Oral and ocular late effects in head and neck cancer patients treated with radiotherapy

Abstract

A broader understanding of oral and ocular late effects in head and neck cancer (HNC) patients who underwent intensity-modulated radiotherapy (IMRT) may provide valuable information in follow-up and improve quality of life. Twenty-nine HNC patients treated at least 6 months earlier and 30 age-matched controls were recruited. After completing several questionnaires: Oral Health Impact Profile-14 (OHIP-14), Shortened Xerostomia Inventory (SXI), Ocular Surface Disease Index (OSDI) and McMonnies Dry Eye questionnaire (MDEQ), participants underwent oral and ocular examinations. Oral examination included clinical oral dryness score (CODS) and secretion rates of unstimulated and stimulated saliva (UWS, SWS). Ocular examination included tear film break-up time, Schirmer test and ocular surface staining. The patients had more problems related to dry mouth than controls based on CODS and SXI, and more complaints of dry eye disease based on OSDI and MDEQ. UWS and SWS rates and oral health related quality of life were significantly lower in the patient group. Subjective oral dryness (SXI) correlated significantly with subjective ocular dryness (OSDI and MDEQ). Our study demonstrates that HNC patients treated with IMRT experience late effects in terms of xerostomia and ocular dryness underlining the importance of interdisciplinary approach in the evaluation and follow-up of HNC patients.

Saliva Metabolomics in Dry Mouth Patients with Head and Neck Cancer or Sjögren’s Syndrome

“…All patients received postoperative radiotherapy (total dose of 50-70 Gy) delivered as 2 Gy per fraction and administered 5-6 times per week. The patient group is fully described in Westgaard et al [18].…”

Cuidados paliativos odontológicos a pacientes com câncer de cabeça e pescoço em Unidades de Terapia Intensiva: uma revisão integrativa da literatura

“…De acordo com Saito et al (2014), o câncer de cabeça e pescoço é o termo utilizado para definir as neoplasias que acometem o trato aero digestivo superior, incluindo as regiões de cavidade oral, faringe, laringe e tireoide. Sobre esses pacientes, Westgaard et al (2021) afirmam em seu estudo que idealmente, os pacientes com neoplasias de cabeça e pescoço são tratados com as terapias antineoplásicas, e que nestas se incluem a radioterapia, quimioterapia e os procedimentos de caráter cirúrgico. Segundo Ledoux et al (2018), nos tratamentos de tumores de cabeça e pescoço, a radioterapia pode ser utilizada isoladamente como o principal método de tratamento, também pode ser usada em combinação com a quimioterapia e pode ser usada como terapia adjuvante após ressecção cirúrgica.…”

“…Com isso, esses pacientes usualmente já foram submetidos pelas terapias antineoplásicas. Essas terapias e o próprio estágio avançado da neoplasia de cabeça e pescoço podem levar aos pacientes a deteriorações progressivas ou repentinas, afirmam, Westgaard et al (2021). Eles também enfatizam que a radioterapia de cabeça e pescoço pode resultar na deterioração da saúde oral, dependendo da localização do tumor e do campo radioterápico.…”

Is There an Interplay between Oral Microbiome, Head and Neck Carcinoma and Radiation-Induced Oral Mucositis?

“…Late complications of RT develop 3 months after completion of RT treatment. The most frequently reported late oral effects include, among others, xerostomia, increased exposure to mucosal infections, pain, sensory disturbances, and dental caries [ 76 ]. Due to vascular and soft tissue damage, atrophy and mucosa vulnerability, there is a risk of chronic ulcers and/or osteoradionecrosis [ 75 ].…”