Patients with head and neck cancer treated with radiotherapy: Their experiences after 6 months of prophylactic tooth extractions and temporary removable dentures

Brahm, Carl-Otto; Borg, Carina; Malm, Dan; Fridlund, Bengt; Lewin, Freddi; Zemar, Ahmed; Nilsson, Peter; Papias, Apostolos; Henricson, Maria

doi:10.1002/cre2.418

Cited by 9 publications

(6 citation statements)

References 18 publications

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“…However, patients reflected that sometimes their challenges with social eating impacted their family's enjoyment of eating. Therefore, balancing and supporting family members' emotional and social needs is an additional aspect to consider within cancer survivorship [31].…”

Section: Discussionmentioning

confidence: 99%

Experiences and perceptions of social eating for patients living with and beyond head and neck cancer: a qualitative study

Dornan

Semple

Moorhead

2022

Support Care Cancer

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Purpose Patients with head and neck cancer (HNC) describe eating as more than a physical activity for nutrition and calories. After treatment for HNC, patients report a changed social experience around food, with eating and drinking in front of family and friends depicted as a challenge. However, there is limited research exploring how patients with HNC adapt and cope with social eating difficulties. This study aims to explore patients’ experiences and perceptions of social eating and drinking following treatment for HNC. Methods A qualitative research design using semi-structured interviews was employed to understand the experiences of social eating of patients living with and beyond HNC. Reflexive thematic analysis was used to inductively develop key themes from the data. Results Fourteen interviews were conducted with patients, and two key themes were identified: (1) “Social eating became a conscious process” and (2) “Strategies to maximise social eating participation”. To maximise social eating enjoyment, patients attempted to minimise the attention on their eating function and the fuss created around food. Patients with HNC established psychological and cognitive adaptations to manage expectations and promote positive participation in social eating. Conclusion This paper identifies key barriers limiting or diminishing social eating for patients with HNC; including being self-conscious, lack of understanding from others and functional issues with eating and drinking. This research highlights the need to raise awareness of social eating challenges and for the social dimensions of eating to be addressed through family-centred, supportive holistic interventions implemented early in the patient’s cancer journey.

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Section: Discussionmentioning

confidence: 99%

Experiences and perceptions of social eating for patients living with and beyond head and neck cancer: a qualitative study

Dornan

Semple

Moorhead

2022

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“…If the use of prophylactic PENTO, which is cheap and safe, can prevent/reduce ORN in irradiated patients, clinicians may be more comfortable preserving patient's dentition to a reasonable limit. Studies have shown that loss of dentition in these patients affects their functional units, mastication, swallowing, and nutritional status, contributing to a decreased quality of life [50][51][52][53][54]. Many oral care providers are not comfortable carrying out invasive dental procedures such as root planning and extractions in post-irradiated oncology patients.…”

Section: Discussionmentioning

confidence: 99%

Prophylactic Use of Pentoxifylline and Tocopherol for Prevention of Osteoradionecrosis of the Jaw after Dental Extraction in Post-Radiated Oral and Oropharyngeal Cancer Patients: An Initial Case Series

Owosho,

DeColibus,

Okhuaihesuyi

et al. 2024

Dentistry Journal

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Osteoradionecrosis of the jaw is a morbid complication of radiotherapy in patients with oral and oropharyngeal cancers that may be precipitated by dental extractions. Pentoxifylline and tocopherol (PENTO) has been utilized in the management of osteoradionecrosis and as prophylaxis for post-radiated head and neck oncology patients requiring an invasive dental procedure. This observational study aims to report the outcome of the prophylactic use of PENTO in the prevention of osteoradionecrosis of the jaw after dental extractions in post-radiated oral and oropharyngeal cancer patients and to review the current literature on this topic. Four post-radiated oral and oropharyngeal oncology patients were referred to the dental oncology clinic of the University Dental Practice, University of Tennessee Health Sciences Center for dental extractions. All four patients were prescribed pentoxifylline 400 mg BID (twice a day) and tocopherol 400 IU BID (oral tablets) for 2 weeks before extraction(s) and for 6 weeks after extraction(s). All patients were followed up every week after the second week post-extraction if feasible until the extraction site(s) healed (covered by mucosa). The assessment endpoint was defined as 6 weeks post-extraction with the outcomes assessed as using four categories determined by the area of exposed bone: complete healing (complete mucosal coverage of extraction site); partial healing (reduction in size of extraction site); no change; and progression (increase in size of the extraction site). At the assessment endpoint, all patients had complete healing of all extraction sites. The ORN rate at the patient level (0/4) and individual tooth level (0/8) was 0%. All patients tolerated the PENTO medications and no adverse effects from the use of these medications were reported. This limited study in addition to the other reviewed studies estimates the rate of ORN at the patient level as 3.2% (14/436) for post-radiated head and neck oncology patients after dental extractions/invasive oral procedures. In conclusion, this PENTO regimen can reduce/prevent the incidence of ORN in post-radiated head and neck oncology patients. This safe and cost-effective protocol (PENTO regimen) should be further evaluated as prophylaxis for post-radiated head and neck oncology patients requiring an invasive dental procedure. We recommend large prospective studies to be carried out to further validate these findings.

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“…Preradiotherapy dental extractions are necessary for most of these patients [ 2 ], which may affect their appearance, impair their ability to speak and chew, and have an overall negative impact on the patients’ health-related quality of life [ 3 , 4 ]. Temporary removable dentures are experienced as painful and they do not fulfill their desired functional purpose during the first 6 months after RT [ 5 ]. Compared to conventional complete- or partial-dentures, implant retained prostheses are recognized to be superior regarding masticatory performance, patients’ satisfaction, and quality of life [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Backscatter from therapeutic doses of ionizing irradiation does not impair cell migration on titanium implants in vitro

et al. 2023

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Objective The influence of radiation backscatter from titanium on DNA damage and migration capacity of human osteoblasts (OBs) and mesenchymal stem cells (MSCs) may be critical for the osseointegration of dental implants placed prior to radiotherapy. In order to evaluate effects of radiation backscatter, the immediate DNA damage and migration capacity of OBs and MSCs cultured on titanium or plastic were compared after exposure to ionizing irradiation. Materials and methods Human OBs and MSCs were seeded on machined titanium, moderately rough fluoride-modified titanium, or tissue culture polystyrene, and irradiated with nominal doses of 2, 6, 10, or 14 Gy. Comet assay was performed immediately after irradiation, while a scratch wound healing assay was initiated 24 h post-irradiation. Fluorescent live cell imaging documented the migration. Results DNA damage increased with higher dose and with backscatter from titanium, and MSCs were significantly more affected than OBs. All doses of radiation accelerated the cell migration on plastic, while only the highest dose of 10 Gy inhibited the migration of both cell types on titanium. Conclusions High doses (10 Gy) of radiation inhibited the migration capacity of both cell types on titanium, whereas lower doses (2 and 6 Gy) did not affect the migration of either OBs or MSCs. Clinical relevance Fractionated doses of 2 Gy/day, as distributed in conventional radiotherapy, appear not to cause severe DNA damage or disturb the migration of OBs or MSCs during osseointegration of dental implants.

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Patients with head and neck cancer treated with radiotherapy: Their experiences after 6 months of prophylactic tooth extractions and temporary removable dentures

Cited by 9 publications

References 18 publications

Experiences and perceptions of social eating for patients living with and beyond head and neck cancer: a qualitative study

Experiences and perceptions of social eating for patients living with and beyond head and neck cancer: a qualitative study

Prophylactic Use of Pentoxifylline and Tocopherol for Prevention of Osteoradionecrosis of the Jaw after Dental Extraction in Post-Radiated Oral and Oropharyngeal Cancer Patients: An Initial Case Series

Backscatter from therapeutic doses of ionizing irradiation does not impair cell migration on titanium implants in vitro

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