors contributed equally to this work.

Received 19 March 2018 Revised 11 May 2018 Accepted 20 June 2018

Journal of Korean Academy of Oral Health

(open-access):

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objectives

This study evaluated the relationship between oral hygiene and health status and radiation-induced mucositis among patients with head and neck cancer over an 8-week period.

Methods

We recruited 40 patients with head and neck cancer scheduled to receive radiation therapy (RT), and 25 patients were included in the study. Before commencing RT, a dentist examined the patients for plaque, and determined the gingival index and pocket depth. A dental hygienist assessed the patients for radiation-induced mucositis once weekly, for 8 weeks, during RT.

Results

The mean patient age was 60.96 (±8.47) years, and 21 (87.5%) patients were male. Twenty patients (83.3%) had been diagnosed with squamous cell carcinoma. Patients with cancer located in the head region had more severe mucositis than those with cancer in the neck region, but this was not significant statistically (P=0.053). However, toothbrushing frequency, plaque, gingival index, and pocket depth were not related to radiation-induced mucositis. During RT, the severity of mucositis significantly worsened compared to that at baseline.

Conclusions

Mucositis severity worsened during RT, but this was not related to oral hygiene and health status among patients with head and neck cancer.

Keywords: Head & neck cancer, Mucositis, Radiotherapy

Figures and Tables

Fig. 1

Interaction of cancer or radiotherapy related variables and radiotherapy treatment affecting mucositis.

Table 1

General characteristics by study population

Table 2

Oral status by study population

Table 3

Changes in oral mucositis according to cancer or radiotherapy related variables after radiotherapy treatment

^*P values by paired t-test. ^†P values by repeated measures ANOVA.

^a)Comparision between baseline and after radiotherapy, ^b)Comparision between groups and ^c)interactions of time and group.

Table 4

Changes in oral mucositis according to oral status after radiotherapy treatment

^*P values by paired t-test.^†P values by repeated measures ANOVA.

^a)Comparision between baseline and after radiotherapy, ^b)Comparision between groups and ^c)interactions of time and group.

References

1. Vissink A, Jansma J, Spijkervet FKL, Burlage FR, Coppes RP. Oral sequelae of head and neck radiotherapy. Crit Rev Oral Biol Med. 2003; 14:199–212.

2. Park Y, Kim YH. Chemotherapy related oral and gastrointestinal mucositis. J Korean Med Assoc. 2009; 52:897–906.

3. Woo SB, Sonis ST, Monopoli M, Sonis AL. A longitudinal study of oral ulcerative mucositis in bone marrow transplant recipients. Cancer. 1993; 72:1612–1617.

4. Scully C, Epstein J, Sonis S. Oral mucositis: a challenging complication of radiotherapy, chemotherapy, and radiochemotherapy: part 1, pathogenesis and prophylaxis of mucositis. Head Neck. 2003; 25:1057–1070.

5. Trotti A, Bellm LA, Epstein JB, Frame D, Fuchs HJ, Gwede CK, et al. Mucositis incidence, severity and associated outcomes in patients with head and neck cancer receiving radiotherapy with or without chemotherapy: a systematic literature review. Radiother Oncol. 2003; 66:253–262.

6. Raber-Durlacher JE, Elad S, Barasch A. Oral mucositis. Oral Oncol. 2010; 46:452–456.

7. Sonis S, Kunz A. Impact of improved dental services on the frequency of oral complications of cancer therapy for patients with non-head-and-neck malignancies. Oral Surg Oral Med Oral Pathol. 1988; 65:19–22.

8. Rubenstein EB, Peterson DE, Schubert M, Keefe D, McGuire D, Epstein J, et al. Clinical practice guidelines for the prevention and treatment of cancer therapy-induced oral and gastrointestinal mucositis. Cancer. 2004; 100:2026–2046.

9. Loe H. The gingival index, the plaque index and the retention index systems. J Periodontol. 1967; 38:610–616.

10. Choi SE, Kim HS. Reliability and validity of patient self-reported daily questionnaire on oral Mucositis in acute leukemic patients under chemotherapy. J Korean Biol Nurs Sci. 2010; 12:148–156.

11. Sciubba JJ, Goldenberg D. Oral complications of radiotherapy. Lancet Oncol. 2006; 7:175–183.

12. Naidu MU, Ramana GV, Rani PU, Suman A, Roy P. Chemotherapy-induced and/or radiation therapy-induced oral mucositis-complicating the treatment of cancer. Neoplasia. 2004; 6:423–431.

13. Vanhoecke B, De Ryck T, Stringer A, Van de Wiele T, Keefe D. Microbiota and their role in the pathogenesis of oral mucositis. Oral Dis. 2015; 21:17–30.

14. Avila M, Ojcius DM, Yilmaz . The oral microbiota: living with a permanent guest. DNA Cell Biol. 2009; 28:405–411.

15. Elting LS, Cooksley CD, Chambers MS, Garden AS. Risk, outcomes, and costs of radiation-induced oral mucositis among patients with head-and-neck malignancies. Int J Radiat Oncol Biol Phys. 2007; 68:1110–1120.

16. Rose-Ped AM, Bellm LA, Epstein JB, Trotti A, Gwede C, Fuchs HJ. Complications of radiation therapy for head and neck cancers: the patient's perspective. Cancer Nurs. 2002; 25:461–467.

17. McGuire DB, Fulton JS, Park J, Brown CG, Correa MEP, Eilers J, et al. Systematic review of basic oral care for the management of oral mucositis in cancer patients. Support Care Cancer. 2013; 21:3165–3177.

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