Assessment of Cancer Therapy-Induced Oral Mucositis Using a Patient-Reported Oral Mucositis Experience Questionnaire

Abstract

ObjectivesTreatment of oral mucositis (OM) is challenging. In order to develop and test useful treatment approaches, the development of reliable, reproducible and simpler methods than are currently available for assessment of OM is important. A Patient-Reported Oral Mucositis Symptom (PROMS) scale was assessed in patients with head and neck cancer to determine if the patient-reported OM experience, as determined by using the PROMS scale, correlate with OM assessed by clinician-based scoring tools.Materials and MethodsFifty patients with head and neck cancer and undergoing radiotherapy consented to participate. They were examined before cancer treatment and twice weekly during 6–7 weeks of therapy and once 4–6 weeks after therapy. Signs of OM were evaluated using the 3 clinician-based scoring tools; NCI-CTCAE v.3, the OMAS criteria and the Total VAS-OMAS. The participants' OM experiences were recorded using PROMS-questionnaires consisting of 10 questions on a visual analogue scale. Spearman rank correlation test were applied between the PROMS scale values and the clinician-determined scores. Repeated measures mixed linear models were applied to appraise the strengths of correlation at the different time points throughout the observation period.ResultsThirty-three participants completed all stages of the study. The participant experience of OM using the PROMS scale demonstrates good correlations (Spearman's Rho 0.65–0.78, p<0.001) with the clinician-determined scores on the group level over all time points and poor to good correlations (Spearman's Rho -0.12–0.70, p<0.001) on the group level at different time points during and after therapy. When mouth opening was problematic, i.e. during the 6th and 7th week after commencing cancer treatment, the Spearman's Rho varied between 0.19 and 0.70 (p<0.001).ConclusionPatient experience of OM, as reported by the PROMS scale may be a feasible substitute for clinical assessment in situations where patients cannot endure oral examinations.

Characteristics and prognosis of primary treatment-naïve oral cavity squamous cell carcinoma in Norway, a descriptive retrospective study

“…Patients with alcohol consumption recorded as seldom in the EHRs were classified as "light drinkers" (� 1 times weekly), whereas those with consumption denoted as current, moderate, heavy, or former alcoholic abuse were classified as "drinkers" (> 1 times weekly or daily) [39,40]. Based on information from the EHR, dental status was categorized as good (no dental treatment needed), need of dental therapy before start of treatment, or edentulous [41]. Cancer treatment described in the EHR was categorized into different groups/combinations of treatment modalities.…”

Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis

“…The scale chosen is based upon the nature of the treatment provided and the potential goal of research and clinical care. The PROMs scale has been evaluated for use in settings where specific oral evaluation is not conducted and addresses mucositis specifically .…”

Measuring oral mucositis of pediatric patients with cancer: A psychometric evaluation of chinese version of the oral mucositis daily questionnaire

“…Patient-reported outcome measure (PROM) has been increasingly recognized as an important approach to assess the extent and impact of oral mucositis. Oral Mucositis Daily Questionnaire (OMDQ),[ 11 ] Oral Mucositis Weekly Questionnaire,[ 12 ] Patient-Reported Oral Mucositis Symptom Scale,[ 13 ] and Children's International Mucositis Evaluation Scale[ 14 ] are the few available PROMs, for which psychometric properties have been established that allow subjective reporting of symptoms and dysfunction associated with cancer therapy-induced oral mucosal toxicity. These oral mucositis-specific PROMs use slightly different criteria and items, and their lengths vary.…”