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Clinical Oral Investigations
Published in: Clinical Oral Investigations 4/2016

01-05-2016 | Original Article

Evaluation of oral prophylaxis during and after intensity-modulated radiotherapy due to head and neck cancer—a retrospective study

Authors: D Bichsel, M Lanfranchi, T Attin, KW Grätz, B Stadlinger

Published in: Clinical Oral Investigations | Issue 4/2016

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Abstract

Objectives

The aim of this study was to retrospectively analyze the influence of a prophylaxis protocol of head and neck tumor (HNT) patients during and after intensity-modulated radiotherapy (IMRT).

Material and method

In this 5-year retrospective study (2009–2013), 70 (m 55, f 15; age range 28–8 years; median 58.7 years) out of 248 HNT patients of the Clinic of Cranio-Maxillofacial and Oral Surgery at the University of Zurich, Switzerland, fulfilled the inclusion criteria. Parameters of investigation were the salivary flow rates, possible dental foci and the dental status, oral side effects of radiotherapy, the prophylaxis protocol, and patient’s compliance to this protocol. The following time points before during and after IMRT (6 weeks) were analyzed: prior to IMRT, 2–4 weeks, 6 weeks and 3, 6, and 12 months after the onset of radiotherapy.

Result

Unstimulated salivary flow rate, pH value of unstimulated salivary, and stimulated salivary flow rate showed a significant reduction over time (p < 0.001). One year after IMRT, both unstimulated and stimulated salivary flow showed a statistically significant lower salivary flow. The number of caries-affected sites per patient was significantly higher for patients with low compliance to the prophylaxis protocol (mean: low compliance 1.36, high compliance 0.26). Almost 75 % of the evaluated patients suffered immediate gustatory change, and 47.1 % showed signs of radiostomatitis through IMRT.

Conclusions

High compliance to the prophylaxis protocol during and after radiotherapy is a key factor for the reduction of radiation side effects on dental hard tissue.

Clinical relevance

High compliance to a monitored prophylaxis program is crucial for patients after head and neck surgery.
Literature
1.
2.
Grotz KA (2003) Dental care for patients with antineoplastic radiotherapy of the head and neck. Strahlenther Onkol 179:275–278PubMed
3.
Shaw MJ, Kumar ND, Duggal M, Fiske J, Lewis DA, Kinsella T, Nisbet T (2000) Oral management of patients following oncology treatment: literature review. Br J Oral Maxillofac Surg 38:519–524CrossRefPubMed
4.
Studer G, Glanzmann C, Studer SP, Gratz KW, Bredell M, Locher M, Lutolf UM, Zwahlen RA (2011) Risk-adapted dental care prior to intensity-modulated radiotherapy (IMRT). Schweiz Monatsschr Zahnmed 121:216–229PubMed
5.
Cozzi L, Fogliata A, Bolsi A, Nicolini G, Bernier J (2004) Three-dimensional conformal vs. intensity-modulated radiotherapy in head-and-neck cancer patients: comparative analysis of dosimetric and technical parameters. Int J Radiat Oncol Biol Phys 58:617–624CrossRefPubMed
6.
Garden AS, Morrison WH, Rosenthal DI, Chao KS, Ang KK (2004) Target coverage for head and neck cancers treated with IMRT: review of clinical experiences. Semin Radiat Oncol 14:103–109CrossRefPubMed
7.
de Arruda FF, Puri DR, Zhung J, Narayana A, Wolden S, Hunt M, Stambuk H, Pfister D, Kraus D, Shaha A, Shah J, Lee NY (2006) Intensity-modulated radiation therapy for the treatment of oropharyngeal carcinoma: the Memorial Sloan-Kettering Cancer Center experience. Int J Radiat Oncol Biol Phys 64:363–373CrossRefPubMed
8.
Karbach J, Walter C, Al-Nawas B (2012) Evaluation of saliva flow rates, Candida colonization and susceptibility of Candida strains after head and neck radiation. Clin Oral Investig 16:1305–1312CrossRefPubMed
9.
Lee N, Xia P, Quivey JM, Sultanem K, Poon I, Akazawa C, Akazawa P, Weinberg V, Fu KK (2002) Intensity-modulated radiotherapy in the treatment of nasopharyngeal carcinoma: an update of the UCSF experience. Int J Radiat Oncol Biol Phys 53:12–22CrossRefPubMed
10.
Puri DR, Chou W, Lee N (2005) Intensity-modulated radiation therapy in head and neck cancers: dosimetric advantages and update of clinical results. Am J Clin Oncol 28:415–423CrossRefPubMed
11.
12.
Studer G, Huguenin PU, Davis JB, Kunz G, Lutolf UM, Glanzmann C (2006) IMRT using simultaneously integrated boost (SIB) in head and neck cancer patients. Radiat Oncol 1:7CrossRefPubMedPubMedCentral
13.
Studer G, Luetolf UM, Glanzmann C (2007) Locoregional failure analysis in head-and-neck cancer patients treated with IMRT. Strahlenther Onkol 183:417–423 discussion 424-5CrossRefPubMed
14.
Studer G, Lutolf UM, Davis JB, Glanzmann C (2006) IMRT in hypopharyngeal tumors. Strahlenther Onkol 182:331–335CrossRefPubMed
15.
16.
Kouloulias V, Thalassinou S, Platoni K, Zygogianni A, Kouvaris J, Antypas C, Efstathopoulos E, Nikolaos K (2013) The treatment outcome and radiation-induced toxicity for patients with head and neck carcinoma in the IMRT era: a systematic review with dosimetric and clinical parameters. Biomed Res Int 2013:401261CrossRefPubMedPubMedCentral
17.
Grotz KA, Riesenbeck D, Brahm R, Seegenschmiedt MH, al-Nawas B, Dorr W, Kutzner J, Willich N, Thelen M, Wagner W (2001) Chronic radiation effects on dental hard tissue (radiation caries). Classification and therapeutic strategies. Strahlenther Onkol 177:96–104CrossRefPubMed
18.
Kielbassa AM, Hellwig E, Meyer-Lueckel H (2006) Effects of irradiation on in situ remineralization of human and bovine enamel demineralized in vitro. Caries Res 40:130–135CrossRefPubMed
19.
Kielbassa AM, Hinkelbein W, Hellwig E, Meyer-Luckel H (2006) Radiation-related damage to dentition. Lancet Oncol 7:326–335CrossRefPubMed
20.
Dreizen S, Brown LR, Daly TE, Drane JB (1977) Prevention of xerostomia-related dental caries in irradiated cancer patients. J Dent Res 56:99–104CrossRefPubMed
21.
Fleming TJ (1990) Oral tissue changes of radiation-oncology and their management. Dent Clin N Am 34:223–237PubMed
22.
Grotz KA, Genitsariotis S, Vehling D, Al-Nawas B (2003) Long-term oral Candida colonization, mucositis and salivary function after head and neck radiotherapy. Support Care Cancer 11:717–721CrossRefPubMed
23.
Duarte VM, Liu YF, Rafizadeh S, Tajima T, Nabili V, Wang MB (2014) Comparison of dental health of patients with head and neck cancer receiving IMRT vs conventional radiation. Otolaryngol Head Neck Surg 150:81–86CrossRefPubMed
24.
Epstein JB, Chin EA, Jacobson JJ, Rishiraj B, Le N (1998) The relationships among fluoride, cariogenic oral flora, and salivary flow rate during radiation therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 86:286–292CrossRefPubMed
25.
Epstein JB, van der Meij EH, Lunn R, Stevenson-Moore P (1996) Effects of compliance with fluoride gel application on caries and caries risk in patients after radiation therapy for head and neck cancer. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 82:268–275CrossRefPubMed
26.
Rath C, Imfeld T (2008) Dry mouth—oral care for patients with oligoliasia and xerostomia. Ther Umsch 65:91–96CrossRefPubMed
27.
Abe K (2008) Studies on taste: molecular biology and food science. Biosci Biotechnol Biochem 72:1647–1656CrossRefPubMed
28.
Bornstein M, Buser D, Filippi A (2001) Concepts of prevention and therapy of radiation-induced side effects. Schweiz Monatsschr Zahnmed 111:962–977PubMed
Metadata
Title
Evaluation of oral prophylaxis during and after intensity-modulated radiotherapy due to head and neck cancer—a retrospective study
Authors
D Bichsel
M Lanfranchi
T Attin
KW Grätz
B Stadlinger
Publication date
01-05-2016
Publisher
Springer Berlin Heidelberg
Published in
Clinical Oral Investigations / Issue 4/2016
Print ISSN: 1432-6981
Electronic ISSN: 1436-3771
DOI
https://doi.org/10.1007/s00784-015-1546-9

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