Oral Mucositis Affects Care of Patients with Head and Neck Cancer

Oral Mucositis Affects Care of Patients with Head and Neck Cancer

In a study published in the journal Cancer, oral mucositis developed in over 80% of patients undergoing radiation therapy for head and neck cancer. Patients who developed oral mucositis were more likely to have unplanned breaks in radiation therapy and were also more likely to be hospitalized.

Approximately 40,000 people in the U.S. are diagnosed with head and neck cancer every year. Cancers of the head and neck comprise several types of cancer affecting the nasal cavity, sinuses, oral cavity, nasopharynx, oropharynx, and other sites throughout the head and neck. The American Cancer Society estimates that 11,000 people will die from head and neck cancer in 2005.

Oral mucositis refers to inflammation of the oral mucosa (lining of the mouth) that results from chemotherapy or radiation therapy. Symptoms may include redness, swelling, and ulceration. When oral mucositis is severe, patients cannot swallow food or liquid and often have to be given nutrients through a vein. In addition, oral mucositis can cause severe pain, increase the risk of infection, and may limit a patient’s ability to tolerate further treatment.

Oral mucositis is known to be a common side-effect of radiation therapy for head and neck cancer, but relatively little is known about factors that increase or decrease the risk of developing oral mucositis. In order to explore the frequency, predictors, and consequences of oral mucositis in patients with head and neck cancer, researchers conducted a study among 450 head and neck cancer patients who had been treated with radiation therapy. The average age of the patients was 61 years; 80% were men.

  • 83% of patients developed oral mucositis.
  • 29% developed severe oral mucositis.
  • Severe oral mucositis was more common in patients with nasopharyngeal or orophyaryngeal tumors, patients who had received high doses of radiation therapy, and patients who received concomitant chemotherapy.
  • Compared to patients without oral mucositis, patients with oral mucositis had an almost four-fold increased risk of unplanned breaks in radiation therapy and a three and a half-fold increased risk of hospitalization.

The researchers conclude that oral mucositis is common among patients undergoing radiation therapy for head and neck cancer and can disrupt treatment. The subsets of patients who were at increased risk of developing oral mucositis were patients with nasopharyngeal or oropharyngeal tumors, patients receiving high doses of radiation therapy, and patients who received concomitant chemotherapy.

Reference: Vera-Llonch M, Oster G, Hagiwara M et al. Oral Mucositis in Patients Undergoing Radiation Treatment for Head and Neck Carcinoma. Cancer. 2006;106:329-36.

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