Prevention and treatment of oral mucositis in patients with head and neck cancer treated with (chemo) radiation: report of an Italian survey

Abstract

A variety of preventive and therapeutic protocols for OM exists among the participating Italian centers, with some uniformity in respect to nutritional support, use of antimycotic and painkillers. There is an urgent need for well-conducted clinical trials aimed at assessing the best choices for OM prevention and treatment in HNC.

Prospective assessment of oral mucositis and its impact on quality of life and patient-reported outcomes during radiotherapy for head and neck cancer

“…It is one of the most potentially troublesome side effects of combination therapy which can affect patient's compliance to treatment, QoL and consequently impact on global oncological outcomes. Hence, its timely and adequate management is of paramount importance [5,7]. Robust and precise reporting of OM is crucial to be able to evaluate prophylactic or therapeutic measures and to correctly compare treatment-related toxicity profiles.…”

“…Combined modality treatment including RT and chemotherapy (CT) and/or bio-therapy is a well-established option providing a survival advantage over radiation alone [3,4]. Oral mucositis (OM) is a frequent finding in HNC patients undergoing RT and the concurrent administration of CT, for example with agents having a radiosensitizing action such as cisplatin (CDDP), may enhance the damage to the mucosal layer, impairing the mechanism of sublethal damage repair and, hence, increasing the likelihood to develop this side effect [5,6]. The incidence, intensity and duration of OM depend on the site and subsite involved by the primary tumor and on RT-related (total dose, fractionation, treatment volumes) and patient-related (poor oral hygiene, alcohol and tobacco use, xerostomia, comorbid conditions) factors [6,7].…”

The association between cumulative radiation dose and the incidence of severe oral mucositis in head and neck cancers during radiotherapy

“…It is necessary to implement OM management strategies before the initiation of RT in patients with HNC 7 . Some studies have reported on the risk factors for OM in HNC patients 8‐10 . The initial clinical signs of OM include mucosal erythema and superficial sloughing that may occur with a cumulative radiation dose of 20 to 30 Gy, which is accompanied by the beginning of the breakdown of the intact mucosa followed by ulceration 11 .…”

Measuring the Quality of Life among Head-and/or-Neck Cancer Patients with Oral Mucositis Using the Functional Assessment of Cancer Therapy-General in Jordan

“…It has been well documented in literature that OM significantly influences QOL in cancer patients. [ 10 11 ] However, the main obstacle remains in reporting the incidence of OM and the severity of symptoms. [ 12 ] This study highlights the problem and raises awareness to improve the reporting and management of OM.…”

“…There is a scarcity in the literature reporting the prevalence of OM, which might be related to patients and their carers viewing this issue as minor compared to the general health condition of the patient (i.e., head and/or neck cancer). [ 11 12 ] There is a scarcity of literature examining OM among neck-and/or-head cancer patients in Jordan. Therefore, this study aimed to validate the Functional Assessment of Cancer Therapy-General Questionnaire (FACT-G) and to measure the QOL among head-and/or-neck cancer patients suffering from various degrees of OM.…”