Matched case–control study of quality of life and xerostomia after intensity-modulated radiotherapy or standard radiotherapy for head-and-neck cancer: Initial report

Jabbari, Siavash; Kim, Hyungjin Myra; Feng, Mary; Lin, Alexander; Tsien, Christina; Elshaikh, Mohamed A.; Terrel, Jeffrey E.; Murdoch‐Kinch, Carol Anne; Eisbruch, Avraham

doi:10.1016/j.ijrobp.2005.02.045

Cited by 160 publications

(88 citation statements)

References 38 publications

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“…Pathogenic modification of the oral flora can also occur, and the risk of dental caries increases (16). Xerostomia appears early from the second week after the start of radiotherapy, and may prove irreversible (17). In our series, 33.3% of the irradiated patients e�perienced �erostomia, though to a lesser degree than at the end of oncological treatment.…”

Section: Discussionmentioning

confidence: 61%

Dental implications in oral cancer patients

et al. 2011

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Objectives. A study is made of the dental implications of oral cancer, with a view to avoiding the complications that appear once oncological treatment is started. Patients and Methods. The study comprised a total of 22 patients diagnosed with oral cancer according to clinical and histological criteria in the Service of Ma�illofacial Surgery (Dental Clinic of the University of Barcelona, Spain) during the period 1996-2005, and posteriorly treated in different hospital centers in Barcelona. Results. Of the 22 patients diagnosed with oral cancer in our Service, the present study finally analyzed the 12 subjects who reported for the dental controls. As regards the remaining 10 patients, 5 had died and 5 could not be located; these subjects were thus e�cluded from the analysis. All of the smokers had abandoned the habit. The most common tumor location was the lateral margin of the tongue. None of the patients visited the dentist regularly before the diagnosis of oral cancer. T1N0M0 was the most common tumor stage. Surgery was carried out in 50% of the cases, while 8.4% of the patients received radiotherapy and 41.6% underwent surgery with postoperative radiotherapy. In turn, 66.6% of the patients reported treatment sequelae such as dysgeusia, �erostomia or speech difficulties, and one patient suffered osteoradionecrosis. Forty-one percent of the patients did not undergo regular dental controls after cancer treatment. As regards oral and dental health, 16.6% presented caries, and 50% had active periodontal disease. Conclusions. Protocols are available for preventing the complications of oral cancer treatment, and thus for improving patient quality of life. However, important shortcomings in the application of such protocols on the part of the public health authorities make it difficult to reach these objectives.

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Section: Discussionmentioning

confidence: 61%

Dental implications in oral cancer patients

et al. 2011

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“…In many surveys that monitored the results of RT in patients with head and neck cancer, xerostomia usually was cited as the most prevalent late complication. [28][29][30][31][32] It has been reported that patient-reported xerostomia is correlated significantly with the mean RT dose to the parotid glands and the minor salivary glands in the oral cavity. 33 Our study further confirmed that RT technique is the unique variable affecting xerostomia in NPC survivors.…”

Section: Discussionmentioning

confidence: 99%

Intensity‐modulated or conformal radiotherapy improves the quality of life of patients with nasopharyngeal carcinoma

Fang

Tsai

Chen

et al. 2007

Cancer

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BACKGROUND.It was reported previously that the dosimetric superiority of conformal radiotherapy (RT), either 3‐dimensional conformal RT (3D‐CRT) or intensity‐modulated RT (IMRT), over conventional 2D‐RT translated into clinical benefits for patients with nasopharyngeal carcinoma (NPC). In this study, the authors compared quality‐of‐life (QOL) outcomes of NPC survivors who received treatment with 1 of 4 different RT techniques at a single institute during different periods.METHODS.The authors analyzed QOL data of from 237 patients with NPC who were cancer free for 2 or 3 years when their QOL was assessed. The study population included 152 patients who received conventional RT (2D‐RT, 61 patients; 2D‐RT plus 3D‐CRT boost, 91 patients) and 85 patients who received conformal RT (3D‐CRT, 33 patients; IMRT, 52 patients). The European Organization for the Research and Treatment of Cancer (EORTC) Core QOL questionnaire and the EORTC Head and Neck QOL questionnaire were completed.RESULTS.Compared with patients who received with conventional RT, patients who received conformal RT had both statistically (P < .05) and clinically (a difference in mean scores ≥10 points) significant improvements in the scales of global QOL, pain, appetite loss, senses, speech, social eating, teeth, opening mouth, xerostomia, sticky saliva, and feeling ill. No significant difference was observed in any of the scales that compared 2D‐RT with 2D‐RT plus 3D‐CRT boost or that compared 3D‐CRT with IMRT. Survivors who received conformal RT had a 2.01‐fold higher probability (odds ratio [OR], 2.01; 95% confidence interval [95% CI], 1.19–3.68) of reporting good global QOL and a 2.70‐fold lower probability (OR, 0.37; 95% CI, 0.20–0.66) of reporting a high level of xerostomia than survivors who received conventional RT.CONCLUSIONS.Conformal RT substantially improved head and neck‐related symptoms and broad aspects of QOL for survivors of NPC. Cancer 2007. © 2006 American Cancer Society.

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“…Each item score is added, and the sum is linearly transformed to produce the final summary score ranging from 0 to 100, with higher scores representing higher levels of xerostomia. The results of this questionnaire are correlated with more global QoL parameters (7,8). The XQ has recently been validated in the Greek population by the research team conducting the present study, in an attempt to yield a reliable xerostomia tool for Greek patients.…”

Section: Methodsmentioning

confidence: 98%

“…The patients answered three questionnaires at the same time: The Greek version of the XQ Instrument (7,8) the EORTC Quality of Life Questionnaire-Core 30 (QLQ-C30) and the Quality of Life Questionnaire Head and Neck Module (QLQ-H&N35) (9) from the EORTC group. All the questionnaires have been validated in the Greek population.…”

Section: Methodsmentioning

confidence: 99%

Assessment of xerostomia and its impact on quality of life in head and neck cancer patients undergoing radiation therapy

Memtsa

Tolia

Tzitzikas

et al. 2017

Molecular and Clinical Oncology

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Abstract. Xerostomia in head and neck (H&N) cancer patients significantly affects their quality of life (QoL). The aim of the present study was to investigate the associations among QoL, xerostomia and quantity of saliva in a sample of H&N cancer patients who had received conventional radiotherapy (RT). A total of 60 H&N adult patients were enrolled in this prospective study. The patients completed the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (QLQ-C30), the Quality of Life Questionnaire Head and Neck Module (QLQ-H&N35) and the Greek version of the XQ questionnaire at 4 timepoints: At the beginning of RT, at the end of RT, 6 months after RT completion and 1 year after RT completion. Patients with distant metastases or serious comorbidities were excluded from the study. Salivary pH, and stimulated and unstimulated salivary flow rate were assessed. All functional scales and symptom scales, apart from cognitive functioning in QLQ-C30 and feeding tube in H&N35 exhibited an abrupt deterioration at timepoint 3 and were then gradually restored over time. The difference was statistically significant (P<0.001). XQ scores at different timepoints exhibited a statistically significant negative correlation with salivary flow rates. Salivary flow rate and XQ scores almost parallelled one another. Flow rates recovered at a mean level of 20% below baseline values at the end of the follow-up period. The subjective symptom of xerostomia parallelled salivary flow and QoL. Despite receiving conventional RT, the participants exhibited a considerable preservation of salivary gland function after 12 months, allowing some optimism regarding the course of xerostomia in selected patients.

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Matched case–control study of quality of life and xerostomia after intensity-modulated radiotherapy or standard radiotherapy for head-and-neck cancer: Initial report

Cited by 160 publications

References 38 publications

Dental implications in oral cancer patients

Dental implications in oral cancer patients

Intensity‐modulated or conformal radiotherapy improves the quality of life of patients with nasopharyngeal carcinoma

Assessment of xerostomia and its impact on quality of life in head and neck cancer patients undergoing radiation therapy

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