Preservation of oral health–related quality of life and salivary flow rates after inverse-planned intensity- modulated radiotherapy (IMRT) for head-and-neck cancer

Parliament, Matthew; Scrimger, Rufus; Anderson, Stephanie G; Kurien, Elizabeth; Thompson, Heather; Field, G; Hanson, John

doi:10.1016/s0360-3016(03)01571-2

Cited by 164 publications

(72 citation statements)

References 36 publications

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“…Fox et al, in a double-blind, placebo-controlled study of 39 patients with post-irradiation �erostomia, found 94.8% of the subjects to e�perience improvement after one month of treatment with 5 mg of pilocarpine three times a day -this improvement being maintained for 6 months after the end of radiotherapy (21). Many studies have shown that intensity-modulated radiotherapy contributes to improve salivary gland preservation (17,(22)(23)(24)(25). Dysgeusia induced by radiotherapy is conditioned by a series of factors: direct neuroto�ic action upon the taste receptor cells, �erostomia and possible overinfections.…”

Section: Discussionmentioning

confidence: 99%

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: 99%

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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“…Both prospective and cross-sectional studies (Bjordal et al, 2001;Hammerlid et al, 2001aHammerlid et al, , 2001bHammerlid et al, , 2001cNguyen et al, 2002;Talmi et al, 2002;Shepherd and Fisher, 2004) have documented reductions in HRQOL in populations of H&N cancer patients who have received RT. Several studies have also examined changes in HRQOL during the treatment period (Bjordal et al, 2001;Henson et al, 2001; Airolldi et al, 2004;Parliament et al, 2004;Jabbari et al, 2005; Braam et al, 2007; Curran et al, 2007; Ackerstaff et al, 2009; Ackerstaff et al, 2012;Maguire et al, 2011;Maurer et al, 2011;Nutting et al, 2011). These studies show that QOL worsens during treatment and improves after cessation of treatment, returning to baseline QOL by 12 months after treatment (So et al, 2012; Curran et al, 2007; Bjordal et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

Changes in health related quality of life in women and men undergoing radiation treatment for head and neck cancer and the impact of smoking status in the radiation treatment period

Egestad

Emaus

2014

European Journal of Oncology Nursing

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Abstract:Purpose The aim of this study was to evaluate health-related quality of life (HRQOL) in women and men undergoing radiation treatment for head and neck cancer through the intervention period and examine if age, body mass index (BMI) and smoking status at baseline may modify changes in HRQOL. Results Most aspects of HRQOL declined substantially and significantly (p<0.001) with a magnitude of more than one standard deviation during the radiation treatment period irrespective of sex and age. Smoking status at baseline had some, albeit minor, influence on changes in HRQOL. Patients who continued smoking during therapy had significantly higher decline in several aspects of HRQOL, compared to patients who stopped smoking.Conclusions HRQOL decline with substantial magnitude in patients undergoing radiation treatment for head and neck cancer, but smoking cessation may modify the declining quality of life. IntroductionTreatments of head and neck (H&N) cancer include surgery, radiotherapy (RT), chemotherapy, target therapy or a combination of these modalities. The diagnosis and the following treatment may exert a severe impact on patient's quality of life (QOL) (So et al., 2012). The malignancy affects the most visible area of the body, and may influence the most fundamental activities of daily life in a negative way, such as speech, breathing, eating and drinking (Larsson and Hedelin, 2003;Wells 1998). H&N cancer patients' illness often involves physical symptoms, psychological distress, as well as side effects from RT (Archer et al., 2008). The treatment can result in dry mouth (xerostomia), oral discomfort, mucositis, recurrent microbial infections, difficulty in chewing and swallowing, increased incidence of dental caries, impaired taste, and an inability to wear dentures (Parsons et al., 1994). In addition, depression is reported to increase in H&N cancer patients undergoing RT (Neilson et al., 2010;Kelly et al., 2007).The interest in health-related quality of life (HRQOL) (i.e. the physical, mental, and social functioning and well-being) in H&N cancer patients has increased over the two decades (So et al., 2012). Even if the most important outcome for cancer patients is overall survival, the disease and its treatment often have a major impact on HRQOL and functional status (List et al., 2002). Reliable and valid HRQOL questionnaires are available (Aaronson et al., 1993; Bjordal et al., 2000;Ringash and Bezjak, 2001). The EORTC QLQ-H&N35 is widely used to measure quality of life in H&N cancer patients (Singer et al., 2013). Both prospective and cross-sectional studies (Bjordal et al., 2001;Hammerlid et al., 2001aHammerlid et al., , 2001bHammerlid et al., , 2001cNguyen et al., 2002;Talmi et al., 2002;Shepherd and Fisher, 2004) have documented reductions in HRQOL in populations of H&N cancer patients who have received RT. Several studies have also examined changes in HRQOL during the treatment period (Bjordal et al., 2001;Henson et al., 2001; Airolldi et al., 2004;Parliament et al., 2004;Jabbari et al., 2...

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Preservation of oral health–related quality of life and salivary flow rates after inverse-planned intensity- modulated radiotherapy (IMRT) for head-and-neck cancer

Cited by 164 publications

References 36 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

Changes in health related quality of life in women and men undergoing radiation treatment for head and neck cancer and the impact of smoking status in the radiation treatment period

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