Mucositis-Induced Pain due to Barrier Dysfunction may have a Direct Effect on Nutritional Status and Quality of Life in Head and Neck Cancer Patients Receiving Radiotherapy
Mucositis-Induced Pain due to Barrier Dysfunction may have a Direct Effect on Nutritional Status and Quality of Life in Head and Neck Cancer Patients Receiving Radiotherapy
OBJECTIVETo maintain the barrier function against mucositis-induced pain and to improve the nutritional statusand quality of life in head and neck cancer patients during radiotherapy.METHODSAll patients (n=30) used oral gel to reduce mucositis-induced pain. Patients were examined weekly forthe severity of mucositis, pain and nutritional status. The quality of life parameters was measured at thebeginning and at the end of treatment. There was no restriction for pain killers against mucositis.RESULTSThe only significant factor affecting the severity and frequency of mucositis was the cumulative radiationdose (p
___
- 1. Trotti A, Bellm LA, Epstein JB, Frame D, Fuchs HJ, Gwede CK, et al. Mucositis incidence, severity and associated outcomes in patients with head and neck cancer receiving radiotherapy with or without chemotherapy: a systematic literature review. Radiother Oncol 2003;66(3):253−62.
- 2. Bese NS, Hendry J, Jeremic B. Effects of prolongation of overall treatment time due to unplanned interruptions during radiotherapy of different tumor sites and practical methods for compensation. Int J Radiat Oncol Biol Phys 2007;68(3):654−61.
- 3. Russo G, Haddad R, Posner M, Machtay M. Radiation treatment breaks and ulcerative mucositis in head and neck cancer. Oncologist 2008;13(8):886−98.
- 4. Ranna V, Cheng KKF, Castillo DA, Porcello L, Vaddi A, Lalla RV, et al; Mucositis Study group of the Multinational Association of Supportive Care in Cancer/ International Society for Oral Oncology (MASCC/ ISOO). Development of the MASCC/ISOO clinical practice guidelines for mucositis: an overview of the methods. Support Care Cancer 2019;27(10):3933−48.
- 5. Lalla RV, Bowen J, Barasch A, Elting L, Epstein J, Keefe DM, et al; Mucositis Guidelines Leadership Group of the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO). MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer 2014;120(10):1453−61.
- 6. De Sanctis V, Bossi P, Sanguineti G, Trippa F, Ferrari D, Bacigalupo A, et al. Mucositis in head and neck cancer patients treated with radiotherapy and systemic therapies: Literature review and consensus statements. Crit Rev Oncol Hematol 2016;100:147−66.
- 7. Chung YL, Pui NNM. Confounding factors associated with oral mucositis assessment in patients receiving chemoradiotherapy for head and neck cancer. Support Care Cancer 2017;25(9):2743−51.
- 8. Lee SC, Wang TJ, Chu PY. Predictors of weight loss during and after radiotherapy in patients with head and neck cancer: A longitudinal study. Eur J Oncol Nurs 2019;39:98−104.
- 9. Jung YS, Park EY, Sohn HO. Oral Health Status and Oral Health-related Quality of Life According to Presence or Absence of Mucositis in Head and Neck Cancer Patients. J Cancer Prev 2019;24(1):43−7.
- 10.Buchsel PC. Polyvinylpyrrolidone-sodium hyaluronate gel (Gelclair): a bioadherent oral gel for the treatment of oral mucositis and other painful oral lesions. Expert Opin Drug Metab Toxicol 2008;4(11):1449−54.
- 11.Barber C, Powell R, Ellis A, Hewett J. Comparing pain control and ability to eat and drink with standard therapy vs Gelclair: a preliminary, double centre, randomised controlled trial on patients with radiotherapy-induced oral mucositis. Support Care Cancer 2007;15(4):427−40.
- 12.Innocenti M, Moscatelli G, Lopez S. Efficacy of gelclair in reducing pain in palliative care patients with oral lesions: preliminary findings from an open pilot study. J Pain Symptom Manage 2002;24(5):456−7.
- 13.Hadjieva T, Cavallin-Ståhl E, Linden M, Tiberg F. Treatment of oral mucositis pain following radiation therapy for head-and-neck cancer using a bioadhesive barrier-forming lipid solution. Support Care Cancer 2014;22(6):1557−62.
- 14.National Cancer Institude. Common Terminology Criteria for Adverse Events v3.0 (CTCAE). Available from: https://ctep.cancer.gov/protocolDevelopment/ electronic_applications/docs/ctcaev3.pdf. Accessed, January 2, 2020.
- 15.Detsky AS, McLaughlin JR, Baker JP, Johnston N, Whittaker S, Mendelson RA, et al. What is subjective global assessment of nutritional status? JPEN J Parenter Enteral Nutr 1987;11(1):8−13.
- 16.Bentzen SM, Saunders MI, Dische S, Bond SJ. Radiotherapy-related early morbidity in head and neck cancer: quantitative clinical radiobiology as deduced from the CHART trial. Radiother Oncol 2001;60(2):123−35.
- 17.Price DD, McGrath PA, Rafii A, Buckingham B. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain 1983;17(1):45−56.
- 18.Sherman AC, Simonton S, Adams DC, Vural E, Owens B, Hanna E. Assessing quality of life in patients with head and neck cancer: cross-validation of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Head and Neck module (QLQ-H&N35). Arch Otolaryngol Head Neck Surg 2000;126(4):459−67.
- 19.Zadik Y, Arany PR, Fregnani ER, Bossi P, Antunes HS, Bensadoun RJ, et al; Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). Systematic review of photobiomodulation for the management of oral mucositis in cancer patients and clinical practice guidelines. Support Care Cancer 2019;27(10):3969−83.
- 20.Flook C, Calman F, Mant M, Subramanian R, O’Connell M. GELCLAIR® vs benzydamine in a randomised controlled study in patients with oral mucositis due to radical radiotherapy. Abstracts of the 17th MASCC International Symposium. Support Care Cancer 2005;13(6):401−83.
- 21.Bossi P, Giusti R, Tarsitano A, Airoldi M, De Sanctis V, Caspiani O, et al. The point of pain in head and neck cancer. Crit Rev Oncol Hematol 2019;138:51−9.