Oral mucositis (OM) can be a significant problem for patients undergoing radiation or chemoradiation for head and neck cancer. In modern clinical trials, grade 3-4 OM can be seen in over 40% of patients and can cause a significant impact on their quality of life (QOL). Despite this fact, strategies for the prevention and treatment of OM vary widely, with options including both lifestyle modifications and pharmaceuticals. Here we evaluate and summarize the current clinical interventions for the management of radiation-induced OM. The majority of the current evidence focuses on reducing OM related pain.These agents are detailed over multiple clinical trials including treatment modalities such as: GC4419, doxepin mouthwash, diphenhydramine-lidocaine-antacid (DLA) mouthwash, gabapentin, and methadone.While several strategies have been employed to prevent radiation-induced OM, there is currently no strong evidence for the routine use of these agents in the clinic. After summarization of these treatments, we offer practical guidance for the treatment of OM in the clinic. We recommend a multiagent approach of pharmacological and non-pharmacological treatments including oral rinses, home humidification, escalating doses of gabapentin, doxepin or DLA mouthwash, over the counter analgesics, and lastly methadone. These interventions are tailored to address the expected increase of severity of symptoms during the course of head and neck radiotherapy.

Background: The SARS-CoV-2 pandemic introduced a dangerous distraction effect in all aspects of oncological patients' care. The aim of this research was to explore the effect of the pandemic on the efficacy of the largest molecular diagnostics centre for cancer patients and high-risk individuals in Serbia (IORS).

No abstract

Methods: Unicentric, cross-sectional survey conducted on cancer patients with a solid malignancy under chemotherapy, targeted agents or immunotherapy, between March and April 2021. Results:We included 169 patients (109 female; 60 male) with a median age of 61 years old (29-82). More than half (n¼105; 62.1%) had a lower literacy degree, 97 (57.4%) lived in the countryside. The majority of the patients were receiving palliative treatment (n¼87; 51.5%). Most of the patients intended to be vaccinated (n¼142, 84.0%), 24 (14.2%) were unsure and 3 (1.8%) did not. All the negative answers were given by patients receiving palliative treatment. Logistic regression analysis revealed that high school qualification (p¼0.007), divorced status (p¼ 0.037), rural residence (p¼0.047), and believing in the vaccine (p¼0.001), had a statistically significant effect on the probability of the patients wanting to be vaccinated. The most frequent reasons for wanting to be vaccinated were the sense of collective responsibility and the fear of having severe disease. The most frequent reasons for not wanting to be vaccinated were the lack of evidence and the wish to wait for the end of treatment. The need for more information on effectiveness and safety were the main reasons for uncertainty related to the vaccine.Conclusions: Despite the lack of information regarding efficacy, duration of immunity and timing of vaccination in cancer patients under immunosuppressive therapy, this study demonstrated that the majority of patients intend to be vaccinated against COVID-19. These results were related to residence type, literacy and belief in the effectiveness of the vaccine. The higher acceptance rate in our study when compared with other studies must be noted.Legal entity responsible for the study: M.J.P. de Sousa.

Background:The COVID pandemic has forced organisations to adapt to restrict spread of the virus while continuing to function. Oncology Clinical Nurse Specialists (CNS) have been forefront in these endeavours, often below the radar, ensuring coordination and administration of complex care. Nursing / Midwifery National Planning & Development Unit funding was awarded for a "task versatile" (tv) CNS in 2019 to focus on non ED direct access to a CNS. The key areas of this analysis were telephone triage and the ability of tvCNS COVID screening pre-chemotherapy visits to maintain a safe environment.Methods: Changes in primary roles of individual oncology CNS posts were recorded for 1/20 to 12/20. Data on the activity of the varied adaptive roles of the CNS were captured from the hospital information systems. All patients attending for chemotherapy were contacted 24 hours prior to their planned visit for chemotherapy to screen for COVID symptoms. Patients on arrival for chemotherapy were screened again prior to being allowed up to the chemotherapy unit. Those with concerning COVID symptoms were referred for COVID testing. Activity numbers were recorded by the tvCNS.Results: Nurse-lead telephone triage (NLTT) was assessed from 1/20 to 12/20. From the outbreak of COVID on 1/3/20 the "tv"CNS moved from the NLTT to that of COVID screening / risk reduction. A new CNS was appointed to continue NLTT. Of the 1837 telephone calls received requesting help from 1/20 to 12/20, 93% were resolved by the triage nurse, with only 121 cases attending the ER. In that time period 1304 individual patients made 11606 attendances to the oncology day unit for treatment. From 3/20 to 12/20 COVID pre-screening was performed for 10,417 patient visits. Screening was performed by phone the day before attendance, and on arrival on the day of planned treatment. 133 patients required COVID swab in view of symptoms. No day unit linked outbreaks of COVID occured. Conclusions:The COVID pandemic has demonstrated that versatility is essential in adjusting to the ever-changing scenarios which arise during peaks and troughs of COVID outbreaks. The broad skill mix within specialist oncology nursing were key to such adaptations, allowing continued availability of essential anti-cancer therapies.Legal entity responsible for the study: The authors.