Evaluation of Quality of Life and Oral Changes of Patients in Head and Neck Radiotherapy: Observational Study
- 1 Dental School, Pará University Center, Rua Nove de Janeiro, Belém, Pará, Brazil
- 2 Dental School, Pará University Center, Rua Nove de Janeiro, Belém, Pará, Brazil
- 3 Dental School, Pará University Center, Rua Nove de Janeiro, Belém, Pará, Brazil
- 4 Dental School, Pará University Center, Rua Nove de Janeiro, Belém, Pará, Brazil
- 5 Dental School, Montes Claros State University, Montes Claros, Minas Gerais, Brazil
- 6 Dental School, Pará University Center, Rua Nove de Janeiro, Belém, Pará, Brazil
Abstract
Radiotherapy (RT) in the head and neck, despite coming from technological evolution, is challenged by the acute and late side effects of local irradiation, including permanent loss of saliva, osteoradionecrosis, dental caries induced by radiation and necrosis of the oral cavity, mucositis, xerostomia and secondary infections like candidiasis. Since these manifestations are limiting and the integrity of the vital organs contemplates the patient’s general health status, the oral health-related quality of life (OHRQoL) can be significantly aff ected by the treatment of head and neck cancer (HNC), since cancer ca n cause important changes in vital functions related to communication, food and social contact, causing disturbances in the patient’s life. An observational and longitudinal study was carried out with 16 cancer patients submitted to RT in the head and neck, between the years 2019-2020 with the objectives of collecting clinical and epidemiological data on the main oral changes caused by RT in the head and neck and correlating them with the impact on OHRQoL. To analyze the OHRQoL, the University of Washington’s Quality of Life Assessment questionnaire (UW-QOL) was applied once a week for 4 weeks and to observe oral manifestations, a dental clinic file standardized by the re searchers was applied. The main oral manifestations clinically observed were hyposalivation, trismus and oral mucositis. The UW-QOL presented pain, chewing and taste as the main complaints reported by patients, however, appearance, salivation and chewing showed statistically significant differences over t he weeks. The main manifestations observed were hyposalivation, trismus and oral mucositis, the physical limitations resulting from these manifestations impact the OHRQoL of cancer patients in terms of appearance, salivation and chewing.
- Yeh, S. (2010) Radiotherapy for Head and Neck Cancer. Seminars in Plastic Surgery, 24, 127-136. https://doi.org/10.1055/s-0030-1255330
- Leemans, C.R., Snijders, P.J.F. and Brakenhoff, R.H. (2018) The Molecular Landscape of Head and Neck Cancer. Nature Reviews Cancer, 18, 269-282. https://doi.org/10.1038/nrc.2018.11
- Ministry of Health and National Cancer Institute (2020) Ministério da Saúde, Instituto Nacional de Cancer. Estimativa 2020: incidência de cancer no Brasil. INCA, Rio de Janeiro.
- Forouzanfar, M.H., et al. (2016) Global, Regional, and National Comparative Risk Assessment of 79 Behavioural, Environmental and Occupational, and Metabolic Risks or Clusters of Risks, 1990-2015: A Systematic Analysis for the Global Burden of Disease Study 2015. The Lancet, 388, 1659-1724. https://doi.org/10.1016/S0140-6736(16)31679-8
- Freitas, D.A., et al. (2011) Oral Sequelae of Head and Neck Radiotherapy. Revista CEFAC, 13, 1103-1108. https://doi.org/10.1590/S1516-18462011005000071
- Ardito, F., et al. (2016) Expression of Salivary Biomarkers in Patients with Oral Mucositis: Evaluation by SELDI-TOF/MS. Oral Diseases, 22, 209-219. https://doi.org/10.1111/odi.12405
- Brook, I. (2020) Late Side Effects of Radiation Treatment for Head and Neck Cancer. Radiation Oncology Journal, 38, 84-92. https://doi.org/10.3857/roj.2020.00213
- Klein, J., Livergant, J. and Ringash, J. (2014) Health Related Quality of Life in Head and Neck Cancer Treated with Radiation Therapy with or without Chemotherapy: A Systematic Review. Oral Oncology, 50, 254-262. https://doi.org/10.1016/j.oraloncology.2014.01.015
- Iriya, P.M. DE O., Romaniszen, L.W., Fernandes, T.M.F. and Poleti, M.L. (2017) Health-Related Quality of Life of Patients with Squamous Cell Carcinoma: A Comparison According to Tumor Location. Brazilian Oral Research, 31, 1-7. https://doi.org/10.1590/1807-3107bor-2017.vol31.0105
- Vartanian J.G., et al. (2006) Brazilian-Portuguese Validation of the University of Washington Quality of Life Questionnaire for Patients with Head and Neck Cancer. Head & Neck, 28, 1115-1121. https://doi.org/10.1002/hed.20464
- Ojo, B., et al. (2012) A Systematic Review of Head and Neck Cancer Quality of Life Assessment Instruments. Oral Oncology, 48, 923-937. https://doi.org/10.1016/j.oraloncology.2012.03.025
- Da Silva, R.G.B., et al. Evaluation of Xerostomia in Patients with Head and Neck Cancer Undergoing Radiotherapy Treatment. Revista Contexto & Saúde, 17, 5-14.