Quality of life, mucositis, and xerostomia from radiotherapy for head and neck cancers: A report from the NCIC CTG HN2 randomized trial of an antimicrobial lozenge to prevent mucositis

Duncan, Graeme; Epstein, Joel B.; Tu, Dongsheng; Sayed, Suhail I.; Bezjak, Andrea; Ottaway, J.; Pater, Joe

doi:10.1002/hed.20162

Cited by 138 publications

(94 citation statements)

References 55 publications

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“…Therefore, the treatment type and the time point of assessment seem to be the crucial factors to consider when evaluating dose tolerance limits for the oral mucosa. Similar to previous studies,27, 28, 29 items assessing GH and QOL were poorly correlated OM‐related item.…”

Section: Discussionsupporting

confidence: 87%

Feasibility of optimizing intensity‐modulated radiation therapy plans based on measured mucosal dose adjacent to dental fillings and toxicity outcomes

Seol

Aggarwal

Eyben

et al. 2018

J Applied Clin Med Phys

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We prospectively investigated the feasibility of IMRT treatment plan optimization based on dosimeter measurements of lateral tongue mucosal dose adjacent to the dental fillings and evaluated dose‐toxicity relationship and factors affecting oral mucositis (OM) in head and neck cancer patients. Twenty‐nine head and neck cancer patients with metallic dental fillings who were scheduled to undergo fractionated external beam radiation therapy (RT) ± chemotherapy were enrolled. The lateral tongue dose was measured and if the calculated dose for the entire treatment was ≥35 Gy, a re‐plan was generated to reduce the lateral tongue mucosal dose. OM was graded weekly according to Common Terminology Criteria for Adverse Events version 4.0 and the patients completed the Oral Mucositis Weekly Questionnaire‐Head and Neck Cancer. The result showed that it was not feasible to optimize the IMRT plan based on measured tongue dose in most of the patients who needed re‐plan as re‐planning compromised the target coverage in 60% of these patients. The duration of grade (Gr) 2 OM was correlated with measured lateral tongue dose (P = 0.050). Concurrent cetuximab was significantly associated with faster onset of Gr2 OM than concurrent cisplatin (P = 0.006) and with longer duration of OM (P = 0.041) compared to concurrent cisplatin or IMRT‐alone. The pattern of reported pain over time was significantly different for each treatment type (RT and cetuximab, RT and cisplatin and RT‐alone) and depending on the dose level (P = 0.006). In conclusion, optimizing the IMRT plan based on measured lateral tongue dose was not feasible. Measured lateral tongue dose was significantly correlated with longer duration of OM ≥Gr2, and concurrent cetuximab was associated with earlier onset and longer duration of OM ≥Gr2.

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Section: Discussionsupporting

confidence: 87%

Feasibility of optimizing intensity‐modulated radiation therapy plans based on measured mucosal dose adjacent to dental fillings and toxicity outcomes

Seol

Aggarwal

Eyben

et al. 2018

J Applied Clin Med Phys

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“…It can also lead to mucositis, tongue fissures, dysgeusia, difficulty speaking, halitosis, oral soreness and burning, inability to wear dentures, and difficulty chewing and swallowing, culminating in a decreased quality of life. 82,83 Xerostomia is the subjective complaint of dry mouth that usually reflects a decreased presence of saliva. 79 …”

Section: 72mentioning

confidence: 99%

Oral complications of cancer and cancer therapy

Epstein

Thariat

Bensadoun

et al. 2012

CA A Cancer J Clinicians

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431

356

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Answer questions and earn CME/CNEOral complications resulting from cancer and cancer therapies cause acute and late toxicities that may be underreported, underrecognized, and undertreated. Recent advances in cancer treatment have led to changes in the incidence, nature, and severity of oral complications. As the number of survivors increases, it is becoming increasingly recognized that the aggressive management of oral toxicities is needed to ensure optimal long‐term oral health and general well‐being. Advances in care have had an impact on previously recognized oral complications and are leading to newly recognized adverse effects. Here, the authors briefly review advances in cancer therapy, including recent advances in surgery, oral care, radiation therapy, hematopoietic cell transplantation, and medical oncology; describe how these advances affect oral health; and discuss the frequent and/or severe oral health complications associated with cancer and cancer treatment and their effect upon long‐term health. Although some of the acute oral toxicities of cancer therapies may be reduced, they remain essentially unavoidable. The significant impact of long‐term complications requires increased awareness and recognition to promote prevention and appropriate intervention. It is therefore important for the primary oncologist to be aware of these complications so that appropriate measures can be implemented in a timely manner. Prevention and management is best provided via multidisciplinary health care teams, which must be integrated and communicate effectively in order to provide the best patient care in a coordinated manner at the appropriate time. CA Cancer J Clin 2012. © 2012 American Cancer Society.

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“…Despite that, RT used in HNC that does not target salivary glands has lesser damage and also, in a study made by Henson et al, contralateral glands are preserved at 1 year post-RT [46]. Duncan et al performed a randomized trial that suggested antimicrobial lozenge did not impact QOL, however notes that the side effects of RT are mostly oral pain in more than 90% of HNC patients, fatigue and increased dry mouth syndrome (DMS) [47,48].…”

Section: Quality Of Lifementioning

confidence: 99%

Head and Neck Cancer Patients’ Quality of Life

et al. 2014

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Patients suffering from head and neck cancers often require a multidisciplinary approach before and after surgery. Restoration of facial esthetics, speech, mastication and others often requires a long-lasting, divided rehabilitation. Quality of life (QOL) is measurable in a patient's life before and after surgery and complete treatment. The state of QOL has different parameters depending on the patient's clinical diagnosis, type of treatment and surgeries performed. In this paper, the authors are focusing on the quality of life of patients suffering from head and neck cancers and a proper multidisciplinary approach to achieving proper functions will be described. Also, the patient's self-esteem improvement and psychological evaluation is necessary (Adv Clin Exp Med 2014, 23, 6, 1019-1027).

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Quality of life, mucositis, and xerostomia from radiotherapy for head and neck cancers: A report from the NCIC CTG HN2 randomized trial of an antimicrobial lozenge to prevent mucositis

Abstract: This study highlights the benefits of combining the EORTC QLQ-30 with an "oral" TSC in a randomized controlled trial and provides valuable baseline data for their use with an objective mucositis scoring system.

Cited by 138 publications

References 55 publications

Feasibility of optimizing intensity‐modulated radiation therapy plans based on measured mucosal dose adjacent to dental fillings and toxicity outcomes

Feasibility of optimizing intensity‐modulated radiation therapy plans based on measured mucosal dose adjacent to dental fillings and toxicity outcomes

Oral complications of cancer and cancer therapy

Head and Neck Cancer Patients’ Quality of Life

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