Skip to main content
Top
Published in: Supportive Care in Cancer 11/2015

01-11-2015 | Original Article

Professional oral health care reduces oral mucositis pain in patients treated by superselective intra-arterial chemotherapy concurrent with radiotherapy for oral cancer

Authors: Kosei Kubota, Wataru Kobayashi, Hirotaka Sakaki, Hiroshi Nakagawa, Takao Kon, Mayu Mimura, Ryohei Ito, Ken Furudate, Hiroto Kimura

Published in: Supportive Care in Cancer | Issue 11/2015

Login to get access

Abstract

Purpose

Oral mucositis (OM) is a painful complication of radiation therapy (RT) for head and neck cancer. OM can compromise nutrition, require opioid analgesics and hospitalization for pain control, and lead to interruption of treatment. Severe oral mucositis appears inevitable in superselective intra-arterial chemotherapy concurrent with radiotherapy (SSIACRT), requiring management of OM for the patient. The objective of this study was to assess the utility of professional oral health care (POHC) for the management of OM in patients undergoing SSIACRT.

Methods

Thirty-three patients were enrolled in this study. The first 17 patients underwent SSIACRT before we created an oral management team, and thus did not receive POHC. The remaining 16 patients received POHC. Fever duration, duration of oral feeding difficulty, opioid usage, duration of opioid administration, duration of hospitalization, and number of hospital days from the end of irradiation to discharge were compared between these two groups.

Results

Median total dose of morphine during SSIACRT, median number of hospital days from end of irradiation to discharge, and duration of hospitalization all differed significantly between groups (P < 0.05). Duration of opioid administration, fever duration, and duration of oral feeding difficulty did not differ significantly between groups.

Conclusions

These findings indicate that POHC may reduce opioid use and shorten the hospital stay. Such results might be obtained through infection control by POHC. This report appears to be the first study to evaluate the efficiency of POHC in SSIACRT for oral cancer from the perspective of mucositis pain and opioid use.
Literature
1.
go back to reference Ruescher TJ, Sodeifi A, Scrivani SJ, Kaban LB, Sonis ST (1998) The impact of mucositis on alpha-hemolytic streptococcal infection in patients undergoing autologous bone marrow transplantation for hematologic malignancies. Cancer 82:2275–2281CrossRefPubMed Ruescher TJ, Sodeifi A, Scrivani SJ, Kaban LB, Sonis ST (1998) The impact of mucositis on alpha-hemolytic streptococcal infection in patients undergoing autologous bone marrow transplantation for hematologic malignancies. Cancer 82:2275–2281CrossRefPubMed
2.
go back to reference Ohrn KE, Sjödén PO, Wahlin YB, Elf M (2001) Oral health and quality of life among patients with head and neck cancer or haematological malignancies. Support Care Cancer 9:528–538CrossRefPubMed Ohrn KE, Sjödén PO, Wahlin YB, Elf M (2001) Oral health and quality of life among patients with head and neck cancer or haematological malignancies. Support Care Cancer 9:528–538CrossRefPubMed
3.
go back to reference Sonis ST, Oster G, Fuchs H, Bellm L, Bradford WZ, Edelsberg J, Hayden V, Eilers J, Epstein JB, LeVeque FG, Miller C, Peterson DE, Schubert MM, Spijkervet FK, Horowitz M (2001) Oral mucositis and the clinical and economic outcomes of hematopoietic stem-cell transplantation. J Clin Oncol 19(8):2201–2205PubMed Sonis ST, Oster G, Fuchs H, Bellm L, Bradford WZ, Edelsberg J, Hayden V, Eilers J, Epstein JB, LeVeque FG, Miller C, Peterson DE, Schubert MM, Spijkervet FK, Horowitz M (2001) Oral mucositis and the clinical and economic outcomes of hematopoietic stem-cell transplantation. J Clin Oncol 19(8):2201–2205PubMed
4.
go back to reference Stiff P (2001) Mucositis associated with stem cell transplantation: current status and innovative approaches to management. Bone Marrow Transplant 27(Suppl 2):S3–S11CrossRefPubMed Stiff P (2001) Mucositis associated with stem cell transplantation: current status and innovative approaches to management. Bone Marrow Transplant 27(Suppl 2):S3–S11CrossRefPubMed
5.
go back to reference Elting LS, Cooksley C, Chambers M, Cantor SB, Manzullo E, Rubenstein EB (2003) The burdens of cancer therapy. clinical and economic outcomes of chemotherapy-induced mucositis. Cancer 98(7):1531–1539CrossRefPubMed Elting LS, Cooksley C, Chambers M, Cantor SB, Manzullo E, Rubenstein EB (2003) The burdens of cancer therapy. clinical and economic outcomes of chemotherapy-induced mucositis. Cancer 98(7):1531–1539CrossRefPubMed
6.
go back to reference Trotti A, Bellm LA, Epstein JB, Frame D, Fuchs HJ, Gwede CK, Komaroff E, Nalysnyk L, Zilberberg MD (2003) 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 66(3):253–262CrossRefPubMed Trotti A, Bellm LA, Epstein JB, Frame D, Fuchs HJ, Gwede CK, Komaroff E, Nalysnyk L, Zilberberg MD (2003) 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 66(3):253–262CrossRefPubMed
7.
go back to reference Robbins KT, Storniolo AM, Kerber C, Seagren S, Berson A, Howell SB (1992) Rapid superselective high-dose cisplatin infusion for advanced head and neck malignancies. Head Neck 14(5):364–371CrossRefPubMed Robbins KT, Storniolo AM, Kerber C, Seagren S, Berson A, Howell SB (1992) Rapid superselective high-dose cisplatin infusion for advanced head and neck malignancies. Head Neck 14(5):364–371CrossRefPubMed
8.
go back to reference Robbins KT, Kumar P, Wong FS, Hartsell WF, Flick P, Palmer R, Weir AB 3rd, Neill HB, Murry T, Ferguson R, Hanchett C, Vieira F, Bush A, Howell SB (2000) Targeted chemoradiation for advanced head and neck cancer: analysis of 213 patients. Head Neck 22(7):687–693CrossRefPubMed Robbins KT, Kumar P, Wong FS, Hartsell WF, Flick P, Palmer R, Weir AB 3rd, Neill HB, Murry T, Ferguson R, Hanchett C, Vieira F, Bush A, Howell SB (2000) Targeted chemoradiation for advanced head and neck cancer: analysis of 213 patients. Head Neck 22(7):687–693CrossRefPubMed
9.
go back to reference Robbins KT, Wong FS, Kumar P, Hartsell WF, Vieira F, Mullins B, Niell HB (1999) Efficacy of targeted chemoradiation and planned selective neck dissection to control bulky nodal disease in advanced head and neck cancer. Arch Otolaryngol Head Neck Surg 125(6):670–675CrossRefPubMed Robbins KT, Wong FS, Kumar P, Hartsell WF, Vieira F, Mullins B, Niell HB (1999) Efficacy of targeted chemoradiation and planned selective neck dissection to control bulky nodal disease in advanced head and neck cancer. Arch Otolaryngol Head Neck Surg 125(6):670–675CrossRefPubMed
10.
go back to reference Kobayashi W, Teh BG, Sakaki H, Sato H, Kimura H, Kakehata S, Nagahata M (2010) Superselective intra-arterial chemoradiotherapy with docetaxel-nedaplatin for advanced oral cancer. Oral Oncol 46(12):860–863CrossRefPubMed Kobayashi W, Teh BG, Sakaki H, Sato H, Kimura H, Kakehata S, Nagahata M (2010) Superselective intra-arterial chemoradiotherapy with docetaxel-nedaplatin for advanced oral cancer. Oral Oncol 46(12):860–863CrossRefPubMed
11.
go back to reference Saito H, Watanabe Y, Sato K, Ikawa H, Yoshida Y, Katakura A, Takayama S, Sato M (2014) Effects of professional oral health care on reducing the risk of chemotherapy-induced oral mucositis. Support Care Cancer 22(11):2935–2940PubMedCentralCrossRefPubMed Saito H, Watanabe Y, Sato K, Ikawa H, Yoshida Y, Katakura A, Takayama S, Sato M (2014) Effects of professional oral health care on reducing the risk of chemotherapy-induced oral mucositis. Support Care Cancer 22(11):2935–2940PubMedCentralCrossRefPubMed
12.
go back to reference Lalla RV, Bowen J, Barasch A, Elting L, Epstein J, Keefe DM, McGuire DB, Migliorati C, Nicolatou-Galitis O, Peterson DE, Raber-Durlacher JE, Sonis ST, Elad S, Mucositis Guidelines Leadership Group of the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) (2014) MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer 120(10):1453–1461PubMedCentralCrossRefPubMed Lalla RV, Bowen J, Barasch A, Elting L, Epstein J, Keefe DM, McGuire DB, Migliorati C, Nicolatou-Galitis O, Peterson DE, Raber-Durlacher JE, Sonis ST, Elad S, Mucositis Guidelines Leadership Group of the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) (2014) MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer 120(10):1453–1461PubMedCentralCrossRefPubMed
13.
go back to reference Fainsinger RL, Fairchild A, Nekolaichuk C, Lawlor P, Lowe S, Hanson J (2009) Is pain intensity a predictor of the complexity of cancer pain management? J Clin Oncol 27(4):585–590CrossRefPubMed Fainsinger RL, Fairchild A, Nekolaichuk C, Lawlor P, Lowe S, Hanson J (2009) Is pain intensity a predictor of the complexity of cancer pain management? J Clin Oncol 27(4):585–590CrossRefPubMed
14.
go back to reference National Cancer Institute (2009) Common terminology criteria for adverse events (CTCAE) version 4.0. U.S. Department of Health and Human Services, Bethesda National Cancer Institute (2009) Common terminology criteria for adverse events (CTCAE) version 4.0. U.S. Department of Health and Human Services, Bethesda
15.
go back to reference Spijkervet FK, van Saene HK, Panders AK, Vermey A, Mehta DM (1989) Scoring irradiation mucositis in head and neck cancer patients. J Oral Pathol Med 18(3):167–171CrossRefPubMed Spijkervet FK, van Saene HK, Panders AK, Vermey A, Mehta DM (1989) Scoring irradiation mucositis in head and neck cancer patients. J Oral Pathol Med 18(3):167–171CrossRefPubMed
16.
go back to reference Stokman MA, Spijkervet FK, Boezen HM, Schouten JP, Roodenburg JL, de Vries EG (2006) Preventive intervention possibilities in radiotherapy- and chemotherapy-induced oral mucositis: results of meta-analyses. J Dent Res 85(8):690–700CrossRefPubMed Stokman MA, Spijkervet FK, Boezen HM, Schouten JP, Roodenburg JL, de Vries EG (2006) Preventive intervention possibilities in radiotherapy- and chemotherapy-induced oral mucositis: results of meta-analyses. J Dent Res 85(8):690–700CrossRefPubMed
17.
go back to reference List MA, Stracks J (2003) Quality of life and late toxicities in head and neck cancer. Cancer Treat Res 114:331–351CrossRefPubMed List MA, Stracks J (2003) Quality of life and late toxicities in head and neck cancer. Cancer Treat Res 114:331–351CrossRefPubMed
19.
go back to reference Sonis ST (2009) Mucositis: the impact, biology and therapeutic opportunities of oral mucositis. Oral Oncol 45(12):1015–1020CrossRefPubMed Sonis ST (2009) Mucositis: the impact, biology and therapeutic opportunities of oral mucositis. Oral Oncol 45(12):1015–1020CrossRefPubMed
20.
go back to reference Yoneyama T, Yoshida M, Matsui T, Sasaki H, Oral Care Working Group (1999) Oral care and pneumonia. Lancet 354:515CrossRefPubMed Yoneyama T, Yoshida M, Matsui T, Sasaki H, Oral Care Working Group (1999) Oral care and pneumonia. Lancet 354:515CrossRefPubMed
21.
go back to reference Yamagata K, Arai C, Sasaki H, Takeuchi Y, Onizawa K, Yanagawa T, Ishibashi N, Karube R, Shinozuka K, Hasegawa Y, Chiba S, Bukawa H (2012) The effect of oral management on the severity of oral mucositis during hematopoietic SCT. Bone Marrow Transplant 47(5):725–730CrossRefPubMed Yamagata K, Arai C, Sasaki H, Takeuchi Y, Onizawa K, Yanagawa T, Ishibashi N, Karube R, Shinozuka K, Hasegawa Y, Chiba S, Bukawa H (2012) The effect of oral management on the severity of oral mucositis during hematopoietic SCT. Bone Marrow Transplant 47(5):725–730CrossRefPubMed
Metadata
Title
Professional oral health care reduces oral mucositis pain in patients treated by superselective intra-arterial chemotherapy concurrent with radiotherapy for oral cancer
Authors
Kosei Kubota
Wataru Kobayashi
Hirotaka Sakaki
Hiroshi Nakagawa
Takao Kon
Mayu Mimura
Ryohei Ito
Ken Furudate
Hiroto Kimura
Publication date
01-11-2015
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 11/2015
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-015-2774-x

Other articles of this Issue 11/2015

Supportive Care in Cancer 11/2015 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine