Impact of oral mucositis on quality of life in patients undergoing oncological treatment: a systematic review

Abstract

Oral mucositis (OM) is one of the most prominent side effects of cancer treatment and is believed to have a significant impact on the quality of life (QoL) of the affected patients. However, measurements for the investigation of OM is plagued by heterogeneity in symptoms that varies with the type of cancer or the treatment. We aimed to carry out a qualitative assessment of the current evidence on the impact of OM on QoL in patients undergoing oncologic treatment. A systematic search for studies evaluating the impact of OM on QoL was performed in MEDLINE and Embase databases from inception to December 2018 using the MeSH terms for the keywords “Antineoplastic”, “Stomatitis”, and “Quality of life”. Studies were initially assessed based on the selection criteria and underwent a selection process based on the title and abstract followed by a full text review. Data extraction was performed into a standardized data collection form to collect data pertaining to the author/year, study design, study characteristics, mucositis assessment, QoL assessment and results. A qualitative assessment was performed. A total of 459 articles were selected after removal of duplicates. Following the full text review, only ten articles qualified for the systematic review based on the selection criteria. Several studies have identified a correlation between the severity of mucositis and reduction in QoL. The impact of OM on QoL extend beyond the local oral complications and has been shown to affect the physical, emotional, and psychological functional domains. However, heterogeneity in the study parameters and evaluation (cancer types, treatment regimens, chosen time points (during or after therapy) and the instruments used for QoL measurements) does not permit a robust assessment of the impact of OM on QoL. A standardized approach to the measurement of oral mucositis and evaluation of QoL is required to enhance the utility of QoL data in patients afflicted with oral mucositis following cancer treatment.

Efficacy of Photobiomodulation in the Treatment of Cancer Chemotherapy-Induced Oral Mucositis: A Meta-Analysis with Trial Sequential Analysis

“…The MASCC/ISOO guidelines recommend informing the patients of this risk, despite the contradicting evidence regarding the risk of developing a malignancy secondary to PBM [ 39 ]. Long-term follow-up is also recommended to evaluate the risk of relapse and overall survival of the patient [ 40 ]. Additional limitations of PBM include the high price of the laser machines and the need for regular maintenance and personnel training.…”

Efficacy of Oral Cryotherapy in the Prevention of Oral Mucositis Associated with Cancer Chemotherapy: Systematic Review with Meta-Analysis and Trial Sequential Analysis

“…In subjects undergoing radiotherapy with or without concomitant chemotherapy for head and neck malignancies, the incidence of oral mucositis is higher than 90% [3][4][5]. OM can significantly affect nutritional status, oral hygiene and quality of life [6]. For those patients receiving chemotherapy prior to BMT, OM has been found to be the single most debilitating complication [7].…”

Experiences of patients who developed oral mucositis during solid neoplasms treatment: a Ugandan qualitative study

“…On the other hand, globally patient-reported outcomes measures have increasingly taken center stage [ 13 ], and as such mucositis has not been left behind. The effect of mucositis on the different aspects of the quality of life has been well documented albeit to varying degrees [ 14 ]. However, studies with a qualitative angle are still few and in most cases have insufficient power.…”