Correlation Between Saliva Production and Quality of Life Measurements in Head and Neck Cancer Patients Treated With Intensity-Modulated Radiotherapy

Scrimger, Rufus; Kanji, Aliyah; Parliament, Matthew; Warkentin, Heather; Field, Colin; Jha, Naresh; Hanson, John

doi:10.1097/01.coc.0000258081.70643.3d

Cited by 54 publications

(26 citation statements)

References 20 publications

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“…This apparent therapeutic gain with IMRT was even more pronounced at 1 year, where the rates of G-tube dependence were 33% and 0% among patients treated by CRT and IMRT, respectively. These findings are consistent with those of others showing that xerostomia is the predominant factor contributing to health-related morbidity in the late setting after radiation therapy (17,18). In the only randomized study comparing CRT vs. IMRT published to date, the incidence of observer-rated severe xerostomia was 39% at 1-year post-treatment compared with 82% among those treated by CRT (19).…”

Section: Discussionsupporting

confidence: 91%

Improved Dosimetric and Clinical Outcomes With Intensity-Modulated Radiotherapy for Head-and-Neck Cancer of Unknown Primary Origin

Chen

Farwell

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

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Section: Discussionsupporting

confidence: 91%

Improved Dosimetric and Clinical Outcomes With Intensity-Modulated Radiotherapy for Head-and-Neck Cancer of Unknown Primary Origin

Chen

Farwell

et al. 2011

International Journal of Radiation Oncology*Biology*Physics

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“…This has also been described before with the combined use of different quality-of-life questionnaires. 49,50 When interpreting this data, a pitfall has to be pointed out: Even though nine study centers have worked together in the data collection process, the majority of patients came from Germany. However, on comparing summary scores among the study centers, there was no systematic difference between German and non-German study centers.…”

Section: Discussionmentioning

confidence: 99%

Assessment of functioning in patients with head and neck cancer according to the International Classification of Functioning, Disability, and Health (ICF): A multicenter study

et al. 2009

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“…The extent to which oral cGVHD is a contributor to these impairments is unknown. Xerostomia induced by radiation therapy has a significant negative impact on HRQL in patients with head and neck cancer (32, 33, 34) and lymphoma (35, 36). However, the relationship between oral cGVHD-related symptoms and HRQL has not been examined.…”

Section: Introductionmentioning

confidence: 99%

Oral Symptom Intensity, Health-Related Quality of Life, and Correlative Salivary Cytokines in Adult Survivors of Hematopoietic Stem Cell Transplantation with Oral Chronic Graft-versus-Host Disease

Fall‐Dickson

Mitchell²,

Marden

et al. 2010

Biology of Blood and Marrow Transplantation

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Oral chronic graft-versus-host disease (cGVHD) is a frequent, clinically significant sequela of allogeneic hematopoietic stem cell transplant (HSCT). This study was designed to elucidate relationships among clinical characteristics of oral cGVHD and related oral pain and oral dryness, salivary proinflammatory cytokine IL6 and IL1α concentrations, and health-related quality of life (HRQL). An understanding of the characteristics and correlates of oral cGVHD manifestations and related symptoms such as dryness is fundamental to the development of therapeutic interventions. Methods: Oral cGVHD severity was assessed with the Oral Mucositis Rating Scale (OMRS). Oral pain and perceived oral dryness intensity were self-reported via a visual analogue scale and a numeric rating scale respectively. HRQL was assessed with the Functional Assessment of Cancer Therapy-General (FACT-G). Salivary IL1α and IL6 concentrations were measured by enzyme-linked immunosorbent assay (R & D Systems, Minneapolis, MN). Results: All 42 adult subjects (male 59%) had clinician-assessed oral cGVHD by OMRS scale (mean = 18.38 ± 12.99; range = 2 to 46). Oral dryness (43%) (mean = 2.56 ± 3.45; range = 0 to 10) was more prevalent than oral pain (8%) (mean = 0.13 ± 0.47). Salivary IL6 was associated with oral cGVHD severity (r = .49; p < .01), oral ulceration (r = .38; p = .04), and erythema (r = .63; p < .01). FACT-G total, and physical and emotional well-being subscale scores were meaningfully lower than US population normative values. Participants with more severe oral cGVHD manifestations had significantly inferior social/family well-being (r = −.49; p < .01). Oral dryness was associated with higher salivary IL1α (r = .41; p = .04), and controlling for cGVHD severity, with lower health-related quality of life (r = −.41; p = .03). Subjects with moderate to severe oral dryness tended to report the poorest overall HRQL. This study provides preliminary evidence of the relationship between oral dryness and HRQL, the contribution of oral cGVHD to inferior HRQL, and the association between IL6 and oral cGVHD overall severity, ulceration and erythema. The high prevalence of oral dryness and its relationship to HRQL in a sample of patients with oral cGVHD underscores the importance of improving our evaluation and management of this symptom in long-term survivors of allogeneic HSCT. The positive association seen between IL6 and oral sGVHD overall severity, and erythema, as well as the positive trend seen with oral ulceration, warrant further exploration of this cytokine as a potential biomarker of active oral cGVHD.

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Correlation Between Saliva Production and Quality of Life Measurements in Head and Neck Cancer Patients Treated With Intensity-Modulated Radiotherapy

Abstract: Patients with HNC treated with IMRT experienced a small drop in QOL which recovered to baseline by 12 months post-RT. There was no statistically significant correlation seen between global health-related QOL scores and stimulated saliva production rates in the post-RT period.

Cited by 54 publications

References 20 publications

Improved Dosimetric and Clinical Outcomes With Intensity-Modulated Radiotherapy for Head-and-Neck Cancer of Unknown Primary Origin

Improved Dosimetric and Clinical Outcomes With Intensity-Modulated Radiotherapy for Head-and-Neck Cancer of Unknown Primary Origin

Assessment of functioning in patients with head and neck cancer according to the International Classification of Functioning, Disability, and Health (ICF): A multicenter study

Oral Symptom Intensity, Health-Related Quality of Life, and Correlative Salivary Cytokines in Adult Survivors of Hematopoietic Stem Cell Transplantation with Oral Chronic Graft-versus-Host Disease

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