Skip to main content
Top
Published in: Supportive Care in Cancer 11/2014

Open Access 01-11-2014 | Original Article

Effects of professional oral health care on reducing the risk of chemotherapy-induced oral mucositis

Authors: Hirokazu Saito, Yutaka Watanabe, Kazumichi Sato, Hiroaki Ikawa, Yoshifumi Yoshida, Akira Katakura, Shin Takayama, Michio Sato

Published in: Supportive Care in Cancer | Issue 11/2014

Login to get access

Abstract

Purpose

Recent years have seen remarkable progress in cancer therapy, although treatment-induced adverse reactions and complications are not uncommon. Approximately 40 % of patients undergoing chemotherapy for cancer experience adverse reactions in the oral cavity, with nearly half of them developing severe oral mucositis that necessitates postponing therapy and/or changing the drug dosage. The objective of this study was to assess the usefulness of prophylactic professional oral health care (POHC) for preventing mucositis in patients undergoing chemotherapy.

Methods

Twenty-six female patients scheduled for chemotherapy for breast cancer were included in this study and randomized to the self-care or POHC groups. Assessment parameters included oral cavity photographs, plaque control records, Saxon test scores, Oral Assessment Guide scores, and grading using the Common Terminology Criteria for Adverse Events. Beginning before surgery and continuing through the completion of chemotherapy, the POHC patient group received weekly professional oral health care, including scaling, professional cleaning of the tooth surfaces, brushing instructions, and nutritional and lifestyle guidance.

Results

More patients in the self-care group developed oral mucositis than in the POHC group. The Oral Assessment Guide score, which was used as an index of oral mucositis, was also significantly lower in the POHC group. Based on the Oral Assessment Guide and plaque control records, there was almost no deterioration of the oral environment in the POHC group, whereas deterioration was observed in the self-care group.

Conclusions

These findings demonstrate the efficacy of regular POHC in reducing the risk of oral mucositis in breast cancer patients undergoing chemotherapy.
Literature
1.
go back to reference Sonis ST (1998) Mucositis as a biological process: a new hypothesis for the development of chemotherapy-induced stomatotoxicity. Oral Oncol 34:39–43PubMedCrossRef Sonis ST (1998) Mucositis as a biological process: a new hypothesis for the development of chemotherapy-induced stomatotoxicity. Oral Oncol 34:39–43PubMedCrossRef
2.
go back to reference Majorana A, Schubert MM, Porta F, Ugazio AG, Sapelli PL (2000) Oral complications of pediatric hematopoietic cell transplantation: diagnosis and management. Support Care Cancer 8:353–365PubMedCrossRef Majorana A, Schubert MM, Porta F, Ugazio AG, Sapelli PL (2000) Oral complications of pediatric hematopoietic cell transplantation: diagnosis and management. Support Care Cancer 8:353–365PubMedCrossRef
3.
go back to reference Raber-Durlacher JE, Weijl NI, Abu Saris M, de Koning B, Zwinderman AH, Osanto S (2000) Oral mucositis in patients treated with chemotherapy for solid tumors: a retrospective analysis of 150 cases. Support Care Cancer 8:366–371PubMedCrossRef Raber-Durlacher JE, Weijl NI, Abu Saris M, de Koning B, Zwinderman AH, Osanto S (2000) Oral mucositis in patients treated with chemotherapy for solid tumors: a retrospective analysis of 150 cases. Support Care Cancer 8:366–371PubMedCrossRef
4.
go back to reference Barber C, Powell R, Ellis A, Hewett J (2007) 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 15:427–440PubMedCrossRef Barber C, Powell R, Ellis A, Hewett J (2007) 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 15:427–440PubMedCrossRef
5.
go back to reference Sonis ST, Elting LS, Keefe D, Petersen DE, Schubert M, Hauer-Jensen M, Bekele BN, Raber-Durlacher J, Donnelly JP, Rubenstein EB (2004) Mucositis Study Section of the Multinational Association for Supportive Care in Cancer, International Society for Oral Oncology Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer 100:1995–2025PubMedCrossRef Sonis ST, Elting LS, Keefe D, Petersen DE, Schubert M, Hauer-Jensen M, Bekele BN, Raber-Durlacher J, Donnelly JP, Rubenstein EB (2004) Mucositis Study Section of the Multinational Association for Supportive Care in Cancer, International Society for Oral Oncology Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer 100:1995–2025PubMedCrossRef
6.
go back to reference Keefe DM, Schubert MM, Elting LS, Sonis ST, Epstein JB, Raber-Durlacher JE, Migliorati CA, McGuire DB, Hutchins RD, Peterson DE (2007) Mucositis Study Section of the Multinational Association for Supportive Care in Cancer and the International Society for Oral Oncology Updated clinical practice guidelines for the prevention and treatment of mucositis. Cancer 109:820–831PubMedCrossRef Keefe DM, Schubert MM, Elting LS, Sonis ST, Epstein JB, Raber-Durlacher JE, Migliorati CA, McGuire DB, Hutchins RD, Peterson DE (2007) Mucositis Study Section of the Multinational Association for Supportive Care in Cancer and the International Society for Oral Oncology Updated clinical practice guidelines for the prevention and treatment of mucositis. Cancer 109:820–831PubMedCrossRef
7.
go back to reference Kennedy HF, Morrison D, Kaufmann ME, Jackson MS, Bagg J, Gibson BE, Gemmell CG, Michie JR (2000) Origins of Staphylococcus epidermidis and Streptococcus oralis causing bacteraemia in a bone marrow transplant patient. J Med Microbiol 49:367–370PubMed Kennedy HF, Morrison D, Kaufmann ME, Jackson MS, Bagg J, Gibson BE, Gemmell CG, Michie JR (2000) Origins of Staphylococcus epidermidis and Streptococcus oralis causing bacteraemia in a bone marrow transplant patient. J Med Microbiol 49:367–370PubMed
8.
go back to reference Yoneyama T, Yoshida M, Matsui T, Sasaki H (1999) Oral care and pneumonia. Oral Care Working Group. Lancet 354:515PubMedCrossRef Yoneyama T, Yoshida M, Matsui T, Sasaki H (1999) Oral care and pneumonia. Oral Care Working Group. Lancet 354:515PubMedCrossRef
9.
go back to reference McGuire DB, Fulton JS, Park J, Brown CG, Correa ME, Eilers J, Elad S, Gibson F, Oberle-Edwards LK, Bowen J, Lalla RV (2013) Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) Systematic review of basic oral care for the management of oral mucositis in cancer patients. Support Care Cancer 21:3165–3177PubMedCrossRef McGuire DB, Fulton JS, Park J, Brown CG, Correa ME, Eilers J, Elad S, Gibson F, Oberle-Edwards LK, Bowen J, Lalla RV (2013) Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) Systematic review of basic oral care for the management of oral mucositis in cancer patients. Support Care Cancer 21:3165–3177PubMedCrossRef
10.
go back to reference Greene FL, Page DL, Fleming ID, Fritz AG, Balch CM, Haller DG, Morrow M (2002) AJCC cancer staging manual, 6th edn. Springer, New YorkCrossRef Greene FL, Page DL, Fleming ID, Fritz AG, Balch CM, Haller DG, Morrow M (2002) AJCC cancer staging manual, 6th edn. Springer, New YorkCrossRef
12.
go back to reference Eilers J, Berger AM, Peterson MC (1988) Development, testing, and application of the oral assessment guide. Oncol Nurs Forum 15:325–330PubMed Eilers J, Berger AM, Peterson MC (1988) Development, testing, and application of the oral assessment guide. Oncol Nurs Forum 15:325–330PubMed
13.
go back to reference Koshino M, Sakai C, Ogura T, Kawasaki A, Fukuzato F, Miyazaki Y (2009) Efficacy of oral cavity care in preventing stomatitis (mucositis) in cancer chemotherapy. Gan To Kagaku Ryoho 36:447–451PubMed Koshino M, Sakai C, Ogura T, Kawasaki A, Fukuzato F, Miyazaki Y (2009) Efficacy of oral cavity care in preventing stomatitis (mucositis) in cancer chemotherapy. Gan To Kagaku Ryoho 36:447–451PubMed
14.
15.
go back to reference Seki S, Sonoda S, Suzuki M, Fujii W (2003) The saliva secretion test in stroke patients: reliability of the Saxon test. Japan J Rehabil Med 40:858–862CrossRef Seki S, Sonoda S, Suzuki M, Fujii W (2003) The saliva secretion test in stroke patients: reliability of the Saxon test. Japan J Rehabil Med 40:858–862CrossRef
16.
go back to reference Jellema AP, Slotman BJ, Doornaert P, Leemans CR, Langendijk JA (2007) Impact of radiation-induced xerostomia on quality of life after primary radiotherapy among patients with head and neck cancer. Int J Radiat Oncol Biol Phys 69:751–760PubMedCrossRef Jellema AP, Slotman BJ, Doornaert P, Leemans CR, Langendijk JA (2007) Impact of radiation-induced xerostomia on quality of life after primary radiotherapy among patients with head and neck cancer. Int J Radiat Oncol Biol Phys 69:751–760PubMedCrossRef
17.
go back to reference Tamura Y, Sakurai A, Yamamura C (2009) Comparison of oral mucosa humidity and salivary flow rate, and the effects of moisturizer on the salivary flow rate. Niigata Dent J 39:35–42 Tamura Y, Sakurai A, Yamamura C (2009) Comparison of oral mucosa humidity and salivary flow rate, and the effects of moisturizer on the salivary flow rate. Niigata Dent J 39:35–42
18.
go back to reference Hovan AJ, Williams PM, Stevenson-Moore P, Wahlin YB, Ohrn KE, Elting LS, Spijkervet FK, Brennan MT (2010) Dysgeusia Section, Oral Care Study Group, Multinational Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO) A systematic review of dysgeusia induced by cancer therapies. Support Care Cancer 18:1081–1087PubMedCrossRef Hovan AJ, Williams PM, Stevenson-Moore P, Wahlin YB, Ohrn KE, Elting LS, Spijkervet FK, Brennan MT (2010) Dysgeusia Section, Oral Care Study Group, Multinational Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO) A systematic review of dysgeusia induced by cancer therapies. Support Care Cancer 18:1081–1087PubMedCrossRef
19.
go back to reference Kobayashi M, Okada Y, Toda K (2007) Gustatory sensitivity in different regions of the tongue in Japanese young women. J Jpn Dent Soc Orient Med 25:1–2 Kobayashi M, Okada Y, Toda K (2007) Gustatory sensitivity in different regions of the tongue in Japanese young women. J Jpn Dent Soc Orient Med 25:1–2
20.
go back to reference Schubert MM, Williams BE, Lloid ME, Donaldson G, Chapko MK (1992) Clinical assessment scale for the rating of oral mucosal changes associated with bone marrow transplantation. Development of an oral mucositis index. Cancer 69:2469–2477PubMedCrossRef Schubert MM, Williams BE, Lloid ME, Donaldson G, Chapko MK (1992) Clinical assessment scale for the rating of oral mucosal changes associated with bone marrow transplantation. Development of an oral mucositis index. Cancer 69:2469–2477PubMedCrossRef
21.
go back to reference Sonis ST, Eilers JP, Epstein JB, LeVeque FG, Liggett WH Jr, Mulagha MT, Peterson DE, Rose AH, Schubert MM, Spijkervet FK, Wittes JP (1999) Validation of a new scoring system for the assessment of clinical trial research of oral mucositis induced by radiation or chemotherapy. Mucositis Study Group. Cancer 85:2103–2113PubMedCrossRef Sonis ST, Eilers JP, Epstein JB, LeVeque FG, Liggett WH Jr, Mulagha MT, Peterson DE, Rose AH, Schubert MM, Spijkervet FK, Wittes JP (1999) Validation of a new scoring system for the assessment of clinical trial research of oral mucositis induced by radiation or chemotherapy. Mucositis Study Group. Cancer 85:2103–2113PubMedCrossRef
22.
go back to reference McGuire DB, Peterson DE, Muller S, Owen DC, Slemmons MF, Schubert MM (2002) The 20 item oral mucositis index: reliability and validity in bone marrow and stem cell transplant patients. Cancer Investig 20:893–903CrossRef McGuire DB, Peterson DE, Muller S, Owen DC, Slemmons MF, Schubert MM (2002) The 20 item oral mucositis index: reliability and validity in bone marrow and stem cell transplant patients. Cancer Investig 20:893–903CrossRef
23.
go back to reference Borowski B, Benhamou E, Pico JL, Laplanche A, Margainaud JP, Hayat M (1994) Prevention of oral mucositis in patients treated with high-dose chemotherapy and bone marrow transplantation: a randomised controlled trial comparing two protocols of dental care. Eur J Cancer B Oral Oncol 30B:93–97PubMedCrossRef Borowski B, Benhamou E, Pico JL, Laplanche A, Margainaud JP, Hayat M (1994) Prevention of oral mucositis in patients treated with high-dose chemotherapy and bone marrow transplantation: a randomised controlled trial comparing two protocols of dental care. Eur J Cancer B Oral Oncol 30B:93–97PubMedCrossRef
24.
go back to reference Sugiura Y, Soga Y, Tanimoto I, Kokeguchi S, Nishide S, Kono K, Takahashi K, Fujii N, Ishimaru F, Tanimoto M, Yamabe K, Tsutani S, Nishimura F, Takashiba S (2008) Antimicrobial effects of the saliva substitute, oral balance, against microorganisms from oral mucosa in the hematopoietic cell transplantation period. Support Care Cancer 16:421–424PubMedCrossRef Sugiura Y, Soga Y, Tanimoto I, Kokeguchi S, Nishide S, Kono K, Takahashi K, Fujii N, Ishimaru F, Tanimoto M, Yamabe K, Tsutani S, Nishimura F, Takashiba S (2008) Antimicrobial effects of the saliva substitute, oral balance, against microorganisms from oral mucosa in the hematopoietic cell transplantation period. Support Care Cancer 16:421–424PubMedCrossRef
25.
go back to reference Soga Y, Sugiura Y, Takahashi K, Nishimoto H, Maeda Y, Tanimoto M, Takashiba S (2010) Progress of oral care and reduction of oral mucositis—a pilot study in a hematopoietic stem cell transplantation ward. Support Care Cancer 19:303–307PubMedCrossRef Soga Y, Sugiura Y, Takahashi K, Nishimoto H, Maeda Y, Tanimoto M, Takashiba S (2010) Progress of oral care and reduction of oral mucositis—a pilot study in a hematopoietic stem cell transplantation ward. Support Care Cancer 19:303–307PubMedCrossRef
27.
go back to reference Katsura K, Goto S, Sasai K, Sato K, Tomita M, Matsuyama H, Hayashi T (2009) The effect of dental management for maintaining dental health in patients with head and neck cancer after radiotherapy. Japan J Head Neck Cancer 35:266–272 Katsura K, Goto S, Sasai K, Sato K, Tomita M, Matsuyama H, Hayashi T (2009) The effect of dental management for maintaining dental health in patients with head and neck cancer after radiotherapy. Japan J Head Neck Cancer 35:266–272
28.
go back to reference Akintoye SO, Brennan MT, Graber CJ, McKinney BE, Rams TE, Barrett AJ, Atkinson JC (2002) A retrospective investigation of advanced periodontal disease as a risk factor for septicemia in hematopoietic stem cell and bone marrow transplant recipients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 94:581–588PubMedCrossRef Akintoye SO, Brennan MT, Graber CJ, McKinney BE, Rams TE, Barrett AJ, Atkinson JC (2002) A retrospective investigation of advanced periodontal disease as a risk factor for septicemia in hematopoietic stem cell and bone marrow transplant recipients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 94:581–588PubMedCrossRef
29.
go back to reference Raber-Durlacher JE, Epstein JB, Raber J, van Dissel JT, van Winkelhoff AJ, Guiot HF, van der Velden U (2002) Periodontal infection in cancer patients treated with high-dose chemotherapy. Support Care Cancer 10:466–473PubMedCrossRef Raber-Durlacher JE, Epstein JB, Raber J, van Dissel JT, van Winkelhoff AJ, Guiot HF, van der Velden U (2002) Periodontal infection in cancer patients treated with high-dose chemotherapy. Support Care Cancer 10:466–473PubMedCrossRef
30.
go back to reference Myers RA, Marx RE (1990) Use of hyperbaric oxygen in postradiation head and neck surgery. NCI Monogr 9:151–157PubMed Myers RA, Marx RE (1990) Use of hyperbaric oxygen in postradiation head and neck surgery. NCI Monogr 9:151–157PubMed
Metadata
Title
Effects of professional oral health care on reducing the risk of chemotherapy-induced oral mucositis
Authors
Hirokazu Saito
Yutaka Watanabe
Kazumichi Sato
Hiroaki Ikawa
Yoshifumi Yoshida
Akira Katakura
Shin Takayama
Michio Sato
Publication date
01-11-2014
Publisher
Springer Berlin Heidelberg
Published in
Supportive Care in Cancer / Issue 11/2014
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-014-2282-4

Other articles of this Issue 11/2014

Supportive Care in Cancer 11/2014 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