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Fasanaro E, Del Bianco P, Groff E, Riva A, Petrangolini G, Busato F, Stritoni P, Scarzello G, Loreggian L, De Salvo GL. Role of SAMITAL in the Prevention and Treatment of Chemo-Radiotherapy-Induced Oral Mucositis in Head and Neck Carcinoma: A Phase 2, Randomized, Double-Blind, Placebo-Controlled Clinical Trial (ROSAM). Cancers (Basel) 2022; 14:cancers14246192. [PMID: 36551677 PMCID: PMC9776559 DOI: 10.3390/cancers14246192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 12/12/2022] [Accepted: 12/13/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND In patients affected by head and neck squamous cell carcinoma, the onset of severe oral mucositis is a decisive factor in completing concurrent chemo-radiotherapy, and few interventions have demonstrated a modest benefit. The primary aim of this clinical study was to evaluate the role of SAMITAL in reducing the incidence of severe mucositis induced by concurrent chemo-radiotherapy; the secondary aims were the tolerability and patient-reported quality of life measures. METHODS Patients were randomized to receive SAMITAL granules for oral suspension of 20 mL, four-time daily or matching placebo in a 1:1 fashion using a stratified-block randomization scheme by disease site and type of chemotherapy. The SAMITAL/placebo was dispensed at the baseline visit and at each weekly visit following radiotherapy initiation. Patients were subjected to weekly endoscopic evaluations to assess the presence of mucositis. In addition, patient-reported outcomes were measured. RESULTS Among the 116 patients treated with a median total dose of 66 Gy, 59 were randomized to SAMITAL and 57 to placebo. Overall, the incidence of severe mucositis was 51.7%, with 45.8% in the SAMITAL and 57.9% in the placebo arm (OR = 0.6; 95% CI: 0.3-1.3). After chemo-radiotherapy, patients randomized to SAMITAL reported significantly lower xerostomia, coughing and swallowing scores and a better quality of life. CONCLUSION SAMITAL did not significantly reduce the incidence of severe mucositis in all studied populations. However, the lower rate of mucositis, together with a significantly better quality of life, suggested that a clinical benefit existed. This trial is registered with the EU Clinical Trials Register database, number 2012-002046-20, and with ClinicalTrials.gov, NCT01941992.
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Affiliation(s)
- Elena Fasanaro
- Otolaryngology Unit, Department of Surgery, Ospedale S. Antonio, Azienda Ospedaliera–Universitaria, 35127 Padova, Italy
| | - Paola Del Bianco
- Clinical Research Unit, Istituto Oncologico Veneto IOV–IRCCS, 35128 Padova, Italy
| | - Elena Groff
- Radiotherapy Unit, Istituto Oncologico Veneto IOV–IRCCS, 35128 Padova, Italy
| | - Antonella Riva
- Product Innovation and Development Department, Indena SpA, 20139 Milano, Italy
| | | | - Fabio Busato
- Radiotherapy Unit, Istituto Oncologico Veneto IOV–IRCCS, 35128 Padova, Italy
| | - Paola Stritoni
- Otolaryngology Unit, Ospedale dell’Angelo, 30174 Venezia Mestre, Italy
| | - Giovanni Scarzello
- Radiotherapy Unit, Istituto Oncologico Veneto IOV–IRCCS, 35128 Padova, Italy
| | - Lucio Loreggian
- Radiotherapy Unit, Istituto Oncologico Veneto IOV–IRCCS, 35128 Padova, Italy
| | - Gian Luca De Salvo
- Clinical Research Unit, Istituto Oncologico Veneto IOV–IRCCS, 35128 Padova, Italy
- Correspondence:
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Matsuda Y, Jayasinghe RD, Zhong H, Arakawa S, Kanno T. Oral Health Management and Rehabilitation for Patients with Oral Cancer: A Narrative Review. Healthcare (Basel) 2022; 10:healthcare10050960. [PMID: 35628095 PMCID: PMC9140416 DOI: 10.3390/healthcare10050960] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 04/29/2022] [Accepted: 05/20/2022] [Indexed: 12/10/2022] Open
Abstract
Surgery is the current first choice for oral cancer treatment. Intensity-modulated radiation therapy, molecular targeted drugs, and immune checkpoint inhibitors are still used as adjuvant therapy for advanced cancer. In addition, postoperative rehabilitation and multidisciplinary treatment have also been developed in recent years. Multidisciplinary team approaches and supportive care in oral cancer treatment reportedly shorten the time to treatment and improve outcomes. Although there is enough evidence confirming the role of oral and maxillofacial surgeons, dentists, and dental hygienists in supportive care in oral cancer treatment, there are very few systematic studies. In particular, oral health management is a concept that encompasses oral function management, oral hygiene management, and oral care during oral cancer treatment. We provide a narrative review focusing on oral health management from a multidisciplinary and supportive care perspective, applicable in oral cancer treatment.
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Affiliation(s)
- Yuhei Matsuda
- Department of Lifetime Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8501, Japan; (H.Z.); (S.A.)
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo 693-8501, Japan;
- Correspondence: ; Tel.: +81-3-5803-4649
| | - Ruwan D. Jayasinghe
- Center for Research in Oral Cancer, Department of Oral Medicine and Periodontology, Faculty of Dental Sciences, University of Peradeniya, Getambe 20400, Sri Lanka;
| | - Hui Zhong
- Department of Lifetime Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8501, Japan; (H.Z.); (S.A.)
| | - Shinichi Arakawa
- Department of Lifetime Oral Health Care Sciences, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8501, Japan; (H.Z.); (S.A.)
| | - Takahiro Kanno
- Department of Oral and Maxillofacial Surgery, Shimane University Faculty of Medicine, Izumo 693-8501, Japan;
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Effect of Ozonated Water on Oral Mucositis and Pain Induced by Head and Neck Radiotherapy: A Cross-sectional Study. ARCHIVES OF NEUROSCIENCE 2021. [DOI: 10.5812/ans.118914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Oral mucositis and local pain are the negative effects of the treatment of head and neck cancer with radiotherapy. Objectives: The study aimed to investigate the effect of ozonated water on the severity of mucositis and pain in (1) patients who were treated with ozonated water and (2) patients who were not treated with ozonated water. Methods: We randomly divided 93 patients with head and neck malignancy (aged 18 to 80) into three groups. Ozone-treated group 1 rinsed their mouth with 15 mL of ozonated water with a concentration of 20 - 50 ppm from the first session of radiotherapy for one minute before and after each session. Ozone-treated group 2 rinsed their mouth with 15 mL of ozonated water with a concentration of 20 - 50 ppm for three minutes and then swallowed it before and after each session. Ozone-treated groups 1 and 2 and the non-ozone-treated group received standard treatment if mucositis symptoms appeared in each patient. The minimum number of radiotherapy sessions was 30, and the minimum planned dose for each patient was 50 Gray. Anamnesis and the following clinical parameters were taken: the degree of mucositis, the use of corticosteroids, radiotherapy method, radiation dose, and Pain Visual Analog Scale. Multi-level and subgroup analyses were performed on the ozone-treated and non-ozone-treated levels. Results: The mean degrees of oral mucositis and pain were lower in the ozone-treated group 2 than in the ozone-treated group 1 and non-ozone-treated group (P < 0.05). The non-ozone-treated group had the highest degrees of oral mucositis and pain severity (P < 0.05). The Kruskal-Wallis H test showed that there was a statistically significant difference in the Visual Analog Scale of sessions 5, 10, 15, 20, 25, and 30 between different groups. However, there was no statistically significant difference in the Visual Analog Scale of session 1 (χ2 (2) = 1.022, P = 0.6). This study revealed that ozonated water can be used for preemptive pain control and mucositis. This finding aligned with previous studies. Also, former research proved the safety and efficacy of ozonated water in dentistry and medical uses. Conclusions: The use of ozonated water in patients with head and neck malignancy can reduce the pain severity and oral mucositis induced by radiotherapy. It seems that ozonated water can be used as a preemptive agent in patients who receive head and neck radiotherapy.
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Sunaga T, Nagatani A, Fujii N, Hashimoto T, Watanabe T, Sasaki T. The association between cumulative radiation dose and the incidence of severe oral mucositis in head and neck cancers during radiotherapy. Cancer Rep (Hoboken) 2020; 4:e1317. [PMID: 33295153 PMCID: PMC8451373 DOI: 10.1002/cnr2.1317] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 10/05/2020] [Accepted: 10/21/2020] [Indexed: 12/27/2022] Open
Abstract
Background Quality of life can be influenced by oral mucositis (OM), and it is necessary to implement OM management strategies before the initiation of radiotherapy (RT) in patients with head and neck cancer (HNC). Aims To examine the association between the cumulative radiation dose and the incidence of severe OM in HNC patients receiving RT. Methods and results A retrospective observational cohort study was conducted in a Showa University Fujigaoka Hospital, in Japan. We retrospectively analyzed 94 patients with HNC who developed OM during RT. We defined OM as a more than grade 2 OM. The cumulative incidence of OM curves of the two categories was estimated using the Kaplan–Meier method and compared using the log‐rank test. We estimated the hazard ratio (HR) for OM after the adjustment of factors for covariates using Cox's regression analysis. Patients with smoking history had a significantly later development of OM than those with no smoking history (20 Gy‐incidence OM 68.7% vs 39.7%, P = .003). In contrast, patients undergoing concurrent chemotherapy had an earlier development of OM than those undergoing RT alone (20 Gy‐incidence OM 24.2% vs 55.7%, P < .001). Multivariate analysis revealed that no smoking history and concurrent chemotherapy were independent predictive factors, with a HR of 0.526 (P = .025) and 2.690 (P < .001), respectively. Conclusion We demonstrated that no smoking history and concurrent chemotherapy may be predictive of OM in HNC patients.
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Affiliation(s)
- Tomiko Sunaga
- Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Tokyo, Japan.,Department of Pharmacy, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Akiko Nagatani
- Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Tokyo, Japan.,Department of Pharmacy, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Naokazu Fujii
- Department of Otorhinolaryngology, Showa University Toyosu Hospital, Tokyo, Japan
| | - Touji Hashimoto
- Department of Radiology, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Toru Watanabe
- Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Tokyo, Japan.,Department of Pharmacy, Showa University Fujigaoka Hospital, Yokohama, Japan
| | - Tadanori Sasaki
- Department of Hospital Pharmaceutics, School of Pharmacy, Showa University, Tokyo, Japan
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Iatì G, Parisi S, Santacaterina A, Pontoriero A, Cacciola A, Brogna A, Platania A, Palazzolo C, Cambareri D, Davì V, Napoli I, Lillo S, Severo C, Tamburella C, Vadalà R, Delia P, Pergolizzi S. Simultaneous Integrated Boost Radiotherapy in Unresectable Stage IV (M0) Head and Neck Squamous Cell Cancer Patients: Daily Clinical Practice. Rep Pract Oncol Radiother 2020; 25:399-404. [PMID: 32368191 PMCID: PMC7190747 DOI: 10.1016/j.rpor.2020.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 03/07/2020] [Accepted: 04/02/2020] [Indexed: 12/21/2022] Open
Abstract
AIM To evaluate clinical outcome in locally-advanced stage IV (M0) head and neck cancer patients treated using intensity-modulated radiotherapy (IMRT) with simultaneous integrated boost (SIB) in daily clinical practice. BACKGROUND Despite SIB-IMRT has been reported as a feasible and effective advanced head and neck cancer treatment, there are few data about its concurrent use with systemic therapies. MATERIAL AND METHODS We reviewed 41 staged IV (M0) head and neck cancer patients treated in two radiotherapy units in the city of Messina (Italy) during the last six years, using intensity modulated techniques-SIB. 22/41 patients had concomitant chemotherapy or cetuximab. Acute and late toxicities, objective response (OR) rate, local control (LC) and overall survival (OS) have been evaluated. RESULTS 37/41 patients received the planned doses of radiotherapy, 2 patients died during the therapy. The major acute regional toxicities were skin reaction and mucositis. A case of mandibular osteoradionecrosis was recorded. At completion of treatment, OR was evaluated in 38 patients: 32/38 patients (84.2%) had complete (55.3%) and partial (28.9%) response. The 1- and 5-year LC rates were 73.4% and 69.73%, respectively. The 1-, 3-, and 5-year OS rates were 85.93%, 51.49% and 44.14%, respectively. No statistically significant differences in outcomes have been observed in patients treated with radiotherapy alone vs. irradiation concomitant to chemo/biotherapy. The median OS was 45 months. CONCLUSION SIB-IMRT is safeand can be used with concomitant chemotherapy/biotherapy in real-life daily clinical practice. SIB-IMRT alone is a valid alternative in patients unfit for systemic therapies.
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Affiliation(s)
- Giuseppe Iatì
- Unit of Radiation Oncology - University Hospital “G. Martino”, Via Consolare Valeria, 1 – 98125 Messina, Italy
| | - Silvana Parisi
- Department of Biomedical and Dental Sciences, and of Morphological and Functional Images, University of Messina, Italy
| | | | - Antonio Pontoriero
- Unit of Radiation Oncology - University Hospital “G. Martino”, Via Consolare Valeria, 1 – 98125 Messina, Italy
| | - Alberto Cacciola
- Department of Biomedical and Dental Sciences, and of Morphological and Functional Images, University of Messina, Italy
| | - Anna Brogna
- Unit of Medical Physics, University Hospital “G. Martino”, Messina, Italy
| | - Angelo Platania
- Unit of Radiation Oncology - Papardo Hospital, Messina, Italy
| | | | - Domenico Cambareri
- Department of Biomedical and Dental Sciences, and of Morphological and Functional Images, University of Messina, Italy
| | - Valerio Davì
- Department of Biomedical and Dental Sciences, and of Morphological and Functional Images, University of Messina, Italy
| | - Ilenia Napoli
- Department of Biomedical and Dental Sciences, and of Morphological and Functional Images, University of Messina, Italy
| | - Sara Lillo
- Department of Biomedical and Dental Sciences, and of Morphological and Functional Images, University of Messina, Italy
| | - Cesare Severo
- Department of Biomedical and Dental Sciences, and of Morphological and Functional Images, University of Messina, Italy
| | - Consuelo Tamburella
- Department of Biomedical and Dental Sciences, and of Morphological and Functional Images, University of Messina, Italy
| | - Roberta Vadalà
- Department of Biomedical and Dental Sciences, and of Morphological and Functional Images, University of Messina, Italy
| | - Pietro Delia
- Unit of Radiation Oncology - University Hospital “G. Martino”, Via Consolare Valeria, 1 – 98125 Messina, Italy
| | - Stefano Pergolizzi
- Unit of Radiation Oncology - University Hospital “G. Martino”, Via Consolare Valeria, 1 – 98125 Messina, Italy
- Department of Biomedical and Dental Sciences, and of Morphological and Functional Images, University of Messina, Italy
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Queiroz NDCA, Jorge MP, Sousa IMDO, Lima CSP, Matias MCDM, Dal Rio AC, Pereira EB, Galassi VHK, de Carvalho JE, Galvao TF, Foglio MA. Arrabidaea chica for oral mucositis in patients with head and neck cancer: a protocol of a randomised clinical trial. BMJ Open 2018; 8:e019505. [PMID: 30341109 PMCID: PMC6196823 DOI: 10.1136/bmjopen-2017-019505] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Oral mucositis is an iatrogenic condition of erythematous inflammatory changes which tends to occur on buccal and labial surfaces, the ventral surface of the tongue, the floor of the mouth and the soft palate of patients receiving chemotherapy. This protocol of ongoing randomised parallel group clinical trial aims to access the therapeutic effect of an herbal gel containing 2.5% Arrabidaea chica Verlot standardised extract on oral mucositis in patients with head and neck cancer compared with low-level laser therapy. METHODS AND ANALYSIS Patients with head and neck cancer held at Clinics Hospital of University of Campinas, Sao Paulo, who develop early signs/symptoms of oral mucositis are eligible. Baseline characteristics of participants include oral mucositis grade and quality of life assessments. Enrolment started in November 2017 with allocation of patients to one of the study groups by means of randomisation. Patients will be treated either with Arrabidaea chica or laser until wound healing. Monitoring includes daily assessment of mucositis grade and diameter measurement by photographs and millimetre periodontal probe. Treatments will be concluded once mucositis is healed. A blinded assessor will evaluate mucositis cure after referred by the study team. At this point, the gel tube will be weighed to indirectly assess patient's compliance. At close-out, data will be analysed by a blinded researcher following the procedures described in the statistical analyses. ETHICS AND DISSEMINATION This clinical trial was approved by the ethics committee of research in humans at the Faculty of Medical Sciences of University of Campinas (report no. 1,613,563/2016). Results from this trial will be communicated in peer-reviewed publications and scientific presentations. TRIAL REGISTRATION NUMBER RBR-5×4397.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Tais Freire Galvao
- Faculty of Pharmaceutical Sciences, State University of Campinas, Sao Paulo, Brazil
| | - Mary Ann Foglio
- Faculty of Pharmaceutical Sciences, State University of Campinas, Sao Paulo, Brazil
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Kanagalingam J, Wahid MIA, Lin JC, Cupino NA, Liu E, Kang JH, Bazarbashi S, Bender Moreira N, Arumugam H, Mueller S, Moon H. Patient and oncologist perceptions regarding symptoms and impact on quality-of-life of oral mucositis in cancer treatment: results from the Awareness Drives Oral Mucositis PercepTion (ADOPT) study. Support Care Cancer 2018; 26:2191-2200. [PMID: 29387994 DOI: 10.1007/s00520-018-4050-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Accepted: 01/15/2018] [Indexed: 02/08/2023]
Abstract
PURPOSE This descriptive cross-sectional survey aims to assess the level of concordance between the perspectives of oncologists and those of patients regarding oral mucositis (OM) symptoms, and the impact of OM on various aspects of daily living and concurrent cancer management. METHODS Oncologists involved in OM management (n = 105), and patients who developed OM during cancer treatment (n = 175), were recruited from seven Asian countries. Oncologists completed a face-to-face, quantitative interview; patients completed a face-to-face interview, and a self-reported questionnaire. RESULTS Oncologists and patients ranked treatment-induced OM among the three most important toxicities of cancer therapy requiring intervention. The most frequent OM symptoms reported by patients were oral ulcers (74%), dry mouth (73%), and difficulty swallowing (62%). Oncologists expected mild OM symptoms to last slightly longer than 1 week, whereas patients reported mild symptoms for more than 2 weeks. In mild-to-moderate OM, oncologists underestimated patients' pain experience. Overall, only 45% of oncologists said they would initiate OM prophylaxis when cancer therapy started. Of the 87% of patients who said they used their prescribed medications, only 16% reported using prophylactically prescribed medication. While oncologists' concerns related to the delays and interruptions of cancer treatment, patients tended to focus on the effects of OM on eating, drinking, and talking. CONCLUSIONS Oncologists' and patients' perceptions about treatment-induced OM differ. To overcome discordant perspectives, there is a need to raise general awareness and improve proactive management of OM. As noted in recent guidelines, supportive cancer care is critical for ensuring optimal therapy and for improving the patient's experience.
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Affiliation(s)
- Jeevendra Kanagalingam
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
- Johns Hopkins Singapore, International Medical Clinic, Tan Tock Seng Hospital, Singapore, Singapore.
| | - Mohamed Ibrahim A Wahid
- Department of Oncology, Beacon International Specialist Centre, Petaling Jaya, Selangor, Malaysia
| | - Jin-Ching Lin
- Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Nonette A Cupino
- Department of Radiology, University of the Philippines-Philippine General Hospital, Manila, Philippines
| | - Edward Liu
- Hong Kong Pacific Cancer Centre, Hong Kong, Hong Kong
| | | | - Shouki Bazarbashi
- Section of Medical Oncology, Oncology Center, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
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Al Barmawi M, Al Hadid LA, Alqudah HN, Al Hadid WA, Shamoun SA. Measuring the Quality of Life among Head-and/or-Neck Cancer Patients with Oral Mucositis Using the Functional Assessment of Cancer Therapy-General in Jordan. Asia Pac J Oncol Nurs 2018; 5:320-326. [PMID: 29963595 PMCID: PMC5996588 DOI: 10.4103/apjon.apjon_14_18] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: Quality of life (QOL) in cancer patients can be influenced by the presence of medical conditions, such as oral mucositis (OM). There is still limited knowledge about this issue among patients in Jordan, and this could be related to the absence of research instruments testing QOL among cancer patients with OM. This study measured the QOL among cancer patients using the Functional Assessment of Cancer Therapy-General (FACT-G), Arabic version. Methods: This was a cross-sectional study on 118 head-and/or-neck cancer patients with OM in Jordan. Data were submitted to measures of normality, reliability, and validity using exploratory factor analysis. The study also measured QOL among the study sample. Results: FACT-G demonstrated good internal consistency reliability and validity. Factor analysis indicated the presence of four factors explained by 24 items representing a valid FACT-G, Arabic version. Scores reflected low QOL compared to reported normative values in the literature. The values used to compare findings from this study were extracted from international literature; no similar values were present in published literature. Conclusions: FACT-G, Arabic version, is valid and reliable when applied to this study population. Further testing is recommended, which would include the establishment of normative values.
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Affiliation(s)
- Marwa Al Barmawi
- Department of Nursing, Faculty of Nursing, Alzaytoonah University of Jordan (ZUJ), Ma'an, Jordan
| | - Lourance A Al Hadid
- Department of Nursing, Aisha Bint Al Hussein College of Nursing and Health Sciences, Al Hussein Bin Talal University, Ma'an, Jordan
| | - Hani Nawaf Alqudah
- Nursing Department, Al-Bashir Hospital, Ministry of Health, Amman, Jordan
| | - Wasfi A Al Hadid
- Department of Dentistry Al Zarqa Hospital, Ministry of Health, Amman, Jordan
| | - Shaimaa A Shamoun
- Department of Clinical Oncology and Radiation Therapy, Al-Bashir Hospital, Ministry of Health, Amman, Jordan
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Rosario M, Francesco R, Sergio F, Niccolò GL, Alba F, Maurizio N, Sergio A, Stefania G, Filippo A. Effectiveness of tapentadol prolonged release for the management of painful mucositis in head and neck cancers during intensity modulated radiation therapy. Support Care Cancer 2016; 24:4451-5. [PMID: 27448104 DOI: 10.1007/s00520-016-3351-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2016] [Accepted: 07/10/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate the effectiveness and tolerability profile of tapentadol prolonged release (PR) in a cohort of head and neck cancer (HNC) patients affected by background pain due to painful mucositis during intensity modulated radiation therapy with or without cisplatin with definitive and adjuvant intent. MATERIALS AND METHODS Tapentadol PR was administered at the moment of pain onset in opioid-naive patients at the dosage of 50 mg BID. The dosage was increased 50 mg twice a day until the optimal dose of no more than 500 mg/day of tapentadol PR. Primary endpoint of the analysis was the evaluation of improved assessment using the numerical rating scale (NRS). Secondary endpoints were as follows: (1) assessment of the treatment received using the patients' global impression of change (PGIC) scale; (2) weight increase/stability; (3) sleep quality; and (4) tolerability. The period of observation was 90 days from the start of antineoplastic treatment. RESULTS Between September 2014 and May 2015, 30 HNC patients were observed. The average age was 64.9 years (range, 36-80). Twenty-two days after the start of antineoplastic treatment, tapentadol PR was administered to 25 % of patients. This percentage was increased to 50 % after 39 days and to 75 % after 43 days. Considering the efficacy of tapentadol PR on daily pain, there was a reduction of 30 % (95 % C.I. 69.3 ÷ 96.2 %) in the pain score in 26 patients (86.7 %), and a reduction of 50 % (95 % C.I. 57.7 ÷ 90.1 %) in 23 patients (76.7 %). CONCLUSION The use of tapentadol PR is feasible and well tolerated in HNC patients affected by background pain due to painful mucositis during intensity modulated radiotherapy with or without cisplatin. Further studies are needed to enhance current findings.
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Affiliation(s)
- Mazzola Rosario
- Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy.
| | - Ricchetti Francesco
- Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy
| | - Fersino Sergio
- Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy
| | - Giaj Levra Niccolò
- Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy
| | - Fiorentino Alba
- Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy
| | - Nicodemo Maurizio
- Medical Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy
| | - Albanese Sergio
- Head Neck Surgery, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy
| | - Gori Stefania
- Medical Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy
| | - Alongi Filippo
- Radiation Oncology, Sacro Cuore Don Calabria Cancer Care Center, Negrar-Verona, Italy
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Topical application of Aloe vera and vitamin E on induced ulcers on the tongue of rats subjected to radiation: clinical and histological evaluation. Support Care Cancer 2015; 24:2557-64. [PMID: 26698599 DOI: 10.1007/s00520-015-3048-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 12/07/2015] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The aim of this study is to assess the effect of two types of antioxidants, vitamin E (VE) and Aloe vera (AV), on healing of induced oral lesions after radiation in a murine model by clinical and histological analysis. METHODS The animals were randomly divided into three groups of 12 animals each (400 mg VE, 70 % AV and control) and two time periods (5 and 7 days). They were irradiated with a single dose of 30 Gy, and after 24 h, a lesion was produced on the ventral tongue of each animal. The products were applied daily in their respective group until euthanasia. RESULTS On clinical analysis, there was a higher frequency of lesions in the animals of the control group at both periods. The area of the lesions was also greater in the control group compared with the groups AV and VE (5 days p = 0.006; 7 days p = 0.002). On microscopic analysis, the degree of inflammation differed between the study groups and experimental periods. At 5 days, the statistical difference was not significant among the groups evaluated, but at 7 days, animals in the control group showed intense inflammation, while those in groups VE and AV exhibited mild to moderate inflammation (p = 0.002). CONCLUSION The results suggest that VE and AV contributed to the decrease in inflammatory response and healing of the lesions induced on the tongue of rats subjected to radiation.
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