Multicenter phase II study of an oral care program for patients with head and neck cancer receiving chemoradiotherapy

作者：Yokota Tomoya^*; Tachibana Hiroyuki; Konishi Tetsuhito; Yurikusa Takashi; Hamauchi Satoshi; Sakai Kensuke; Nishikawa Masaya; Suzuki Miho; Naganawa Yayoi; Hagihara Tomoka; Tsumaki Hiromi; Kubo Tomo; Sato Maho; Taguri Masataka; Morita Satoshi; Eguchi Toru; Kubota Kaoru; Zenda Sadamoto

来源：Supportive Care in Cancer, 2016, 24(7): 3029-3036.

DOI：10.1007/s00520-016-3122-5

• Head and neck cancer
• Chemoradiotherapy
• Oral mucositis
• Oral care
• Multidisciplinary

Purpose This multicenter phase II trial assessed the clinical benefit of a multidisciplinary oral care program in reducing the incidence of severe chemoradiotherapy-induced oral mucositis (OM).
Methods Patients with head and neck cancer (HNC) who were scheduled to receive definitive or postoperative chemo-radiotherapy were enrolled. The oral care program included routine oral screening by dentists and a leaflet containing instructions regarding oral care, nutrition, and lifestyle. Oral hygiene and oral care were evaluated continuously during and after the course of chemoradiotherapy. The primary end-point was the incidence of grade >= 3 OM assessed by certified medical staff according to the Common Terminology Criteria of Adverse Events version 3.0.
Results From April 2012 to December 2013, 120 patients with HNC were enrolled. Sixty-four patients (53.3 %) developed grade >= 3 OM (i.e., functional/symptomatic). The incidence of grade <= 1 OM at 2 and 4 weeks after radiotherapy completion was 34.2 and 67.6 %, respectively. Clinical examination revealed that 51 patients (42.5 %) developed grade >= 3 OM during chemoradiotherapy. The incidence of grade <= 1 OM at 2 and 4 weeks after radiotherapy completion was 54.7 and 89.2 %, respectively. The incidences of grade 3 infection and pneumonitis throughout chemoradiotherapy were <5 %. Only 6.7 % of patients had unplanned breaks in radiotherapy, and 99.2 % completed treatment,
Conclusions A systematic oral care program alone is insufficient to decrease the incidence of severe OM in patients with HNC being treated with chemoradiotherapy. However, systematic oral care programs may indirectly improve treatment compliance by decreasing infection risk.

• 出版日期2016-7