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Published in: BMC Oral Health 1/2023

Open Access 01-12-2023 | Oral Cancer | Research

Oral health related quality of life of oral cancer patients treated with radiotherapy alone or with chemotherapy in a tertiary referral centre in Sri Lanka

Authors: Shamini Kosgallana, Prasanna Jayasekara, Prasad Abeysinghe, Ratilal Lalloo

Published in: BMC Oral Health | Issue 1/2023

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Abstract

Background

Oral cancer is the number one cancer among males in Sri Lanka. Radiotherapy is a common treatment modality for oral cancer, but this can affect oral health related quality of life (OHRQOL). This study assessed the OHRQOL and its changes from baseline to the last week of radiotherapy and three months post radiotherapy among oral cancer patients who received this treatment alone or with chemotherapy.

Methods

A prospective longitudinal study was conducted among 90 oral cancer patients awaiting for radiotherapy alone or with chemotherapy. The modified Sinhala version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Oral Health Module (EORTC QLQ-OH15) was used to gather data related to OHRQOL before radiotherapy. Socio-demographic and clinical data were also recorded. The same cohort of patients were followed up and assessed their OHRQOL during the last week of radiotherapy and three months post radiotherapy. The Modified EORTC QLQ-OH15 assesses the OHRQOL under three domains namely ‘Eating problem’, ‘Gum and speech problem’ and ‘Soreness’, and one item named as ‘Teeth’.

Results

The majority of the sample (88%) was males. The anterior two-thirds of the tongue (40%) and buccal mucosa (22%) were the most common sites. The median scores of ‘Eating problem’ domain at baseline, last week of radiotherapy and three months post radiotherapy were 20 (IQR = 6.7–33.3), 100 (IQR = 86.9–100.0) and 66.7 (IQR = 46.7–93.3) respectively. ‘Gum and speech problem’ was higher during last week of radiotherapy (median, 50.0, IQR, 25.0-58.3) than three months post radiotherapy (median, 8.3, IQR, 0.0-33.3). The changes of OHRQOL between the time frames were statistically significant (p < 0.05). Baseline OHRQOL in relation to ‘Gum and speech problem’ domain and ‘Teeth’ item was identified as an influential factor for OHRQOL during last week of radiotherapy.

Conclusion

The OHRQOL of oral cancer patients who received radiotherapy alone or with chemotherapy had deteriorated from the baseline level to the last week of radiotherapy but then improved at three months post radiotherapy. The OHRQOL however did not return to the baseline level three months post radiotherapy. OHRQOL during the last week of radiotherapy was influenced by the OHRQOL at baseline, civil status and sites of metastasis.
Literature
2.
go back to reference Xie L, Shang Z. Burden of oral cancer in Asia from 1990 to 2019: Estimates from the Global Burden of Disease 2019 study.PLoS ONE. 2022;17(3) Xie L, Shang Z. Burden of oral cancer in Asia from 1990 to 2019: Estimates from the Global Burden of Disease 2019 study.PLoS ONE. 2022;17(3)
3.
go back to reference National Cancer Control Programme Sri Lanka, Annual Report 2020. Ministry of Health Sri Lanka. 2020. National Cancer Control Programme Sri Lanka, Annual Report 2020. Ministry of Health Sri Lanka. 2020.
8.
go back to reference Blanchard P, Baujat B, Holostenco V, Bourredjem A, Baey C, et al. Meta-analysis of Chemotherapy in Head and Neck Cancer (MACH-NC): a comprehensive analysis by Tumour Site. Radiother Oncol. 2011;100(1):33–40.CrossRefPubMed Blanchard P, Baujat B, Holostenco V, Bourredjem A, Baey C, et al. Meta-analysis of Chemotherapy in Head and Neck Cancer (MACH-NC): a comprehensive analysis by Tumour Site. Radiother Oncol. 2011;100(1):33–40.CrossRefPubMed
11.
go back to reference Prelec J, Laronde DM. Treatment modalities of oral cancer. Can J Dent Hyg. 2014;48(1):13–9. Prelec J, Laronde DM. Treatment modalities of oral cancer. Can J Dent Hyg. 2014;48(1):13–9.
13.
go back to reference Sroussi HY, Epstein JB, Bensadoun RJ, Saunders DP, Lalla RV, Migliorati CA, Heaivilin N, Zumsteg ZS. Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis. Cancer Med. 2017;6(12):2918–31.CrossRefPubMedPubMedCentral Sroussi HY, Epstein JB, Bensadoun RJ, Saunders DP, Lalla RV, Migliorati CA, Heaivilin N, Zumsteg ZS. Common oral complications of head and neck cancer radiation therapy: mucositis, infections, saliva change, fibrosis, sensory dysfunctions, dental caries, periodontal disease, and osteoradionecrosis. Cancer Med. 2017;6(12):2918–31.CrossRefPubMedPubMedCentral
14.
go back to reference U.S Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Vol. 44, Oral Health in America: A Report of the Surgeon General. 2000. U.S Department of Health and Human Services. Oral Health in America: A Report of the Surgeon General. Vol. 44, Oral Health in America: A Report of the Surgeon General. 2000.
17.
go back to reference National Cancer Control Programme Sri Lanka. Cancer incidence & mortality data Sri Lanka 2019. Ministry of Health Sri Lanka; 2021. National Cancer Control Programme Sri Lanka. Cancer incidence & mortality data Sri Lanka 2019. Ministry of Health Sri Lanka; 2021.
18.
go back to reference Joseph N, Gunasekera S, Ariyaratne Y, Choudhury A. Clinical oncology in Sri Lanka: embracing the Promise of the future. Int J Radiat Oncol Biol Phys. 2019;105(3):466–70.CrossRefPubMed Joseph N, Gunasekera S, Ariyaratne Y, Choudhury A. Clinical oncology in Sri Lanka: embracing the Promise of the future. Int J Radiat Oncol Biol Phys. 2019;105(3):466–70.CrossRefPubMed
20.
go back to reference Slootweg PJ, Eveson JW. Tumours of the oral cavity and oropharynx:Chap. 4, WHO Classification of of Head and Neck Tumours. 4th Editio. El-Naggar A, Chan J, Grandis J, Takata T, Slootweg P, editors. Lyon Cedex 08: International Agency for Reseach on Cancer; 2017;163–208 p. Slootweg PJ, Eveson JW. Tumours of the oral cavity and oropharynx:Chap. 4, WHO Classification of of Head and Neck Tumours. 4th Editio. El-Naggar A, Chan J, Grandis J, Takata T, Slootweg P, editors. Lyon Cedex 08: International Agency for Reseach on Cancer; 2017;163–208 p.
21.
go back to reference Suresh K, Chandrashekara S. Sample size estimation and power analysis for clinical research studies. J Hum Reproductive Sci. 2012;5(1):7–13.CrossRef Suresh K, Chandrashekara S. Sample size estimation and power analysis for clinical research studies. J Hum Reproductive Sci. 2012;5(1):7–13.CrossRef
22.
go back to reference Hjermstad MJ, Bergenmar M, Bjordal K, Fisher SE, Hofmeister D, Montel S, et al. International field testing of the psychometric properties of an EORTC quality of life module for oral health: the EORTC QLQ-OH15. Support Care Cancer. 2016;24(9):3915–24.CrossRefPubMed Hjermstad MJ, Bergenmar M, Bjordal K, Fisher SE, Hofmeister D, Montel S, et al. International field testing of the psychometric properties of an EORTC quality of life module for oral health: the EORTC QLQ-OH15. Support Care Cancer. 2016;24(9):3915–24.CrossRefPubMed
23.
go back to reference Kosgallana S, Jayasekara P, Abeysinghe P, Hjermstad M, Lalloo R. Translation and validation of Sinhala version of modified EORTC QLQ-OH15 in oral cancer patients who receive radiotherapy with or without chemotherapy in Sri Lanka. BMC Oral Health. 2022;22(1):359.CrossRefPubMedPubMedCentral Kosgallana S, Jayasekara P, Abeysinghe P, Hjermstad M, Lalloo R. Translation and validation of Sinhala version of modified EORTC QLQ-OH15 in oral cancer patients who receive radiotherapy with or without chemotherapy in Sri Lanka. BMC Oral Health. 2022;22(1):359.CrossRefPubMedPubMedCentral
24.
26.
go back to reference Pow EH, Kwong DL, McMillan AS, Wong MC, Sham JS, Leung LH, Leung WK. Xerostomia and quality of life after intensity-modulated radiotherapy vs. conventional radiotherapy for early-stage nasopharyngeal carcinoma: initial report on a randomized controlled clinical trial. Int J Radiat Oncol Biol Phys. 2006;66(4):981–91.CrossRefPubMed Pow EH, Kwong DL, McMillan AS, Wong MC, Sham JS, Leung LH, Leung WK. Xerostomia and quality of life after intensity-modulated radiotherapy vs. conventional radiotherapy for early-stage nasopharyngeal carcinoma: initial report on a randomized controlled clinical trial. Int J Radiat Oncol Biol Phys. 2006;66(4):981–91.CrossRefPubMed
28.
go back to reference Gondivkar SM, Gadbail AR, Sarode SC, Hedaoo A, Dasgupta S, Sharma B, Sharma A, Gondivkar RS, Yuwanati M, Patil S, Gaikwad RN. Oral and general health-related quality of life in oral squamous cell carcinoma patients- comparative analysis of different treatment regimes. J Oral Biol Craniofac Res. 2021;11(2):125–31.CrossRefPubMedPubMedCentral Gondivkar SM, Gadbail AR, Sarode SC, Hedaoo A, Dasgupta S, Sharma B, Sharma A, Gondivkar RS, Yuwanati M, Patil S, Gaikwad RN. Oral and general health-related quality of life in oral squamous cell carcinoma patients- comparative analysis of different treatment regimes. J Oral Biol Craniofac Res. 2021;11(2):125–31.CrossRefPubMedPubMedCentral
29.
go back to reference Naidu GS, Shukla S, Nagi R, Jain S, Makkad RS. Evaluation of oral health related quality of life in subjects diagnosed with head and neck malignancies undergoing chemotherapy, radiotherapy, and surgery. J Indian Acad Oral Med Radiol. 2019;31:228–33.CrossRef Naidu GS, Shukla S, Nagi R, Jain S, Makkad RS. Evaluation of oral health related quality of life in subjects diagnosed with head and neck malignancies undergoing chemotherapy, radiotherapy, and surgery. J Indian Acad Oral Med Radiol. 2019;31:228–33.CrossRef
30.
go back to reference Barrios R, Bravo M, Gil-Montoya JA, Martínez-Lara I, García-Medina B, Tsakos G. Oral and general health-related quality of life in patients treated for oral cancer compared to control group. Health Qual Life Outcomes. 2015;13(1):1–8.CrossRef Barrios R, Bravo M, Gil-Montoya JA, Martínez-Lara I, García-Medina B, Tsakos G. Oral and general health-related quality of life in patients treated for oral cancer compared to control group. Health Qual Life Outcomes. 2015;13(1):1–8.CrossRef
31.
go back to reference Yuwanati M, Gondivkar S, Sarode SC, Gadbail A, Desai A, Mhaske S, et al. Oral health-related quality of life in oral cancer patients: systematic review and meta-analysis. Future Oncol. 2021;17(8):979–90.CrossRefPubMed Yuwanati M, Gondivkar S, Sarode SC, Gadbail A, Desai A, Mhaske S, et al. Oral health-related quality of life in oral cancer patients: systematic review and meta-analysis. Future Oncol. 2021;17(8):979–90.CrossRefPubMed
32.
go back to reference Santos PS, Cremonesi AL, Quispe RA, Rubira CM. The impact of oral health on quality of life in individuals with head and neck cancer after radiotherapy: the importance of dentistry in psychosocial issues. Acta Odontol Latinoam. 2017;30(2):62–7.PubMed Santos PS, Cremonesi AL, Quispe RA, Rubira CM. The impact of oral health on quality of life in individuals with head and neck cancer after radiotherapy: the importance of dentistry in psychosocial issues. Acta Odontol Latinoam. 2017;30(2):62–7.PubMed
34.
go back to reference Pateman KA. Oral health after head and neck cancer: Supportive care needs and quality of life implications [dissertation], Australia: School of Dentistry, The University of Queensland. 2016. 188 p. Pateman KA. Oral health after head and neck cancer: Supportive care needs and quality of life implications [dissertation], Australia: School of Dentistry, The University of Queensland. 2016. 188 p.
35.
go back to reference Doss JG, Ghani WMN, Razak IA, Yang YH, Rogers SN, Zain RB. Changes in health-related quality of life of oral cancer patients treated with curative intent: experience of a developing country. Int J Oral Maxillofac Surg. 2017;46:687–98.CrossRefPubMed Doss JG, Ghani WMN, Razak IA, Yang YH, Rogers SN, Zain RB. Changes in health-related quality of life of oral cancer patients treated with curative intent: experience of a developing country. Int J Oral Maxillofac Surg. 2017;46:687–98.CrossRefPubMed
37.
go back to reference Aizer AA, Chen MH, McCarthy EP, Mendu ML, Koo S, Wilhite TJ, et al. Marital status and survival in patients with cancer. J Clin Oncol. 2013;31:3869–76.CrossRefPubMedPubMedCentral Aizer AA, Chen MH, McCarthy EP, Mendu ML, Koo S, Wilhite TJ, et al. Marital status and survival in patients with cancer. J Clin Oncol. 2013;31:3869–76.CrossRefPubMedPubMedCentral
39.
go back to reference de Melo NB, de Sousa VM, Bernardino IM, de Melo DP, Gomes DQC, Bento PM. Oral health related quality of life and determinant factors in patients with head and neck cancer. Med Oral Patol Oral Cir Bucal. 2019;1(3):e281–9.CrossRef de Melo NB, de Sousa VM, Bernardino IM, de Melo DP, Gomes DQC, Bento PM. Oral health related quality of life and determinant factors in patients with head and neck cancer. Med Oral Patol Oral Cir Bucal. 2019;1(3):e281–9.CrossRef
40.
go back to reference Bhandari S, Soni BW, Jamwal A, Ghoshal S. Oral and dental care before radiotherapy: guidelines and development of a time-bound protocol. Indian J Cancer. 2022;59(2):159–69.PubMed Bhandari S, Soni BW, Jamwal A, Ghoshal S. Oral and dental care before radiotherapy: guidelines and development of a time-bound protocol. Indian J Cancer. 2022;59(2):159–69.PubMed
41.
go back to reference Tian J, Jia LN, Cheng ZC. Relationships between patient knowledge and the severity of side effects, daily nutrient intake, psychological status, and performance status in lung cancer patients. Curr Oncol. 2015;22(4):e254–8.CrossRefPubMedPubMedCentral Tian J, Jia LN, Cheng ZC. Relationships between patient knowledge and the severity of side effects, daily nutrient intake, psychological status, and performance status in lung cancer patients. Curr Oncol. 2015;22(4):e254–8.CrossRefPubMedPubMedCentral
42.
go back to reference Champarnaud M, Villars H, Girard P, et al. Effectiveness of therapeutic patient education interventions for older adults with Cancer: a systematic review. J Nutr Health Aging. 2020;24:772–82.CrossRefPubMed Champarnaud M, Villars H, Girard P, et al. Effectiveness of therapeutic patient education interventions for older adults with Cancer: a systematic review. J Nutr Health Aging. 2020;24:772–82.CrossRefPubMed
Metadata
Title
Oral health related quality of life of oral cancer patients treated with radiotherapy alone or with chemotherapy in a tertiary referral centre in Sri Lanka
Authors
Shamini Kosgallana
Prasanna Jayasekara
Prasad Abeysinghe
Ratilal Lalloo
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2023
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-023-02854-x

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