Confounding factors in the assessment of oral mucositis in head and neck cancer

Abstract

Treatment of locally advanced head and neck carcinoma not amenable for surgical resection or resected with high-risk features is usually based on (chemo-)radiation treatment. Oral mucositis represents one of the main side effects of (chemo-)radiation, with an important impact on quality of life and causing approximately 20% of early interruption of treatment, leading to a suboptimal dose administered. Treatment and prevention of oral mucositis have a central role in the therapeutic pathways of head and neck cancer patients but remains quite challenging. Although extensive research is conducted to identify interventions for the management of mucositis, very few interventions had sufficient evidence to generate an international expert consensus. This may be partially explained by confounding factors that could influence the development and assessment of oral mucositis. Little is known about the confounding factors of oral mucositis, which, if not well balanced in an experimental study, could lead to non-solid results. The current paper aims to review the main oral mucositis confounding factors related to head and neck cancer patients.

Oral mucositis & oral health related quality of life in women undergoing chemotherapy for breast cancer in Karachi, Pakistan: A multicenter hospital based cross-sectional study

“…The mean age of the patients was similar 47.87±1.18 for the OM group and 47.36±1.25 for the patients without OM. As most of the women were of middle age our results were inconsistent with the previous literature as suggested by Lorini L et al that the risk developing OM is high in young age due to a faster rate of cell regeneration and also in old age due to a slower pace of healing process [ 13 ]. Our results showed that 60.2% of the patients who developed OM were of low socio-economic status and 58.3% of the patients from low socio-economic status did not develop OM.…”

Evidence summary on managing radiotherapy-induced oral mucositis in patients with head and neck cancer

“…Treatment-related factors include radiation dose, technique, and site, etc. 27 A study 28 showed that compared with older patients (> 58 years), higher incidences and severity of OM in head and neck cancer after radiotherapy were observed in young patients (< 45 years). However, Merlano et al.…”

Oral Complications from Oropharyngeal Cancer Therapy

“…The pathogenesis of mucositis is multifactorial, involving the interaction of various cellular and molecular events triggered by cancer treatments. A recent review summarized individual characteristics associated with the severity of oral mucositis induced by chemotherapy or radiation, including age, gender, oral hygiene status, salivary gland function, physiological parameters, and genetic characteristics [ 15 ]. A comprehensive exploration of the molecular pathogenesis of oral mucositis is beyond the scope of the current paper, but several recent reviews have elucidated advancements in our understanding of this topic [ 16 , 17 ].…”