Skip to main content
Top
Published in: Supportive Care in Cancer 4/2016

01-04-2016 | Original Article

The effect of preventive oral care on treatment outcomes of a cohort of oral cancer patients

Authors: Marilia Oliveira Morais, Marcela Ramos Abrahão Elias, Cláudio Rodrigues Leles, Juliana Castro Dourado Pinezi, Elismauro Francisco Mendonça

Published in: Supportive Care in Cancer | Issue 4/2016

Login to get access

Abstract

Purpose

The purpose of this study was to assess patient adherence to an oral preventive measures (OPM) protocol and its impact on cancer treatment outcomes.

Methods

A retrospective cohort of oral cancer of 133 patients submitted to radiotherapy (RT) was selected, excluding those with metastasis. Patients were grouped according to their local tumor response after finishing RT (favorable or unfavorable) and adherence to an OPM (none, ≤6 months, and >6 months). OPM included education and counseling about adverse effects, elimination of infection foci, restorative procedures, fluoride therapy, oral rehydration, and maintenance and supervision of oral hygiene throughout treatment. Clinical and pathological characteristics were recorded, and patient outcomes (frequency of adverse effects, RT interruption, and overall survival) were analyzed.

Results

Patients with higher adherence to the OPM had greater occurrence of RT interruption as a consequence of symptoms (p = 0.01); however, these patients were more likely to complete the established RT protocol (p = 0.02). Overall survival (p = 0.01) was higher in the group with higher adherence.

Conclusions

This study suggests that the implementation of oral preventive measures may contribute to improving the prognosis of squamous cell carcinoma (SCC) treatment by reducing the negative impact of oral complications.
Literature
1.
go back to reference Pernot M, Hoffstetter S, Peiffert D, Luporsi E, Marchal C, Kozminski P, Dartois D, Bey P (1995) Epidermoid carcinomas of the floor of mouth treated by exclusive irradiation: statistical study of a series of 207 cases. Radiother Oncol 35(3):177–185CrossRefPubMed Pernot M, Hoffstetter S, Peiffert D, Luporsi E, Marchal C, Kozminski P, Dartois D, Bey P (1995) Epidermoid carcinomas of the floor of mouth treated by exclusive irradiation: statistical study of a series of 207 cases. Radiother Oncol 35(3):177–185CrossRefPubMed
2.
go back to reference Patra NB, Goswami J, Basu S, Chatterjee K, Sarkar SK (2009) Outcomes of high dose rate interstitial boost brachytherapy after external beam radiation therapy in head and neck cancer—an Indian (single institutional) learning experience. Brachytherapy 8(2):248–254CrossRefPubMed Patra NB, Goswami J, Basu S, Chatterjee K, Sarkar SK (2009) Outcomes of high dose rate interstitial boost brachytherapy after external beam radiation therapy in head and neck cancer—an Indian (single institutional) learning experience. Brachytherapy 8(2):248–254CrossRefPubMed
3.
go back to reference Stenson KM, Kunnavakkam R, Cohen EE, Portugal LD, Blair E, Haraf DJ, Salama J, Vokes EE (2010) Chemoradiation for patients with advanced oral cavity cancer. Laryngoscope 120(1):93–99. doi:10.1002/lary.20716 PubMed Stenson KM, Kunnavakkam R, Cohen EE, Portugal LD, Blair E, Haraf DJ, Salama J, Vokes EE (2010) Chemoradiation for patients with advanced oral cavity cancer. Laryngoscope 120(1):93–99. doi:10.​1002/​lary.​20716 PubMed
4.
go back to reference Specht L (2002) Oral complications in the head and neck radiation patient. Introduction and scope of the problem. Support Care Cancer 10(1):36–39CrossRefPubMed Specht L (2002) Oral complications in the head and neck radiation patient. Introduction and scope of the problem. Support Care Cancer 10(1):36–39CrossRefPubMed
6.
go back to reference Chen YP, Tsang NM, Tseng CK, Lin SY (2000) Causes of interruption of radiotherapy in nasopharyngeal carcinoma patients in Taiwan. Jpn J Clin Oncol 30(5):230–234CrossRefPubMed Chen YP, Tsang NM, Tseng CK, Lin SY (2000) Causes of interruption of radiotherapy in nasopharyngeal carcinoma patients in Taiwan. Jpn J Clin Oncol 30(5):230–234CrossRefPubMed
10.
go back to reference Tolentino Ede S, Centurion BS, Ferreira LH, Souza AP, Damante JH, Rubira-Bullen IR (2011) Oral adverse effects of head and neck radiotherapy: literature review and suggestion of a clinical oral care guideline for irradiated patients. J Appl Oral Sci 19(5):448–454CrossRefPubMed Tolentino Ede S, Centurion BS, Ferreira LH, Souza AP, Damante JH, Rubira-Bullen IR (2011) Oral adverse effects of head and neck radiotherapy: literature review and suggestion of a clinical oral care guideline for irradiated patients. J Appl Oral Sci 19(5):448–454CrossRefPubMed
11.
go back to reference Huang Q, Li F, Liu X, Li W, Shi W, Liu FF, O’Sullivan B, He Z, Peng Y, Tan AC, Zhou L, Shen J, Han G, Wang XJ, Thorburn J, Thorburn A, Jimeno A, Raben D, Bedford JS, Li CY (2011) Caspase 3-mediated stimulation of tumor cell repopulation during cancer radiotherapy. Nat Med 17(7):860–866. doi:10.1038/nm.2385 PubMedCentralCrossRefPubMed Huang Q, Li F, Liu X, Li W, Shi W, Liu FF, O’Sullivan B, He Z, Peng Y, Tan AC, Zhou L, Shen J, Han G, Wang XJ, Thorburn J, Thorburn A, Jimeno A, Raben D, Bedford JS, Li CY (2011) Caspase 3-mediated stimulation of tumor cell repopulation during cancer radiotherapy. Nat Med 17(7):860–866. doi:10.​1038/​nm.​2385 PubMedCentralCrossRefPubMed
12.
go back to reference Leipzig B, Cummings CW, Chung CT, Sagerman RH (1978) Interruption of combined therapy: a factor in decreased survival. Otolaryngology 86 (6 Pt 1):ORL-881-885 Leipzig B, Cummings CW, Chung CT, Sagerman RH (1978) Interruption of combined therapy: a factor in decreased survival. Otolaryngology 86 (6 Pt 1):ORL-881-885
13.
go back to reference Herrmann T, Jakubek A, Trott KR (1994) The importance of the timing of a gap in radiotherapy of squamous cell carcinomas of the head and neck. Strahlenther Onkol 170(9):545–549PubMed Herrmann T, Jakubek A, Trott KR (1994) The importance of the timing of a gap in radiotherapy of squamous cell carcinomas of the head and neck. Strahlenther Onkol 170(9):545–549PubMed
14.
go back to reference Suwinski R, Sowa A, Rutkowski T, Wydmanski J, Tarnawski R, Maciejewski B (2003) Time factor in postoperative radiotherapy: a multivariate locoregional control analysis in 868 patients. Int J Radiat Oncol Biol Phys 56(2):399–412CrossRefPubMed Suwinski R, Sowa A, Rutkowski T, Wydmanski J, Tarnawski R, Maciejewski B (2003) Time factor in postoperative radiotherapy: a multivariate locoregional control analysis in 868 patients. Int J Radiat Oncol Biol Phys 56(2):399–412CrossRefPubMed
15.
go back to reference Schiodt M, Hermund NU (2002) Management of oral disease prior to radiation therapy. Support Care Cancer 10(1):40–43CrossRefPubMed Schiodt M, Hermund NU (2002) Management of oral disease prior to radiation therapy. Support Care Cancer 10(1):40–43CrossRefPubMed
16.
go back to reference Hancock PJ, Epstein JB, Sadler GR (2003) Oral and dental management related to radiation therapy for head and neck cancer. J Can Dent Assoc 69(9):585–590PubMed Hancock PJ, Epstein JB, Sadler GR (2003) Oral and dental management related to radiation therapy for head and neck cancer. J Can Dent Assoc 69(9):585–590PubMed
17.
18.
go back to reference Langendijk JA, Doornaert P, Rietveld DH, Verdonck-de Leeuw IM, Leemans CR, Slotman BJ (2009) A predictive model for swallowing dysfunction after curative radiotherapy in head and neck cancer. Radiother Oncol 90(2):189–195CrossRefPubMed Langendijk JA, Doornaert P, Rietveld DH, Verdonck-de Leeuw IM, Leemans CR, Slotman BJ (2009) A predictive model for swallowing dysfunction after curative radiotherapy in head and neck cancer. Radiother Oncol 90(2):189–195CrossRefPubMed
19.
go back to reference Oton-Leite AF, Correa de Castro AC, Morais MO, Pinezi JC, Leles CR, Mendonca EF (2012) Effect of intraoral low-level laser therapy on quality of life of patients with head and neck cancer undergoing radiotherapy. Head Neck 34(3):398–404. doi:10.1002/hed.21737 CrossRefPubMed Oton-Leite AF, Correa de Castro AC, Morais MO, Pinezi JC, Leles CR, Mendonca EF (2012) Effect of intraoral low-level laser therapy on quality of life of patients with head and neck cancer undergoing radiotherapy. Head Neck 34(3):398–404. doi:10.​1002/​hed.​21737 CrossRefPubMed
20.
go back to reference Oton-Leite AF, Elias LS, Morais MO, Pinezi JC, Leles CR, Silva MA, Mendonca EF (2013) Effect of low level laser therapy in the reduction of oral complications in patients with cancer of the head and neck submitted to radiotherapy. Spec Care Dentist 33(6):294–300. doi:10.1111/j.1754-4505.2012.00303.x CrossRefPubMed Oton-Leite AF, Elias LS, Morais MO, Pinezi JC, Leles CR, Silva MA, Mendonca EF (2013) Effect of low level laser therapy in the reduction of oral complications in patients with cancer of the head and neck submitted to radiotherapy. Spec Care Dentist 33(6):294–300. doi:10.​1111/​j.​1754-4505.​2012.​00303.​x CrossRefPubMed
21.
go back to reference Cheng KK, Molassiotis A, Chang AM, Wai WC, Cheung SS (2001) Evaluation of an oral care protocol intervention in the prevention of chemotherapy-induced oral mucositis in paediatric cancer patients. Eur J Cancer 37(16):2056–2063CrossRefPubMed Cheng KK, Molassiotis A, Chang AM, Wai WC, Cheung SS (2001) Evaluation of an oral care protocol intervention in the prevention of chemotherapy-induced oral mucositis in paediatric cancer patients. Eur J Cancer 37(16):2056–2063CrossRefPubMed
22.
go back to reference Cheng KK, Molassiotis A, Chang AM (2002) An oral care protocol intervention to prevent chemotherapy-induced oral mucositis in paediatric cancer patients: a pilot study. Eur J Oncol Nurs 6(2):66–73CrossRefPubMed Cheng KK, Molassiotis A, Chang AM (2002) An oral care protocol intervention to prevent chemotherapy-induced oral mucositis in paediatric cancer patients: a pilot study. Eur J Oncol Nurs 6(2):66–73CrossRefPubMed
23.
go back to reference Eduardo Fde P, Bezinelli LM, de Carvalho DL, Lopes RM, Fernandes JF, Brumatti M, Vince CS, de Azambuja AM, Vogel C, Hamerschlak N, Correa L (2015) Oral mucositis in pediatric patients undergoing hematopoietic stem cell transplantation: clinical outcomes in a context of specialized oral care using low-level laser therapy. Pediatr Transplant 19(3):316–325. doi:10.1111/petr.12440 CrossRefPubMed Eduardo Fde P, Bezinelli LM, de Carvalho DL, Lopes RM, Fernandes JF, Brumatti M, Vince CS, de Azambuja AM, Vogel C, Hamerschlak N, Correa L (2015) Oral mucositis in pediatric patients undergoing hematopoietic stem cell transplantation: clinical outcomes in a context of specialized oral care using low-level laser therapy. Pediatr Transplant 19(3):316–325. doi:10.​1111/​petr.​12440 CrossRefPubMed
24.
go back to reference Kubota K, Kobayashi W, Sakaki H, Nakagawa H, Kon T, Mimura M, Ito R, Furudate K, Kimura H (2015) Professional oral health care reduces oral mucositis pain in patients treated by superselective intra-arterial chemotherapy concurrent with radiotherapy for oral cancer. Support Care Cancer. doi:10.1007/s00520-015-2774-x Kubota K, Kobayashi W, Sakaki H, Nakagawa H, Kon T, Mimura M, Ito R, Furudate K, Kimura H (2015) Professional oral health care reduces oral mucositis pain in patients treated by superselective intra-arterial chemotherapy concurrent with radiotherapy for oral cancer. Support Care Cancer. doi:10.​1007/​s00520-015-2774-x
25.
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 (2014) MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer 120(10):1453–1461. doi:10.1002/cncr.28592 PubMedCentralCrossRefPubMed 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 (2014) MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer 120(10):1453–1461. doi:10.​1002/​cncr.​28592 PubMedCentralCrossRefPubMed
26.
go back to reference Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5(6):649–655CrossRefPubMed Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET, Carbone PP (1982) Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am J Clin Oncol 5(6):649–655CrossRefPubMed
27.
go back to reference Rahn R, Adamietz IA, Boettcher HD, Schaefer V, Reimer K, Fleischer W (1997) Povidone-iodine to prevent mucositis in patients during antineoplastic radiochemotherapy. Dermatology 195(Suppl 2):57–61CrossRefPubMed Rahn R, Adamietz IA, Boettcher HD, Schaefer V, Reimer K, Fleischer W (1997) Povidone-iodine to prevent mucositis in patients during antineoplastic radiochemotherapy. Dermatology 195(Suppl 2):57–61CrossRefPubMed
28.
go back to reference Fitzpatrick AL, Powe NR, Cooper LS, Ives DG, Robbins JA (2004) Barriers to health care access among the elderly and who perceives them. Am J Public Health 94(10):1788–1794PubMedCentralCrossRefPubMed Fitzpatrick AL, Powe NR, Cooper LS, Ives DG, Robbins JA (2004) Barriers to health care access among the elderly and who perceives them. Am J Public Health 94(10):1788–1794PubMedCentralCrossRefPubMed
29.
go back to reference Corrigan DM, Walker MP, Liu Y, Mitchell TV (2013) Factors influencing patients seeking oral health care in the oncology dental support clinic at an urban university dental school setting. Spec Care Dentist 34:106–113. doi:10.1111/scd.12037 CrossRefPubMed Corrigan DM, Walker MP, Liu Y, Mitchell TV (2013) Factors influencing patients seeking oral health care in the oncology dental support clinic at an urban university dental school setting. Spec Care Dentist 34:106–113. doi:10.​1111/​scd.​12037 CrossRefPubMed
30.
go back to reference Capuano G, Gentile PC, Bianciardi F, Tosti M, Palladino A, Di Palma M (2010) Prevalence and influence of malnutrition on quality of life and performance status in patients with locally advanced head and neck cancer before treatment. Support Care Cancer 18(4):433–437. doi:10.1007/s00520-009-0681-8 CrossRefPubMed Capuano G, Gentile PC, Bianciardi F, Tosti M, Palladino A, Di Palma M (2010) Prevalence and influence of malnutrition on quality of life and performance status in patients with locally advanced head and neck cancer before treatment. Support Care Cancer 18(4):433–437. doi:10.​1007/​s00520-009-0681-8 CrossRefPubMed
31.
32.
go back to reference Kashiwazaki H, Matsushita T, Sugita J, Shigematsu A, Kasashi K, Yamazaki Y, Kanehira T, Yamamoto S, Kondo T, Endo T, Tanaka J, Hashino S, Nishio M, Imamura M, Kitagawa Y, Inoue N (2012) Professional oral health care reduces oral mucositis and febrile neutropenia in patients treated with allogeneic bone marrow transplantation. Support Care Cancer 20(2):367–373. doi:10.1007/s00520-011-1116-x CrossRefPubMed Kashiwazaki H, Matsushita T, Sugita J, Shigematsu A, Kasashi K, Yamazaki Y, Kanehira T, Yamamoto S, Kondo T, Endo T, Tanaka J, Hashino S, Nishio M, Imamura M, Kitagawa Y, Inoue N (2012) Professional oral health care reduces oral mucositis and febrile neutropenia in patients treated with allogeneic bone marrow transplantation. Support Care Cancer 20(2):367–373. doi:10.​1007/​s00520-011-1116-x CrossRefPubMed
33.
go back to reference Kim JW, Cha Y, Kim SJ, Han SW, Oh DY, Lee SH, Kim DW, Im SA, Kim TY, Heo DS, Bang YJ (2012) Association of oral mucositis with quality of life and symptom clusters in patients with solid tumors receiving chemotherapy. Support Care Cancer 20(2):395–403. doi:10.1007/s00520-011-1126-8 CrossRefPubMed Kim JW, Cha Y, Kim SJ, Han SW, Oh DY, Lee SH, Kim DW, Im SA, Kim TY, Heo DS, Bang YJ (2012) Association of oral mucositis with quality of life and symptom clusters in patients with solid tumors receiving chemotherapy. Support Care Cancer 20(2):395–403. doi:10.​1007/​s00520-011-1126-8 CrossRefPubMed
34.
go back to reference Patel Y, Bahlhorn H, Zafar S, Zwetchkenbaum S, Eisbruch A, Murdoch-Kinch CA (2012) Survey of Michigan dentists and radiation oncologists on oral care of patients undergoing head and neck radiation therapy. J Mich Dent Assoc 94(7):34–45PubMed Patel Y, Bahlhorn H, Zafar S, Zwetchkenbaum S, Eisbruch A, Murdoch-Kinch CA (2012) Survey of Michigan dentists and radiation oncologists on oral care of patients undergoing head and neck radiation therapy. J Mich Dent Assoc 94(7):34–45PubMed
35.
go back to reference Barker GJ, Epstein JB, Williams KB, Gorsky M, Raber-Durlacher JE (2005) Current practice and knowledge of oral care for cancer patients: a survey of supportive health care providers. Support Care Cancer 13(1):32–41. doi:10.1007/s00520-004-0691-5 CrossRefPubMed Barker GJ, Epstein JB, Williams KB, Gorsky M, Raber-Durlacher JE (2005) Current practice and knowledge of oral care for cancer patients: a survey of supportive health care providers. Support Care Cancer 13(1):32–41. doi:10.​1007/​s00520-004-0691-5 CrossRefPubMed
36.
go back to reference Eich HT, Loschcke M, Scheer M, Kocher M, Bongartz R, Wacker S, Zoller JE, Muller RP (2008) Neoadjuvant radiochemotherapy and radical resection for advanced squamous cell carcinoma of the oral cavity. Outcome of 134 patients. Strahlenther Onkol 184(1):23–29. doi:10.1007/s00066-008-1725-6 CrossRefPubMed Eich HT, Loschcke M, Scheer M, Kocher M, Bongartz R, Wacker S, Zoller JE, Muller RP (2008) Neoadjuvant radiochemotherapy and radical resection for advanced squamous cell carcinoma of the oral cavity. Outcome of 134 patients. Strahlenther Onkol 184(1):23–29. doi:10.​1007/​s00066-008-1725-6 CrossRefPubMed
37.
go back to reference Hitter A, Soriano E, Bettega G, Karkas A, Reyt E, Righini CA (2007) Outcome of surgical and adjuvant radiotherapy treatment of T3-T4 squamous cell carcinoma of the floor of the mouth: evaluation of oncological control and treatment related morbidity. Rev Laryngol Otol Rhinol (Bord) 128(3):155–162 Hitter A, Soriano E, Bettega G, Karkas A, Reyt E, Righini CA (2007) Outcome of surgical and adjuvant radiotherapy treatment of T3-T4 squamous cell carcinoma of the floor of the mouth: evaluation of oncological control and treatment related morbidity. Rev Laryngol Otol Rhinol (Bord) 128(3):155–162
38.
go back to reference Kreppel M, Eich HT, Kubler A, Zoller JE, Scheer M (2010) Prognostic value of the sixth edition of the UICC’s TNM classification and stage grouping for oral cancer. J Surg Oncol 102(5):443–449. doi:10.1002/jso.21547 CrossRefPubMed Kreppel M, Eich HT, Kubler A, Zoller JE, Scheer M (2010) Prognostic value of the sixth edition of the UICC’s TNM classification and stage grouping for oral cancer. J Surg Oncol 102(5):443–449. doi:10.​1002/​jso.​21547 CrossRefPubMed
Metadata
Title
The effect of preventive oral care on treatment outcomes of a cohort of oral cancer patients
Authors
Marilia Oliveira Morais
Marcela Ramos Abrahão Elias
Cláudio Rodrigues Leles
Juliana Castro Dourado Pinezi
Elismauro Francisco Mendonça
Publication date
01-04-2016
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 4/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-015-2956-6

Other articles of this Issue 4/2016

Supportive Care in Cancer 4/2016 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