Oral toxicity management in head and neck cancer patients treated with chemotherapy and radiation: Xerostomia and trismus (Part 2). Literature review and consensus statement

Buglione, Michela; Cavagnini, R.; Rosario, Federico Di; Maddalo, Marta; Vassalli, Lucia; Grisanti, Salvatore; Salgarello, Stefano; Orlandi, Ester; Bossi, Paolo; Majorana, Alessandra; Gastaldi, Giorgio; Berruti, Alfredo; Trippa, Fabio; Nicolai, P.; Barasch, Andrei; Russi, Elvio; Raber-Durlacher, Judith E.; Murphy, Barbara A.; Magrini, Stefano Maria

doi:10.1016/j.critrevonc.2016.03.012

Cited by 60 publications

(51 citation statements)

References 88 publications

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“…RT for HNC typically involves total doses of 6,000–7,000 cGy, delivered in daily fractions over 6–7 weeks (Pfister et al., ), and is known to cause a number of oral complications. These include oral mucositis, oral pain, hyposalivation, increased risk of dental caries, reduced mouth opening, and osteoradionecrosis (Buglione, Cavagnini, Di Rosario, Maddalo, et al., ; Buglione, Cavagnini, Di Rosario, Sottocornola, et al., ). Much of the data on oral complications of RT for HNC come from smaller single‐center studies using older RT techniques.…”

Section: Introductionmentioning

confidence: 99%

Oral complications at 6 months after radiation therapy for head and neck cancer

et al. 2017

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Objective To examine oral complications 6 months after modern radiation therapy (RT) for head and neck cancer (HNC). Methods Prospective multicenter cohort study of patients with HNC receiving intensity-modulated radiation therapy or more advanced RT. Stimulated whole salivary flow, maximal mouth opening, oral mucositis, oral pain, oral health-related quality of life (OH-QOL), and oral hygiene practices were measured in 372 subjects pre-RT and 216 subjects at 6 months from the start of RT. Results Mean stimulated whole salivary flow declined from 1.09 to 0.47 ml/min at 6 months (p < .0001). Mean maximal mouth opening reduced from 45.58 to 42.53 mm at 6 months (p < .0001). 8.1% of subjects had some oral mucositis at 6 months, including 3.8% with oral ulceration. Mean overall pain score was unchanged. OH-QOL was reduced at 6 months, with changes related to dry mouth, sticky saliva, swallowing solid foods, and sense of taste (p ≤ .0001). At 6 months, there was greater frequency of using dental floss and greater proportion using supplemental fluoride (p < .0001). Conclusions Despite advances in RT techniques, patients with HNC experience oral complications 6 months after RT, with resulting negative impacts on oral function and quality of life.

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Section: Introductionmentioning

confidence: 99%

Oral complications at 6 months after radiation therapy for head and neck cancer

et al. 2017

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“…Even with radiation doses as low as 10 Gy, the volume and composition of saliva is altered. The degree of xerostomia, like mucositis, is radiation dose-dependent (Buglione et al, 2016). It is possible that the changes in the oral flora noted by Zhu et al were a consequence of changes in salivary function resulting in less buffering, flushing, and immune function, and a surrogate from cumulative radiation dose.…”

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confidence: 99%

The Chicken or the Egg? Changes in Oral Microbiota as Cause or Consequence of Mucositis During Radiation Therapy

Sonis

2017

EBioMedicine

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“…There are several reviews with clinical guidelines and recommendations about means and measures, which should be done before, during, and after treatment to decrease the risk of acute, especially oral mucositis, and late oral complications. (Buglione et al, ; Buglione et al, ; Jensen et al, ; Lalla et al, ; McGuire et al, ; Nicolatou‐Galitis et al, ; Sroussi et al, ) It is therefore noteworthy that none of the C/Rs mentioned that they base their treatment on research. It should also be noted that three C/Rs stated that they base their treatment on proven experience and some C/Rs have stated recommendations, which are not suggested in the document they base their treatment on.…”

Section: Discussionmentioning

confidence: 99%

“…Several review articles have been published suggesting means and methods before, during, and after cancer treatment to prevent and/or relieve oral complications especially oral mucositis. (Buglione et al, ; Buglione et al, ; De Sanctis et al, ; Jensen et al, ; Lalla et al, ; McGuire et al, ; Nicolatou‐Galitis et al, ; Sroussi et al, ) However, as far as we know, no evidence‐based standard protocol regarding the care of these patients exists, and routines for collaborations between different healthcare professions involved in the care of this patient category is sparse. (Lanzós, Herrera, Lanzós, & Sanz, ; Moslemi et al, ; Sroussi et al, ) This may lead to large variations in the amount and/or quality of the odontological care given because it is up to the individual dental clinic to plan for the care of each patient, which may lead to inequalities in the care provided.…”

Section: Introductionmentioning

confidence: 99%

Variations in odontological care routines for patients undergoing treatment for head and neck cancer in county councils/regions of Sweden

Bohm

Karlsson

Andersson

et al. 2019

Clinical & Exp Dental Res

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Objective To investigate current odontological care routines for patients treated for head and neck cancers in the county councils/regions (C/Rs) of Sweden. Methods An invitation to fill in a web‐based questionnaire was sent to dentists/dental hygienists working in dental clinics in the 12 C/Rs, treating and responsible for the odontological care of patients undergoing treatment for cancer of the head and neck. The questionnaire started with two mandatory and one non‐mandatory questions, followed by questions regarding routines before (n = 28), during (n = 23), and after (n = 9) treatment, plus two additional questions, totalling 65 questions. Results Four dental hygienists and six dentists in 10 of the 12 C/Rs answered the questionnaire. Three C/Rs stated that they measure both the unstimulated and stimulated salivary secretion rate, and another C/R stated that they measure the stimulated secretion rate only. Similar recommendations were given regarding oral hygiene, salivary stimulants and substitutes, and extra fluoride. However, great variations were seen regarding recommendations for preventing and relieving oral mucositis. There were also discrepancies regarding information about the importance of avoiding smoking and alcohol. In seven C/Rs, patients visited the dental hygienist once a week during cancer treatment. Conclusion The results suggests that there are great variations in odontological care given to patients undergoing treatment for cancer of the head and neck region in different county councils/regions in Sweden. There is a need to develop and implement evidence‐based guidelines to decrease the risk of oral complications and increase both the quality of life and the quality of care.

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Oral toxicity management in head and neck cancer patients treated with chemotherapy and radiation: Xerostomia and trismus (Part 2). Literature review and consensus statement

Cited by 60 publications

References 88 publications

Oral complications at 6 months after radiation therapy for head and neck cancer

Oral complications at 6 months after radiation therapy for head and neck cancer

The Chicken or the Egg? Changes in Oral Microbiota as Cause or Consequence of Mucositis During Radiation Therapy

Variations in odontological care routines for patients undergoing treatment for head and neck cancer in county councils/regions of Sweden

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