Impact of radiotherapy to the head and neck region on the oral condition
Keywords:Radiotherapy; Oral Health; Head and Neck Neoplasm.
Investigations of the oral function of patients undergoing radiotherapy (RT) to the head and neck region are relevant for the overall quality of life. Considering the possible impact of the side-effects on nutrition, the recovery of these patients might be impaired. This study aimed at investigating the oral condition of patients submitted to RT to the head and neck region. A single-center, cross-sectional mixed analysis assessing the oral conditions of patients before RT (group 1) and after 12-months of RT (group 2) was performed. Following inclusion and exclusion criteria consideration, fifty (n=25) patients were included in this study. A calibrated examiner conducted the oral examination, the following variables were assessed: a) DMF index: decayed, missing and filled teeth; b) xerostomia and dysgeusia, subjective assessment of salivary function and taste; c) simplified oral hygiene index – OHI-S, with plaque disclosing solution; d) unstimulated sialometry, assessment of salivary function. Statistical analysis compared the groups considering a significance level of 5%. The group evaluated after 12 months of RT showed high rate of dry mouth (92%) and dysgeusia complaint (72%) while no patient reported in group 1. Statistically significant difference was observed in the comparison of group 1 and 2 regarding DMF index (> 64%), OHI-S index (>38%), and unstimulated sialometry (<70%). Patients submitted to RT to the head and neck region for the treatment of cancer experience oral complications even at 12 months after the last session of RT.
Aamod, D. S., Peter, V., Per, K., Dinesh, N. (2020). Prevalence and Incidence of Oral Cancer in Low- And Middle-Income Countries: A Scoping Review. Eur J Cancer Care, 29(2): e13207.
Ana, A., Božana, L., Vanja, V., Vlaho, B., Maja, M. (2017). Oral complications of head and neck irradiation. Libri Oncol, 45(2-3):89–93.
Bruno, C., Addah, R. (2006). Oral complications of radiotherapy in the head and neck. Braz J Otorhinolaryngol, 72(5): 704-8.
Buglione, M., Cavagnini, R., Di Rosario, F., et al. (2016). Oral toxicity management in head and neck cancer patients treated with chemotherapy and radiation: Dental pathologies and osteoradionecrosis (Part 1) literature review and consensus statement. Crit Rev Oncol Hematol, 97: 131–42.
Corvò, R., Amichetti, M., Ascarelli, A., et al. (2008). Effects of fluconazole in the prophylaxis of oropharyngeal candidiasis in patients undergoing radiotherapy for head and neck tumour: results from a double-blind placebo-controlled trial. Eur J Cancer Care (Engl),17(3): 270-7.
Dirix, P., Nuyts, S. (2010). Evidence-based organ-sparing radiotherapy in head and neck cancer. Lancet Oncology, 11(1): 85-91.
Elerson, G., Ellen, C., Christiane, M., et al.. (2018). Supragingival and subgingival microbiota from patients with poor oral hygiene submitted to radiotherapy for head and neck cancer treatment. Arch Oral Biol, 90: 45-52.
Epstein, J. B., Smutzer, G., Doty, R. L. (2016) Understanding the impact of taste changes in oncology care. Support Care Cancer, 24(4):1917-31.
Ferlay, J., Ervik, M., Lam, F., et al.. (2018) Global Cancer Observatory: Cancer Today. Lyon, France: International Agency for Research on Cancer.
Jacqui, F., Rhys, H., Jemma, S. (2020) The Prevalence of Patient-Reported Dysphagia and Oral Complications in Cancer Patients. Support Care Cancer, 28(3):1141-1150.
Janaine, S., Karen, S. N., Ana Paula, N. G. (2014). Oral complications in patients receiving head and neck radiation therapy: a literature review. Rev Gaúch Odontol, 62(4): 395-400.
Jensen, S. B., Pedersen, A. M., Vissink, A., et al. (2010). A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: Management strategies and economic impact. Support Care Cancer, 18(8): 1061-1079.
Jin, H., HuiMin, Z., Pan, L., et al. (2018) Distinct shifts in the oral microbiota are associated with the progression and aggravation of mucositis during radiotherapy. Radiother Oncol, 129(1): 44-51.
Joel, B., Safira, M., Geena, L., Jorge, H., et al.. (2019) Taste disorders following cancer treatment: report of a case series. Support Care Cancer, 27(12):4587-4595.
José, L. B. S., Richard, L. D., João, V. M. K. M., et al.. (2019). Gustatory Disturbances Occur in Patients With Head and Neck Cancer Who Undergo Radiotherapy Not Directed to the Oral Cavity. Oral Oncol, 95:115-119.
Kaae, J. K., Johnsen, L., Hansen, C. R., et al.. (2019) Relationship Between Patient and Physician-Rated Xerostomia and Dose Distribution to the Oral Cavity and Salivary Glands for Head and Neck Cancer Patients After Radiotherapy. Acta Oncol, 58(10):1366-1372.
Karthika, N. (2015) Chemo-radiotherapy Induced Oral Mucositis During IMRT for Head and Neck Cancer - An Assessment. Med Oral Patol Oral Cir Bucal, 20(3):e273-7.
Landis, J. R., Koch, G. G. (1977) The measurement of observer agreement for categorical data. Biometrics, 33:159‐74.
Nan, J., Yue, Z., Henrik, J., et al.. (2018) Experiences of xerostomia after radiotherapy in patients with head and neck cancer: A qualitative study. J Clin Nurs. 2018;27(1-2):e100-e108..
PDQ Screening and Prevention Editorial Board. (2020) Oral Cavity, Pharyngeal, and Laryngeal Cancer Prevention (PDQ®): Health Professional Version In: PDQ Cancer Information Summaries. Bethesda: National Cancer Institute (US).
Pfister, D. G., Spencer, S., Brizel, D. M., et al. (2015). Head and Neck Cancers, Version 1. J Natl Compr Canc Netw, 2015 13(7): 847–55.
Pierfrancesco, F., Stefania, M., Jacopo, D. M., et al.. (2017). Prospective assessment of oral mucositis and its impact on quality of life and patient-reported outcomes during radiotherapy for head and neck cancer. Med Oncol. 2017;34(5):81.
Punita, L., Vipul, N., Mranalini, V., et al.. (2018) Objective and Subjective Assessment of Xerostomia in Patients of Locally Advanced Head-And-Neck Cancers Treated by Intensity-Modulated Radiotherapy. J Cancer Res Ther, 14(6):1196-1201.
Rajesh, V. L., Nathaniel, T., Thomas, S., et al.. (2017) Oral Complications at 6 Months After Radiation Therapy for Head and Neck Cancer. Oral Dis. ;23(8):1134-1143.
Sciubba, J.J ., Goldenberg, D. (2006) Oral complications of radiotherapy. Lancet Oncology. 2006;7:175-183.
Spencer, W., Marta, C., William, R., et al.. (2004) Candida glabrata is an emerging cause of oropharyngeal candidiasis in patients receiving radiation for head and neck cancer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 97(1): 47-52.
Victor, W. (2002). The Epidemiology of Oral and Pharynx Cancer in Brazil. Oral Oncol, 38(8):737-46.
How to Cite
Copyright (c) 2020 Yuri Barbosa Alves; Paula Cristina Henriques da Silva; Gabriel Garcia de Carvalho; José Manuel Peixoto Caldas; Heloisa Helena Pinho Veloso
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
1) Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
2) Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
3) Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.