Cohort study of oncologic emergencies in patients with head and neck cancer

Reyes‐Gibby, Cielito C.; Melkonian, Stephanie C.; Hanna, Ehab Y.; Yeung, Sai Ching Jim; Lu, Charles; Chambers, Mark S.; Banala, Srinivas R.; Gunn, G. Brandon; Shete, Sanjay

doi:10.1002/hed.24748

Cited by 20 publications

(16 citation statements)

References 36 publications

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“…Fungal and virus infections in the oral cavity are common in immunocompromised patients [10,25,26]. Similarly, our results showed a prevalence of 5.6 and 5.1% for oral candidiasis and oral herpes simplex, respectively; while in previously published retrospective studies evaluating oncologic inpatients, the incidences ranged from 16.6 to 39.1% [3,[9][10][11].…”

Section: Discussionsupporting

confidence: 85%

Dental treatment needs in hospitalized cancer patients: a retrospective cohort study

Oliveira

Martins

Santos‐Silva

et al. 2019

Support Care Cancer

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Purpose The objectives of this study were to describe the distribution and the clinicopathological features of the most common causes for dental treatment needs during the hospitalization of cancer patients. Methods A retrospective cohort study of 2664 hospitalized cancer patients that analyzed the main dental treatment needs and dental procedures performed from January 2010 to December 2017. Results A total of 2664 medical patients were included in this study. Non-Hodgkin lymphoma (17.2%) was the most common cancer type, followed by leukemia (14.8%), and oral and oropharyngeal squamous cell carcinoma (10.5%). The most common reasons for patients' hospitalization were chemotherapy protocols (18.8%), monitoring head and neck surgeries (9.7%), and febrile neutropenia (9.6%). The main motivation for the medical team to request dental evaluation was oral mucositis (22.8%) followed by oral pain or toothache (10.8%) and fungal, viral oral infections or traumatic oral lesions (9.9%). The dental treatment needs most observed were pain due to oral mucositis (17%), dental treatment prior to radiotherapy (RT), chemotherapy (CT) or bisphosphonate therapy (BP) (10.8%), teeth extractions (6.5%), and prophylactic photobiomodulation therapy (6.3%), whereas the most common dental treatments performed were oral hygiene protocols (30.2%), photobiomodulation therapy (prophylactic and curative) (21.7%), and dental treatment prior to cancer treatment initiation (RT, CT, and BP) (9.5%). Conclusion This study can be considered original in the oncologic context, providing new information about the most frequent dental treatment needs among a large population of hospitalized cancer patients.

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Section: Discussionsupporting

confidence: 85%

Dental treatment needs in hospitalized cancer patients: a retrospective cohort study

Oliveira

Martins

Santos‐Silva

et al. 2019

Support Care Cancer

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“…The visits to ED have been found to be associated with the presence of comorbidities, advanced stage of the disease, and chemoradiation. [57] Another study found chemotherapy to be associated with unplanned admissions. [8] This could be because of decreased blood counts and higher risks for infections.…”

Section: Discussionmentioning

confidence: 99%

Emergency department visits by head-and-neck cancer patients

Malik

Sukumar

Pai

et al. 2019

Indian J Palliat Care

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Aim:This study was conducted to assess the disease status of head-and-neck cancer patients visiting the emergency department (ED) and their reason for presentation. We wanted to analyze if these visits could be avoided by incorporating any changes in our clinical practice.Methods:This was a retrospective analysis of head-and-neck cancer patients attending the ED at a tertiary care cancer center in 2017. Clinical details were noted from the electronic medical records, and descriptive statistics was calculated. The analysis was performed using SPSS version 21 software.Results:Three hundred and thirty-nine head-and-neck cancer patients attended the ED. Of these, 80.2% were males and 48.1% of patients had oral cavity cancers. About 37.2% required palliative care treatment. Nearly, 47.2% of patients presented during their initial evaluation period. About 22.7% required hospital admission and only 14.7% required any sort of emergency intervention.Conclusion:Majority of visits to ED could have been avoided with better counseling of the patients and their attendants.

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“…OM interferes with oral intake and can lead to a reduction in the treatment dose, unplanned hospitalizations (which increase the cost of care), breaks in the treatment regimen, 1,4,5 a reduced quality of life, and an impact on overall survival. Subsequent emergency department visits for OM‐related complaints are common, and they persist as a chief complaint for 15% to 23% of patients across emergency department visits 6 . Standard treatment for OM focuses on pain control, rehydration, and oral hygiene.…”

Section: Introductionmentioning

confidence: 99%

Oral microbiome and onset of oral mucositis in patients with squamous cell carcinoma of the head and neck

Reyes‐Gibby

Wang

Zhang

et al. 2020

Cancer

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Background Oral mucositis (OM) is a debilitating sequela for patients treated for squamous cell carcinoma of the head and neck (HNSCC). This study investigated whether oral microbial features before treatment or during treatment are associated with the time to onset of severe OM in patients with HNSCC. Methods This was a cohort study of newly diagnosed patients with locoregional HNSCC who received chemotherapy with or without radiotherapy from April 2016 to September 2017. OM was based on the National Cancer Institute's Common Terminology Criteria for Adverse Events, version 4.0. The oral microbiome was characterized on the basis of the 16S ribosomal RNA V4 region with the Illumina platform. A mixture cure model was used to generate hazard ratios for the onset of severe OM. Results Eighty‐six percent of the patients developed OM (n = 57 [33 nonsevere cases and 24 severe cases]) with a median time to onset of OM of 21 days. With adjustments for age, sex, and smoking status, genera abundance was associated with the hazard for the onset of severe OM as follows: 1) at the baseline (n = 66), Cardiobacterium (P = .03) and Granulicatella (P = .04); 2) immediately before the development of OM (n = 57), Prevotella (P = .03), Fusobacterium (P = .03), and Streptococcus (P = .01); and 3) immediately before the development of severe OM (n = 24), Megasphaera (P = .0001) and Cardiobacterium (P = .03). There were no differences in α‐diversity between the baseline samples and Human Microbiome Project data. Conclusions Changes in the abundance of genera over the course of treatment were associated with the onset of severe OM. The mechanism and therapeutic implications of these findings need to be investigated in future studies.

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Cohort study of oncologic emergencies in patients with head and neck cancer

Cited by 20 publications

References 36 publications

Dental treatment needs in hospitalized cancer patients: a retrospective cohort study

Dental treatment needs in hospitalized cancer patients: a retrospective cohort study

Emergency department visits by head-and-neck cancer patients

Oral microbiome and onset of oral mucositis in patients with squamous cell carcinoma of the head and neck

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