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Atwiine F, Kyomya J, Atukunda EC, Isiiko J, Yadesa TM. Prevalence and risk factors of chemotherapy-induced oral mucositis among adult cancer patients at the cancer unit of Mbarara Regional Referral Hospital. Asia Pac J Clin Oncol 2024; 20:354-364. [PMID: 38148289 DOI: 10.1111/ajco.14044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 12/04/2023] [Accepted: 12/17/2023] [Indexed: 12/28/2023]
Abstract
BACKGROUND Chemotherapy is a common treatment for cancer, but it is associated with adverse drug reactions like oral mucositis. This condition destroys basal cells in the oral mucosal layer, causing inflammation and ulceration. This can impact the patient's physical, emotional, and psychological well-being, affecting treatment outcomes and quality of life. This study aims to determine the prevalence, severity, and risk factors of chemotherapy-induced oral mucositis among adult cancer patients. METHODS The study was a cross-sectional study conducted among adult cancer patients receiving chemotherapy at the cancer unit of Mbarara Regional Referral Hospital in southwestern Uganda. Data was collected through patient interviews, oral examinations, and patient chart reviews. RESULTS Out of 268 patients, 115 (42.9%) experienced oral mucositis. Grade 2 oral mucositis was the most common (44.3%) followed by grade 1 (35.7%) and grade 3 (20.0%). Independent risk factors of chemotherapy-induced oral mucositis were female gender (Adjusted Odds Ratio (AOR) = 2.19, 95% confidence interval [CI]: 1.27-3.78; p-value = 0.005), poor oral hygiene (AOR = 3.70, 95% CI: 1.51-9.10; p-value = 0.04), and receiving chemotherapy containing an alkylating agent (AOR = 3.17, 95% CI: 1.63-6.19; p-value < 0.001). CONCLUSION The study found that two out of five chemotherapy patients developed oral mucositis, with nearly half being grade 2. The risk factors identified in our study were comparable to those reported in previous studies. Therefore, identification and assessment of cancer patients at high risk for chemotherapy-induced oral mucositis should be routinely done for proper and timely management.
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Affiliation(s)
- Fredrick Atwiine
- Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Julius Kyomya
- Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda
| | - Esther C Atukunda
- Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda
| | - John Isiiko
- Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda
- Cancer Unit, Mbarara Regional Referral Hospital, Mbarara, Uganda
| | - Tadele Mekuriya Yadesa
- Department of Pharmacy, Mbarara University of Science and Technology, Mbarara, Uganda
- Pharm-Biotechnology and Traditional Medicine Center, Mbarara University of Science and Technology, Mbarara, Uganda
- Department of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy, Kampala International University, Ishaka, Uganda
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Babadi F, Ahmadi A, Sarkarian M, Cheraghi M. Relationship between oral health literacy and oral health-related quality of life in patients with bladder cancer. Front Public Health 2024; 12:1385443. [PMID: 38846611 PMCID: PMC11155477 DOI: 10.3389/fpubh.2024.1385443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 04/19/2024] [Indexed: 06/09/2024] Open
Abstract
Introduction Bladder cancer is one of the most important diseases that threatens oral and dental health due to its nature and side effects of chemotherapy. Therefore, the present study was conducted to investigate the relationship between oral health literacy and oral health-related quality of life in patients with bladder cancer. Methods This cross-sectional study was conducted on patients with bladder cancer in Ahvaz, 2023. Subjects were selected randomly from the patients those were registered in Cancer Registry Center in Ahvaz Jundishapur University of Medical sciences and invited to Golestan Hospital for data collection through clinical evaluation, the Oral Health Literacy Adult Questionnaire (OHL-AQ), and the Oral Health Impact Profile-14 (OHIP-14PER) questionnaire. The data were analyzed using Pearson correlation coefficient, independent t-test, and analysis of variance. Results The number of participants was 194. The mean oral health literacy in patients with bladder cancer was 9.74 ± 2.39, indicating insufficient oral health literacy. A significant association was observed between OHL-AQ and DMFT index, but no significant association was found between OHIP-14PER and DMFT index. Furthermore, a significant correlation was found between OHL-AQ and OHIP-14PER (r = -0.68) in patients with bladder cancer. Conclusion Based on the findings of the present study, all dimensions of oral health literacy have correlation with the oral health-related quality of life in patients with bladder cancer. Therefore, adopting oral health behaviors and increasing oral health literacy can be the best way to improve the oral health-related quality of life to among patients with bladder cancer.
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Affiliation(s)
- Fatemeh Babadi
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ahmad Ahmadi
- School of Dentistry, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohsen Sarkarian
- Department of Urology, School of Medicine, Golestan Hospital, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maria Cheraghi
- Cancer Research Center, Department of Public Health, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Allana A, Shamsi U, Rashid Y, Khan FR, Rozi S. Oral mucositis & oral health related quality of life in women undergoing chemotherapy for breast cancer in Karachi, Pakistan: A multicenter hospital based cross-sectional study. PLoS One 2024; 19:e0295456. [PMID: 38625907 PMCID: PMC11020356 DOI: 10.1371/journal.pone.0295456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 02/13/2024] [Indexed: 04/18/2024] Open
Abstract
BACKGROUND Oral mucositis is an inflammatory condition of oral cavity which is a common and serious side effect of cancer treatment. Severe oral mucositis compromises basic functions like eating and swallowing causing malnutrition also affecting overall patient's oral health related quality of life. The aim of the study was to find the frequency of oral mucositis in patients with breast cancer during their chemotherapy, the factors associated with oral mucositis & the overall patient's oral health related quality of life. METHODS A cross-sectional study was conducted and a total of 160 women diagnosed with breast cancer, receiving chemotherapy and who had undergone at least one cycle of chemotherapy were recruited from two hospital settings. In-person interviews were done, patients were asked questions about their sociodemographic history, personal habits, oral history and oral findings, breast cancer stage, chemotherapy history and Oral Health Related Quality of Life. Their oral examination was done at the end of the interview to assess presence or absence of oral mucositis, using World Health Organization oral mucositis tool. Oral Health Related Quality of Life was assessed using Oral Health Impact Profile-14 questionnaire. RESULTS Our results showed that out of 160 patients 88 (55%) of the breast cancer cases developed oral mucositis during chemotherapy. The mean Oral Health Impact Profile -14 scores in patients with oral mucositis was high 18.36±0.96 showing poor Oral Health Related Quality of Life. Occasional frequency of brushing was significantly associated with oral mucositis (Prevalence ratio:2.26, 95%_CI 1.06-4.84) compared to those patients who brushed once and twice daily. Low level of education showed negative association with oral mucositis (Prevalence ratio:0.52, 95%_CI 0.31-0.88). CONCLUSION Our study showed significant positive association of occasional brushing with OM and protective association of low level of education with the development of OM. Emphasis should be given to oral hygiene instructions and dental education to cancer patients in oncology clinics with the prescription of mouth washes, gels and toothpaste to patients to decrease OM during chemotherapy.
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Affiliation(s)
- Asad Allana
- Department of Community Health Sciences, Aga Khan University Karachi, Karachi, Pakistan
| | - Uzma Shamsi
- Department of Community Health Sciences, Aga Khan University Karachi, Karachi, Pakistan
| | - Yasmin Rashid
- Department of Oncology, Aga Khan University Karachi, Karachi, Pakistan
| | - Farhan Raza Khan
- Department of Surgery, Section of Dental Surgery, Aga Khan University Karachi, Karachi, Pakistan
| | - Shafquat Rozi
- Department of Community Health Sciences, Aga Khan University Karachi, Karachi, Pakistan
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Mougeot JLC, Beckman MF, Morton DS, Noll J, Steuerwald NM, Brennan MT, Bahrani Mougeot F. Human oral mucosa and oral microbiome interactions following supragingival plaque reconstitution in healthy volunteers: a diet-controlled balanced design proof-of-concept model to investigate oral pathologies. J Oral Microbiol 2023; 15:2246279. [PMID: 37621744 PMCID: PMC10446812 DOI: 10.1080/20002297.2023.2246279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 07/21/2023] [Accepted: 08/03/2023] [Indexed: 08/26/2023] Open
Abstract
Changes in the oral microbiome may contribute to oral pathologies, especially in patients undergoing cancer therapy. Interactions between oral microbiome and oral mucosa may exacerbate inflammation. We determined whether probiotic-controlled plaque formation could impact proximal oral mucosa gene expression profiles in healthy volunteers. A 3-weeks balanced sample collection design from healthy volunteers (HVs) was implemented. At Week-1 plaques samples and labial mucosa brush biopsies were obtained from HVs in the morning (N = 4) and/or in the afternoon (N = 4), and groups were flipped at Week-3. A fruit yogurt and tea diet were given 2-4hrs before sample collection. mRNA gene expression analysis was completed using RNA-Seq and DESeq2. Bacterial taxa relative abundance was determined by 16S HOMINGS. Bacterial diversity changes and metabolic pathway enrichment were determined using PRIMERv7 and LEfSe programs. Alpha- and beta-diversities did not differ morning (AM) vs. afternoon (PM). The most affected KEGG pathway was Toll-like receptor signaling in oral mucosa. Eighteen human genes and nine bacterial genes were differentially expressed in plaque samples. Increased activity for 'caries-free' health-associated calcifying Corynebacterium matruchotii and reduced activity for Aggregatibacter aphrophilus, an opportunistic pathogen, were observed. Microbial diversity was not altered after 8 hours plaque formation in healthy individuals as opposed to gene expression.
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Affiliation(s)
- Jean-Luc C. Mougeot
- Translational Research Laboratories, Department of Oral Medicine and Cannon Research Center, Carolinas Medical Center, Atrium Health, Charlotte, NC, USA
| | - Micaela F. Beckman
- Translational Research Laboratories, Department of Oral Medicine and Cannon Research Center, Carolinas Medical Center, Atrium Health, Charlotte, NC, USA
| | - Darla S. Morton
- Translational Research Laboratories, Department of Oral Medicine and Cannon Research Center, Carolinas Medical Center, Atrium Health, Charlotte, NC, USA
| | - Jenene Noll
- Translational Research Laboratories, Department of Oral Medicine and Cannon Research Center, Carolinas Medical Center, Atrium Health, Charlotte, NC, USA
| | - Nury M. Steuerwald
- Molecular Biology and Genomics Core Facility, Levine Cancer Institute, Atrium Health, Charlotte, NC, USA
| | - Michael T. Brennan
- Translational Research Laboratories, Department of Oral Medicine and Cannon Research Center, Carolinas Medical Center, Atrium Health, Charlotte, NC, USA
| | - Farah Bahrani Mougeot
- Translational Research Laboratories, Department of Oral Medicine and Cannon Research Center, Carolinas Medical Center, Atrium Health, Charlotte, NC, USA
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de Lima Martins JO, Carlos ACAM, Costa GAJ, Ribeiro RS, Malta CEN, Borges MMF, de Moura JFB, de Arruda LM, Costa FWG, de Barros Silva PG. Oral hygiene protocols reduce the severity and incidence of oral mucositis during antineoplastic treatment: a systematic review and meta-analysis of randomized and non-randomized clinical trials. Support Care Cancer 2023; 31:480. [PMID: 37477721 DOI: 10.1007/s00520-023-07858-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 06/01/2023] [Indexed: 07/22/2023]
Abstract
OBJECTIVE The objective of this systematic review was to determine whether oral and dental hygiene protocols (DHPs) reduce the incidence and severity of oral mucositis (OM) during antineoplastic treatment. MATERIALS AND METHODS This PROSPERO-registered systematic review (CRD42021295322) was based on searches of publicly accessible databases, including PubMed, Scopus, Web of Science, LILACS, EBSCOhost, LIVIVO, Embase, and gray literature (Google Scholar, ProQuest, and Energy) until December 2021. Twenty-five articles from these searches and 14 articles retrieved from the references therein were evaluated in this systematic review and meta-analysis. The risk of bias (RoB) was assessed using RoB-2 and ROBINS-I for randomized (RCT) and non-randomized (n-RCT) clinical trials, respectively. A meta-analysis was performed on RCTs and n-RCTs in two subgroups to evaluate oral mouth rinses or DHP. GRADE-pro was used to assess the degree of certainty of the evidence. RESULTS Of the 3367 articles retrieved, 25 RCTs and 14 n-RCTs involving 2109 and 754 patients, respectively, were included in the analyses. RoB was low for RCTs and moderate-to-very severe for n-RCTs. High heterogeneity and publication RoB were identified. In RCTs, mouth rinses (p = 0.830) and DHP (p = 0.100) did not reduce the incidence of OM. However, mouth rinses strongly reduced the severity of OM (p < 0.001; Cohen's d = - 1.87, 95% confidence interval [CI] = - 2.49 to - 1.24). In non-RCTs, mouth rinses (p < 0.001) and DHP (p < 0.001) reduced the relative risk of OM 0.38 (95% CI = 0.24 to 0.59) and 0.64 (95% CI = 0.53 to 0.70) times, respectively. In addition, DHP strongly reduced OM severity (Cohen's d = - 0.81, 95% CI = - 1.03 to - 0.59). GRADE-pro showed high certainty of OM severity and incidence in RCTs and non-RCTs, respectively, and low (OM incidence in RCTs) to very low (OM severity in non-RCTs) certainty in other outcomes. CONCLUSION DHPs strongly reduce the severity and moderately reduce the incidence of OM. However, further studies with low heterogeneity are needed to validate these findings.
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Affiliation(s)
- Joyce Ohana de Lima Martins
- Oncogenetics Laboratory, Hospital Haroldo Juaçaba, Ceará Cancer Institute, Rua Papi Júnior, 1222 - Rodolfo Teófilo, Fortaleza, Ceará, 60430-230, Brazil.
- Oral Pathology Laboratory, Federal University of Ceará, Fortaleza, Ceará, Brazil.
| | - Anna Clara Aragão Matos Carlos
- Oncogenetics Laboratory, Hospital Haroldo Juaçaba, Ceará Cancer Institute, Rua Papi Júnior, 1222 - Rodolfo Teófilo, Fortaleza, Ceará, 60430-230, Brazil
- Oral Pathology Laboratory, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | | | | | - Cássia Emmanuela Nóbrega Malta
- Oncogenetics Laboratory, Hospital Haroldo Juaçaba, Ceará Cancer Institute, Rua Papi Júnior, 1222 - Rodolfo Teófilo, Fortaleza, Ceará, 60430-230, Brazil
- Oral Pathology Laboratory, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - Marcela Maria Fontes Borges
- Oncogenetics Laboratory, Hospital Haroldo Juaçaba, Ceará Cancer Institute, Rua Papi Júnior, 1222 - Rodolfo Teófilo, Fortaleza, Ceará, 60430-230, Brazil
- Oral Pathology Laboratory, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - José Fernando Bastos de Moura
- Oncogenetics Laboratory, Hospital Haroldo Juaçaba, Ceará Cancer Institute, Rua Papi Júnior, 1222 - Rodolfo Teófilo, Fortaleza, Ceará, 60430-230, Brazil
- Rodolfo Teófilo Faculty, Ceará Cancer Institute, Fortaleza, Ceará, Brazil
| | - Larissa Mont'Alverne de Arruda
- Oncogenetics Laboratory, Hospital Haroldo Juaçaba, Ceará Cancer Institute, Rua Papi Júnior, 1222 - Rodolfo Teófilo, Fortaleza, Ceará, 60430-230, Brazil
| | | | - Paulo Goberlânio de Barros Silva
- Oncogenetics Laboratory, Hospital Haroldo Juaçaba, Ceará Cancer Institute, Rua Papi Júnior, 1222 - Rodolfo Teófilo, Fortaleza, Ceará, 60430-230, Brazil
- Oral Pathology Laboratory, Federal University of Ceará, Fortaleza, Ceará, Brazil
- Graduate Program in Dental Sciences, Unichristus, Fortaleza, Brazil
- Rodolfo Teófilo Faculty, Ceará Cancer Institute, Fortaleza, Ceará, Brazil
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Tang H, Wang R, Yan P, Zhang W, Yang F, Guo S, Li T, Yi L, Bai X, Lin S, Zhang Y, Shang L. Dietary Behavior and Its Association with Nutrition Literacy and Dietary Attitude Among Breast Cancer Patients Treated with Chemotherapy: A Multicenter Survey of Hospitals in China. Patient Prefer Adherence 2023; 17:1407-1419. [PMID: 37325586 PMCID: PMC10263021 DOI: 10.2147/ppa.s413542] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Accepted: 06/06/2023] [Indexed: 06/17/2023] Open
Abstract
Background Chemotherapy often negatively impacts the nutritional status of breast cancer patients, and healthy dietary behaviors are important for patient wellbeing. With the guidance of the "Knowledge, Attitude and Practice model" (KAP model), the objective of this survey was to determine the frequency with which patients engage in healthy dietary behaviors and to explore the association between healthy dietary behaviors and nutrition literacy and dietary attitudes. Methods This study included a total of 284 breast cancer patients undergoing chemotherapy from three hospitals spanning three cities in China. Face-to-face interviews were conducted to collect demographic and clinical characteristics as well as the Dietary Nutritional Knowledge, Attitude and Practice Questionnaire (DNKAPQ) and the Nutrition Literacy Measurement Scale for Chinese Adult (NLMS-CA). Results Participants exhibited medium to high scores for nutrition literacy, dietary attitude and dietary behavior. Nutrition literacy (r = 0.505, p < 0.001) and dietary attitude (r= 0.326, p < 0.001) scores were both positively correlated with the total dietary behavior score. The total nutrition literacy score was positively correlated with the total dietary behavior score (r = 0.286, p < 0.001). In the univariate analysis, age, body mass index, living environment, education level, monthly family income, work status, menopausal status, number of comorbidities, relapse and endocrine therapy were significantly associated with dietary behavior (p < 0.05). In the multiple linear regression analysis, patients' dietary behavior was significantly associated with nutrition literacy (β = 0.449, p < 0.001) and dietary attitude (β = 0.198, p < 0.001). These two factors accounted for 28.6% of the variation in the patients' dietary behavior scores. Conclusion There is an important need for targeted dietary and nutritional interventions designed and implemented by health professionals to improve dietary behaviors. Intervention design and content should take the patients' nutrition literacy and dietary attitudes into consideration. In particular, women who are older, overweight, unemployed, and postmenopausal and live in rural areas, exhibit fewer comorbidities, have a lower family income and education level, have not relapsed and are currently receiving endocrine therapy are in urgent need of diet-specific intervention.
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Affiliation(s)
- Han Tang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
- Department of Clinical Nursing, School of Nursing, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
| | - Ruibo Wang
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, 450001, People’s Republic of China
| | - Pei Yan
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
- Department of Operation Room, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
| | - Wei Zhang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
| | - Feng Yang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
| | - Shengjie Guo
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, 450001, People’s Republic of China
| | - Ting Li
- School of Nursing and Health, Zhengzhou University, Zhengzhou, Henan, 450001, People’s Republic of China
| | - Luanxing Yi
- School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350122, People’s Republic of China
| | - Xue Bai
- Puyang Oilfield General Hospital, Puyang, Henan, 457001, People’s Republic of China
| | - Shan Lin
- Department of Neurology, The 900th Hospital of Joint Logistic Support Force, PLA, Fuzhou, Fujian, 350025, People’s Republic of China
| | - Yuhai Zhang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
| | - Lei Shang
- Department of Health Statistics, School of Public Health, The Fourth Military Medical University, Xi’an, Shaanxi, 710032, People’s Republic of China
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Karacan Y, Yıldız H, Evrensel T, Haznedaroglu IC. The effects of Ankaferd hemostat on preventing oral mucositis in colorectal cancer patients receiving chemotherapy. Support Care Cancer 2023; 31:385. [PMID: 37289263 DOI: 10.1007/s00520-023-07856-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Accepted: 05/31/2023] [Indexed: 06/09/2023]
Abstract
INTRODUCTION New agents are introduced each day to be used in the prevention and treatment of mucositis in cancer treatment. One of those agents is the Ankaferd hemostat. Ankaferd hemostat has pleiotropic effects and anti-infective characteristics in tissue healing. METHODS The study was designed as a randomized controlled experimental study. The sample of the study comprised a total of 66 patients (33 patients in the Ankaferd hemostat group and 33 patients in the sodium bicarbonate group) with colorectal cancer who received FOLFOX combination chemotherapy treatment in the first cycle of chemotherapy to prevent mucositis. Participants who met the criteria were randomly assigned to the groups. Before the patient received chemotherapy, ECOG performance score and Oral Mucositis Grading Scale were applied on the 7th day and 15th day. The Ankaferd hemostat group brushed teeth at least twice a day for 2 min and gargled with Ankaferd hemostat twice for 2 min for 2 weeks. The sodium bicarbonate group brushed teeth at least 2 min a day and gargled with sodium bicarbonate 4 times for 2 min for 2 weeks. The Consolidated Standards of Reporting Trials diagram was used to illustrate the randomization of patients. RESULTS When the Ankaferd hemostat group is compared with the sodium bicarbonate group, there is a significant difference in favor of the Ankaferd hemostat group in the mucositis grade on the 7th day and 15th day after chemotherapy (p < 0.05). In the binary logistic regression analysis, among the factors affecting the formation of mucositis on the 7th day, only neutrophil and thyroid-stimulating hormone (TSH) were included in the model, while only the TSH variable is statistically significant. CONCLUSIONS It was determined that Ankaferd hemostat is effective in preventing oral mucositis due to chemotherapy in adult patients diagnosed with colorectal cancer. In addition, it has been suggested to conduct new studies on the effectiveness of Ankaferd hemostat in the prevention of mucositis in different groups. TRIAL REGISTRATION The study was registered at ClinicalTrials.gov (ID: NCT05438771, Date: 25.06.2022).
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Affiliation(s)
- Yasemin Karacan
- Faculty of Health Sciences, Bursa Uludag University, Bursa, Turkey.
| | - Hicran Yıldız
- Faculty of Health Sciences, Bursa Uludag University, Bursa, Turkey
| | - Turkkan Evrensel
- Faculty of Medicine, Medical Oncology Department, Bursa Uludag University, Bursa, Turkey
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Yoshida K, Watanabe S, Hoshino N, Pak K, Hidaka N, Konno N, Nakai M, Ando C, Yabuki T, Suzuki N, Katsura K, Tomihara K, Toyama A. Hospital pharmacist interventions for the management of oral mucositis in patients with head and neck cancer receiving chemoradiotherapy: a multicenter, prospective cohort study. Support Care Cancer 2023; 31:316. [PMID: 37133630 DOI: 10.1007/s00520-023-07784-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 04/27/2023] [Indexed: 05/04/2023]
Abstract
PURPOSE Oral mucositis is a severe adverse event in patients with head and neck cancer (HNC) receiving chemotherapy and radiotherapy that may cause the termination of cancer treatment. In this study, we aimed to reveal the benefits of pharmacist interventions in oral health care for patients with HNC receiving concurrent chemoradiotherapy (CCRT). METHODS We conducted a multicenter, prospective cohort study on 173 patients from September 2019 to August 2022. We evaluated the association between the occurrence of oral mucositis during CCRT and various factors in the absence or presence of direct medication instructions from hospital pharmacists. RESULTS Sixty-eight patients received medication instructions from pharmacists (the pharmacist intervention group), whereas 105 patients did not receive instructions (the control group). Logistic regression analysis showed that grade 2 (Gr 2) oral mucositis was significantly lower in patients receiving pharmacist interventions than in patients in the control group (adjusted odds ratio [aOR], 0.42; 95% confidence interval [CI], 0.18-0.96; P = 0.04). The time to onset of Gr 2 oral mucositis was significantly longer in the pharmacist intervention group than in the control group (hazard ratio, 0.53; 95% CI, 0.29-0.97; P = 0.04). CONCLUSION Direct intervention, especially when provided by hospital pharmacists, can have a real effect in supporting patients with HNC experiencing severe side effects of treatments. Moreover, the integration of pharmacists into the oral healthcare team is becoming even more essential to reduce the severity of side effects.
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Affiliation(s)
- Kensuke Yoshida
- Division of Hospital Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan.
| | - Shinichi Watanabe
- Department of Clinical Pharmacy, College of Pharmaceutical Sciences, Matsuyama University, Matsuyama, Japan
| | - Naoto Hoshino
- Division of Hospital Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Kyongsun Pak
- Division of Biostatistics, Center for Clinical Research, National Center for Child Health and Development, Tokyo, Japan
| | - Noriaki Hidaka
- Division of Pharmacy, Ehime University Hospital, Toon, Japan
| | - Noboru Konno
- Department of Pharmacy, Yamagata University Hospital, Yamagata, Japan
| | - Masaki Nakai
- Division of Pharmacy, Ehime University Hospital, Toon, Japan
| | - Chinami Ando
- Department of Pharmacy, Yamagata University Hospital, Yamagata, Japan
| | - Tsuyoshi Yabuki
- Department of Pharmacy, Uonuma Kikan Hospital, Minamiuonuma, Japan
| | - Naoto Suzuki
- Division of Hospital Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Kouji Katsura
- Division of Oral Radiology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Kei Tomihara
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Akira Toyama
- Division of Hospital Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan
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Śledzińska A, Śledzińska P, Bebyn M, Komisarek O. Title: Chemotherapy-Induced Oral Complications and Prophylaxis Strategies. Cancer Invest 2023:1-24. [PMID: 36892292 DOI: 10.1080/07357907.2023.2188558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
Cancer is currently a significant therapeutic challenge and is frequently connected with numerous adverse effects. Despite many improvements in chemotherapy, oral complications are common, leading to poor quality of life and chemotherapeutic dose reduction, which impair survival. This review summarizes the most common dental complications in patients receiving chemotherapy. We mainly focus on oral mucositis as it is a major cause of dose-limiting toxicity. Furthermore, oral candidiasis, viral infections, and xerostomia will be discussed. Conclusions: preventing complications is significantly more important than treating them. All patients beginning systemic anticancer treatment should undergo a thorough oral examination and get appropriate prophylaxis.
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Affiliation(s)
- Aleksandra Śledzińska
- Faculty of Medicine, Poznan University of Medical Sciences, Fredry 10, 61-701 Poznań, Poland
| | - Paulina Śledzińska
- Molecular Oncology and Genetics Department, Innovative Medical Forum, The F. Lukaszczyk Oncology Center, 85-796 Bydgoszcz, Poland
| | - Marek Bebyn
- Molecular Oncology and Genetics Department, Innovative Medical Forum, The F. Lukaszczyk Oncology Center, 85-796 Bydgoszcz, Poland
| | - Oskar Komisarek
- Department of Maxillofacial Orthopedics and Orthodontics, Fredry 10, 61-701 Poznań University of Medical Sciences, Poznan, Poland
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10
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Lee K, Takase K, Fushimi K. Factors influencing patient disclosure of cancer diagnosis to the family dentist: online survey in Japan. Sci Rep 2022; 12:17375. [PMID: 36253493 PMCID: PMC9576789 DOI: 10.1038/s41598-022-22219-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 10/11/2022] [Indexed: 01/10/2023] Open
Abstract
Oral care during cancer treatment constitutes essential supportive care. We aimed to identify factors associated with cancer patients informing their family dentists about their cancer diagnosis. Using the generated original questionnaire, we conducted a cross-sectional questionnaire study in 500 cancer patients (gastric, colorectal, lung, breast, and prostate cancer) through the Internet from September 10 to 13, 2019. The factors influencing patients' disclosure of their cancer diagnosis to their family dentist were identified by multivariable logistic regression analysis. Nearly half of the respondents (42.2%) informed their family dentist that they had cancer. The disclosing behavior of cancer patients was distinctively associated with their physician's advice (odds ratio [OR] 59.3; 95% confidence interval [CI] 7.7-456.3); 8.6% of all respondents were advised to inform their dentist about their cancer diagnosis. In the group without the physician's advice, good relationship with family dentist was associated with disclosing behavior. This study indicates the need for support for cancer patients to receive appropriate oral care; patients' perceptions of the physician's advice and communication with the family dentist should be motivators for disclosing the cancer diagnosis to dentists. Medical workers involved in cancer care should demonstrate the benefit of medical-dental collaboration in cancer care of patients.
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Affiliation(s)
- Kyunghee Lee
- grid.265073.50000 0001 1014 9130Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 1138519 Japan
| | - Kozo Takase
- grid.265073.50000 0001 1014 9130Department of Research Development, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kiyohide Fushimi
- grid.265073.50000 0001 1014 9130Department of Health Policy and Informatics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-Ku, Tokyo, 1138519 Japan
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11
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Reis TDC, Bortolotti F, Innocentini LMAR, Ferrari TC, Ricz HMA, Cunha RLG, Costa TCDM, Macedo LDD. Assessment of oral health condition in recipients of allogeneic hematopoietic cell transplantation. Hematol Transfus Cell Ther 2022; 44:549-554. [PMID: 34090846 PMCID: PMC9605891 DOI: 10.1016/j.htct.2021.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2020] [Revised: 01/11/2021] [Accepted: 02/18/2021] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION The optimization of oral health before allogeneic hematopoietic cell transplantation (HCT) is important for preventing infectious complications during treatment. OBJECTIVE The objective of this study was to evaluate the oral health condition and dental treatments performed in patients in pre-allogeneic HCT. METHOD The records of patients treated during 2018 at a Brazilian HCT service were reviewed. The following oral health data were obtained: 1. Decayed, missing and filled teeth / correlated index for primary dentition (DMFT/dmft); 2. Quality of oral hygiene and 3. Dental pathologies: 3.1 Periodontal infectious focus, 3.2 Endodontic infectious focus and 3.3 Carie incidence. All dental procedures performed were surveyed. RESULTS Thirty-three patients were included, with a mean age of 28.42 (±16.37), 20 male (60%) and 13 female. The average DMFT/dmft found in this study was 10.24 (± 8.37), similar to the index found in the population in southeastern Brazil. The younger study population presented a DMFT/dmft considered high, when compared to the general population. A total of 27.2% of the patients had active caries lesions, 33.3%, foci of periodontal infection, 15.1%, endodontic infectious focus and 40%, poor oral hygiene. Almost half of the patients (48.4%) had to undergo dental intervention, 24.2% needing periodontal scaling, 21.2%, fillings and 12.1%, tooth extractions. CONCLUSION We conclude that the studied population had an important incidence of dental pathologies and infectious conditions that could complicate throughout HCT, especially in younger patients, therefore presenting a high demand for dental treatment in the pre-HCT. Studies that assess the impact of dental conditioning on the outcomes of HCT with an emphasis on dental infectious complications, days of hospitalization and survival are necessary."
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Affiliation(s)
- Thiago de Carvalho Reis
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil.
| | - Fernanda Bortolotti
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | | | - Tatiane Cristina Ferrari
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Hilton Marcos Alves Ricz
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | - Renato Luiz Guerino Cunha
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
| | | | - Leandro Dorigan de Macedo
- Faculdade de Medicina de Ribeirão Preto da Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brazil
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Wei X, Jing M, Zhang X, Li C, Li L. Nurses' practice and educational needs in oral care for postoperative patients with oral cancer in ICUs: a multicenter cross-sectional study. BMC Oral Health 2022; 22:389. [PMID: 36071441 PMCID: PMC9454168 DOI: 10.1186/s12903-022-02426-5] [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: 05/04/2022] [Accepted: 08/30/2022] [Indexed: 12/24/2022] Open
Abstract
Background Surgical incision, endotracheal intubation, structural changes in the oral cavity, and other factors lead to a divergence in oral care between patients after oral surgery and ordinary inpatients. High-quality oral care can reduce the incidence of incision infection and ventilator-associated pneumonia. However, there is a lack of guidelines or expert consensus on oral care after oral cancer surgery. Therefore, the aim of this study was to assess the practicing situation of nurses in the intensive care unit (ICU) for postoperative patients with oral cancer and their need for training. Methods A multicenter cross-sectional study design was conducted in 19 ICUs of 11 tertiary hospitals from Henan province in China. Data were collected from 173 nurses and 19 head nurses online using a structured questionnaire. Mann–Whitney U and Kruskal–Wallis H tests were performed to analyze the data using SPSS (Version 25.0). Results Seven ICUs (36.8%) developed evaluation regulations for the oral care of postoperative patients with oral cancer, and eight ICUs (42.1%) described the operating standards. A total of 173 nurses completed the questionnaire, and the median score was 75 (68, 78). Almost all of the examined nurses (91.2%) assessed patients’ oral hygiene at a fixed time, while in 52.0% and 28.3% of nurses, the first oral care and frequency of oral care after surgery was determined based on the individual patient’s situation. More than half of the nurses (55.5%) spent approximately 5–10 min conducting oral care for patients. Physiological saline solution (82.7%), swabbing (91.9%), and oral care package with cotton ball (86.1%) were the most popular oral care mouthwash, method, and tool, respectively. Nurses sought help from senior nurses (87.3%) and doctors (83.8%), mostly to solve difficulties of oral care. Moreover, 76.9% of the nurses believed that the lack of knowledge and skills surrounding oral care was the main barrier for nurses to implement oral care. The majority of participants (69.4%) had never received continuing education or training in oral care for postoperative patients with oral cancer, and almost all (98.8%) of the respondents stated their preference to receive training in standardized oral care skills. Indications and contraindications (84.4%), tools (81.5%), and mouthwash (80.9%) of oral care were the items that the respondents were most eager to learn about. Approximately three quarters of nurses preferred scenario simulation practice as the training method. Conclusion Although the participants had high oral care scores for postoperative patients with oral cancer, there was great diversity in the practice. The lack of oral care knowledge was deemed the main barrier in delivering quality oral care, and the educational need was stated by almost all participants. We suggest that a standard protocol or clinical practice guidelines for oral care for postoperative patients with oral cancer should be developed, and nurses should be educated to equip them with professional knowledge and skills.
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Affiliation(s)
- XiaoJing Wei
- Department of Critical Care Medicine, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou, Henan, China
| | - MengJuan Jing
- Department of Critical Care Medicine, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou, Henan, China
| | - XianXian Zhang
- Department of Infectious Medicine, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou, Henan, China
| | - ChunPeng Li
- Department of Critical Care Medicine, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou, Henan, China
| | - LiMing Li
- Department of Nursing, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan Provincial Key Medicine Laboratory of Nursing, Zhengzhou, Henan, China.
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13
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Yokota T, Ueno T, Soga Y, Ishiki H, Uezono Y, Mori T, Zenda S, Uchitomi Y. J-SUPPORT research policy for oral mucositis associated with cancer treatment. Cancer Med 2022; 11:4816-4829. [PMID: 35691025 PMCID: PMC9761062 DOI: 10.1002/cam4.4811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Revised: 04/22/2022] [Accepted: 04/26/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Oral mucositis is one of the main areas of research in supportive and palliative care of cancer patients. However, the methodology of prospective clinical trials on oral mucositis has not been established, despite its uniqueness. Here, we propose a novel research policy on oral mucositis, including an implementable set of recommendations for researchers conducting clinical trials. METHODS The first draft was developed by an expert panel of six specialists from the Japanese Supportive, Palliative, and Psychosocial Care Study Group. A provisional draft was developed after review by the following medical societies: the Japanese Association of Supportive Care in Cancer, the Japanese Association of Oral Supportive Care in Cancer, the Japanese Cancer Association, and the receipt of public comments. RESULTS The research policy on oral mucositis mainly consists of the following components: (i) definition of oral mucositis; (ii) characteristics of oral mucositis; (iii) characteristics of oral mucositis research; (iv) target population for oral mucositis research; (v) endpoints and assessment measures in oral mucositis; (vi) eligibility criteria; (vii) research design; (viii) minimally recommended intervention in oral mucositis research as a supplement. The final policy (Ver1.0) was completed on August 16, 2021. CONCLUSIONS This policy may serve as a significant reference for planning and conducting clinical trials for the management of oral mucositis.
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Affiliation(s)
- Tomoya Yokota
- Division of Gastrointestinal OncologyShizuoka Cancer CenterSunto‐gunJapan
| | - Takao Ueno
- Department of General Internal Medicine, Dentistry, Oncologic EmergencyNational Cancer Center HospitalTokyoJapan
| | - Yoshihiko Soga
- Division of Hospital DentistryOkayama University HospitalOkayamaJapan
| | - Hiroto Ishiki
- Department of Palliative MedicineNational Cancer Center HospitalTokyoJapan
| | - Yasuhito Uezono
- Department of Pain Control ResearchThe Jikei University School of MedicineTokyoJapan
- Supportive and Palliative Care Research Support OfficeNational Cancer Center Hospital EastKashiwaJapan
- Project for Supportive Care Research, Exploratory Oncology Research and Clinical Trial CenterNational Cancer CenterKashiwaJapan
| | - Takehiko Mori
- Department of HematologyTokyo Medical and Dental UniversityTokyoJapan
| | - Sadamoto Zenda
- Supportive and Palliative Care Research Support OfficeNational Cancer Center Hospital EastKashiwaJapan
- Department of Radiation OncologyNational Cancer Center Hospital EastKashiwaJapan
| | - Yosuke Uchitomi
- Innovation Center for Supportive, Palliative and Psychosocial CareNational Cancer Center HospitalTokyoJapan
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Salivary inflammatory mediators as biomarkers for oral mucositis and oral mucosal dryness in cancer patients: A pilot study. PLoS One 2022; 17:e0267092. [PMID: 35476641 PMCID: PMC9045655 DOI: 10.1371/journal.pone.0267092] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/01/2022] [Indexed: 12/31/2022] Open
Abstract
Oral mucositis (OM) is a common side effect in patients with cancer receiving chemotherapy and radiotherapy; however, no salivary mediator is known to be associated with OM. We aimed to determine candidate salivary inflammatory mediators potentially associated with OM in patients with cancer. To this end, we compared the relationships between OM grade, oral mucosal dryness, and inflammatory mediators (Interleukin (IL)-1β, IL-6, IL-10, IL-12p70, tumor necrosis factor (TNF), prostaglandin E2, and vascular endothelial growth factor) in patients with cancer and in healthy volunteers (HV). We collected saliva samples from 18 patients with cancer according to the following schedule: 1) within 14 days of treatment initiation, 2) within 3 days of OM occurrence, 3) when OM was improved or got worsened, and 4) within 7 days after chemotherapy completion. The oral care support team determined the OM grade at each sample collection point based on CTCAE version 5.0. Salivary inflammatory mediator concentrations were detected using cytometric bead array or enzyme-linked immunoassay. We compared oral mucosal dryness in pre- and post-index patients with cancer to that in HV (n = 33) using an oral moisture-checking device. Fourteen of eighteen patients experienced OM (four, grade 3 OM; four, grade 2 OM; six, grade 1 OM). IL-6, IL-10, and TNF salivary concentrations were significantly increased in the post-index group compared to those in the pre-index group (p = 0.0002, p = 0.0364, and p = 0.0160, respectively). Additionally, salivary IL-6, IL-10, and TNF levels were significantly higher in the post-index group than in the HV group (p < 0.0001, p < 0.05, and p < 0.05, respectively). Significant positive correlations were observed between OM grade and salivary IL-6, IL-10, and TNF levels (p = 0.0004, r = 0.4939; p = 0.0171, r = 0.3394; and p = 0007, r = 0.4662, respectively). Oral mucosal dryness was significantly higher in the HV than in the pre- and post-index groups (p < 0.001). Our findings suggest that salivary IL-6, IL-10, and TNF levels may be used as biomarkers for OM occurrence and grade in patients with cancer. Furthermore, monitoring oral mucosal dryness and managing oral hygiene before cancer treatment is essential.
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15
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Yoshida K, Kodama Y, Tanaka Y, Pak K, Soga M, Toyama A, Katsura K, Takagi R. Pharmacist involved education program in a multidisciplinary team for oral mucositis: Its impact in head-and-neck cancer patients. PLoS One 2021; 16:e0260026. [PMID: 34807914 PMCID: PMC8608342 DOI: 10.1371/journal.pone.0260026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 11/01/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVES This retrospective study examined how a pharmacist-involved education program in a multidisciplinary team (PEMT) for oral mucositis (OM) affected head-and-neck cancer (HNC) patients receiving concurrent chemoradiotherapy (CCRT). MATERIALS AND METHODS Total samples data of 53 patients during the stipulated timeframe were retrospectively collected from electronic medical records from February 2017 to January 2019. We compared the presence/absence of OM (OM: yes/no) between patients with and without PEMT (PEMT: yes/no) as the primary endpoint and OM severity as the secondary endpoint. The following information was surveyed: age, gender, weight loss, steroid or immunosuppressant use, hematological values (albumin, white blood cell count, blood platelets, and neutrophils), cancer grade, primary cancer site, type and use of mouthwash and moisturizer, opioid use (yes/no, days until the start of opioid use, and dose, switch to tape), and length of hospital day (LOD). The two groups were compared using Fisher's exact test for qualitative data and the Mann-Whitney U test for quantitative data, and a significance level of p<0.05 was set. RESULTS The group managed by PEMT had significantly lower weight loss and a significantly lower incidence of local anesthetic and opioid use and switch to tape compared with the group not managed by PEMT (p<0.05). The two groups showed no significant difference in OM (yes/no) or OM severity. The PEMT group had significantly shorter LOD at 57 (53-64) days compared with the non-PEMT group at 63.5 (57-68) days (p<0.05). CONCLUSIONS Our results showed that PEMT did not improve OM (yes/no) or OM severity in HNC patients undergoing CCRT. However, the PEMT group had a lower incidence of grades 3 and 4 OM than the non-PEMT group, although not significantly. In addition, PEMT contributed to oral pain relief and the lowering of the risk for OM by reduction in weight loss.
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Affiliation(s)
- Kensuke Yoshida
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
- Division of Hospital Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Yasumitsu Kodama
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Yusuke Tanaka
- Division of Hospital Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Kyongsun Pak
- Division of Biostatistics, Center for Clinical Research, National Center for Child Health and Development, Tokyo, Japan
| | - Marie Soga
- Division of Oral Radiology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Akira Toyama
- Division of Hospital Pharmacy, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Kouji Katsura
- Division of Oral Radiology, Niigata University Medical and Dental Hospital, Niigata, Japan
| | - Ritsuo Takagi
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry & Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
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Zhang J, Tang Y, Yuan T, Yang M, Fang W, Li L, Fei F, Gong A. Nattokinase crude extract enhances oral mucositis healing. BMC Oral Health 2021; 21:555. [PMID: 34717590 PMCID: PMC8556967 DOI: 10.1186/s12903-021-01914-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Accepted: 10/10/2021] [Indexed: 11/10/2022] Open
Abstract
Background Nattokinase (NK) is a promising alternative in the prevention and treatment of cardiovascular diseases due to its potent fibrinolytic activity. In this study, we investigated the effect of crude nattokinase extract on the healing of acetic acid-induced oral mucositis in mice. Methods Bacillus subtilis culture media (BSCM) was isolated into the supernatant, named nattokinase crude extract (NCE), and the pellet was named Bacillus subtilis mass (BSM). An oral mucositis model was established in mice by applying 50% glacial acetic acid to the buccal mucosa. According to the treatment conditions, the mice were divided into BSCM, NCE, BSM and phosphate buffered saline (PBS) groups. The weight of the mice, oral mucositis healing score and histopathological examination were used to evaluate the treatment. Results Fibrinolytic activities of BSCM, NCE and BSM were approximately 8069, 10,800 and 80 U/ml, respectively. The weight gain of mice in the NCE group was significantly different from the PBS group after three days’ treatment (p < 0.05). The oral mucositis score of NCE group was significantly higher than other groups (p < 0.05). The differences in histopathology scores between the NCE and other groups were statistically significant (p < 0.01). Conclusions NCE could possess remarkable potential to reduce pain and promote oral mucositis healing with minimal safety concerns. In this study, we first report that NCE from the supernatant of Bacillus subtilis can promote the healing of oral mucositis, which extends the application scope of NK.
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Affiliation(s)
- Junyao Zhang
- Department of Cell Biology, School of Medicine, Jiangsu University, 301 Xuefu Road, Zhenjiang, 212003, China
| | - Yu Tang
- Department of Cell Biology, School of Medicine, Jiangsu University, 301 Xuefu Road, Zhenjiang, 212003, China
| | - Tao Yuan
- Department of Cell Biology, School of Medicine, Jiangsu University, 301 Xuefu Road, Zhenjiang, 212003, China
| | - Mengting Yang
- Department of Cell Biology, School of Medicine, Jiangsu University, 301 Xuefu Road, Zhenjiang, 212003, China
| | - Wenjing Fang
- Department of Cell Biology, School of Medicine, Jiangsu University, 301 Xuefu Road, Zhenjiang, 212003, China
| | - Li Li
- Department of Cell Biology, School of Medicine, Jiangsu University, 301 Xuefu Road, Zhenjiang, 212003, China
| | - Fei Fei
- Department of Cell Biology, School of Medicine, Jiangsu University, 301 Xuefu Road, Zhenjiang, 212003, China
| | - Aihua Gong
- Department of Cell Biology, School of Medicine, Jiangsu University, 301 Xuefu Road, Zhenjiang, 212003, China.
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Kamulegeya A, Nakanjako D, Orem J, Mayanja-Kizza H. Experiences of patients who developed oral mucositis during solid neoplasms treatment: a Ugandan qualitative study. J Patient Rep Outcomes 2021; 5:24. [PMID: 33677726 PMCID: PMC7937001 DOI: 10.1186/s41687-021-00301-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 02/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Research on the management of complications of chemotherapy is important in facilitating the growing approaches to individualized patient management. Hence the need to document patient's perspectives about chemotherapy-induced mucositis and the support they need from cancer care teams. METHODS We carried out a qualitative study using in-depth interviews (IDI) and focus group discussions (FGD). We collected patient's experiences on chemotherapy-induced mucositis by conducting 5 FGD and 13 IDIs. RESULTS One glaring improvement that we need to make is the provision of information and counseling before, during, and after chemotherapy. Additionally, we need to explore inexpensive mucositis preventive strategies to aid our patients as they undergo treatment. CONCLUSION As a country, we must move away from taking cancer patients' needs as those of common tropical diseases. This will allow us to provide that extra help needed outside the usual diagnosis and administration of medication.
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Affiliation(s)
- Adriane Kamulegeya
- Department of Dentistry, Oral maxillofacial unit, School of Health Sciences, Makerere University College of Health Sciences, Kampala, Uganda.
| | - Damalie Nakanjako
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | | | - Harriet Mayanja-Kizza
- Department of Medicine, School of Medicine, Makerere University College of Health Sciences, Kampala, Uganda
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Dhaliwal JS, Murang ZR, Haji Husaini HA, Idris DR, Venkatasalu MR. The need for oral assessment and referral practices tool for palliative patients in Brunei Darussalam: A cross-sectional study. Nurs Open 2021; 8:39-47. [PMID: 33318810 PMCID: PMC7729708 DOI: 10.1002/nop2.591] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 06/29/2020] [Accepted: 07/13/2020] [Indexed: 11/07/2022] Open
Abstract
Aim This study aimed to investigate knowledge, experiences, perceptions and barriers of healthcare professionals regarding palliative oral care. Methods The study involved 169 palliative care professionals in Brunei. Data collection tool was pretested, validated and self-administered with sections on demographics; knowledge, attitude and practices; referral of patients; perspectives; and barriers to oral palliative care. Results 97.3% of participants believed that palliative patients need oral care, and 11.6% of participants were trained in this area. 43.8% were unsure about referral process, and 66.1% of participants had never used a tool to assess oral conditions of palliative patients. Most common oral condition encountered was mucositis (54.5%). 74.1% of participants expected family members to be responsible, and the absence of proper guidelines for assessment (66.1%) was the top challenge in providing oral care for palliative patients. Conclusion This study highlights perceptions and experiences of healthcare professionals and need for improved care through development of oral assessment and referral practices tool for palliative patients.
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Affiliation(s)
- Jagjit S. Dhaliwal
- Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health SciencesUniversiti Brunei DarussalamBandar Seri BegawanBrunei Darussalam
- All India Institute of Medical SciencesRishikeshIndia
| | - Zaidah R. Murang
- Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health SciencesUniversiti Brunei DarussalamBandar Seri BegawanBrunei Darussalam
| | - Hajah A. Haji Husaini
- Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health SciencesUniversiti Brunei DarussalamBandar Seri BegawanBrunei Darussalam
| | - Deeni R. Idris
- Anak Puteri Rashidah Sa'adatul Bolkiah Institute of Health SciencesUniversiti Brunei DarussalamBandar Seri BegawanBrunei Darussalam
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Barbosa-Lima R, Kameo SY, Amorim BF, Ramos MJO, Costa JDS, Marinho PML, Sawada NO, Moura Silva G. Occurrence of oral mucositis in women during oncological treatment of breast cancer in the Brazilian Northeast. REVISTA CIÊNCIAS EM SAÚDE 2020. [DOI: 10.21876/rcshci.v10i4.1040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Objective: To describe the occurrence of oral mucositis (OM) in women undergoing cancer treatment for breast cancer (BC). Methods: This is a retrospective, quantitative, and analytical study in medical records of women diagnosed with BC in an oncology service. Clinical data were collected regarding the occurrence and severity of OM according to the World Health Organization criteria and the cancer treatment experienced by the participants. Results: 196 women were included. Of these, 97 (49.5%) developed OM, 43.4% of which were grade 1 or 2 (low or moderate). The occurrence was higher in white women (OR 1.93; 95% CI 1.04 - 3.57; p = 0.035), with metastatic breast cancer (OR 5.46; 95% CI 1.79 - 16.64; p = 0.002) and who experienced taxane agents at some point during chemotherapy (OR 2.26; 95% CI 1.12 - 4.56; p = 0.02). The mean severity of OM in the entire sample was 0.8 ± 1.0, and in the affected women was 1.7 ± 0.7. The difference in the severity of OM by the variables was observed only among women with grade 2 and grade 3 fatigue (p = 0.03). Conclusions: OM is a common mucocutaneous toxicity in women with BC. Despite the low severity observed, care for women with BC undergoing cancer treatment must consider the possible risks and complications associated with OM, adopting strategies to prevent, monitor, and treat them.
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Huang YF, Liu SP, Muo CH, Chen HJ, Liao YF, Chiu KM, Chen CC, Tsai CH, Hong HH, Chang CT. The impact of timing and modalities of dental prophylaxis on the risk of 5-fluorouracil-related oral mucositis in patients with head and neck cancer: a nationwide population-based cohort study. Support Care Cancer 2020; 29:3163-3171. [PMID: 33074358 DOI: 10.1007/s00520-020-05825-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 10/13/2020] [Indexed: 11/27/2022]
Abstract
PURPOSE This study investigated the impact of dental prophylaxis on 5-fluorouracil (5-FU)-related oral mucositis (OM) according to the head and neck cancer (HNC) locations and treatment times. METHODS A total of 13,969 HNC participants, including 482 5-FU-related OM subjects and 13,487 comparisons were enrolled from the Longitudinal Health Insurance Database for Catastrophic Illness Patients of Taiwan between 2000 and 2008. All subjects were stratified into subgroups based on the times to perform chlorhexidine use, scaling, and fluoride application before 5-FU administration. The dental prophylaxis related to 5-FU-related OM was estimated by multiple logistic regression and represented with odds ratio (OR) and 95% confidence interval (CI). RESULTS Fluoride gel application and scaling significantly impacted on OM development (p < 0.001), and the joint effect of fluoride gel and scaling induced 5-FU-related OM (OR = 3.46, 95% CI = 2.39-5.01). The risk of OM was raised 2.25-fold as scaling within 3 weeks before 5-FU-related chemotherapy (95% CI = 1.81-2.81), and a 3.22-fold increased risk of OM while fluoride gel was applied during 5-FU-related treatment (95% CI = 1.46-7.13). CONCLUSION Dental prophylaxis significantly affected 5-FU-related OM in the HNC population. A short interval between dental scaling or fluoride application and 5-FU administration may be associated with higher prevalence of OM. Scaling simultaneously combined with chlorohexidine promoted 5-FU-related OM in specific HNC patients excluding the oral cancer and nasopharyngeal cancer population. Proper timing of the prophylactic dental treatments prior to 5-FU therapy could reduce the risk to develop 5-FU-related OM.
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Affiliation(s)
- Yi-Fang Huang
- Department of General Dentistry, Chang Gung Memorial Hospital, Linkou, 33305, Taiwan
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 11031, Taiwan
- Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan
| | - Shih-Ping Liu
- Center for Translational Medicine, China Medical University and Hospital, Taichung, 40402, Taiwan
- Program for Aging, College of Medicine, China Medical University, Taichung, 40402, Taiwan
- Department of Social Work, Asia University, Taichung, 41354, Taiwan
| | - Chih-Hsin Muo
- Management Office for Health Data, China Medical University Hospital, Taichung, 40402, Taiwan
| | - Hsuan-Ju Chen
- Management Office for Health Data, China Medical University Hospital, Taichung, 40402, Taiwan
| | - Yu-Fang Liao
- Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan
- Department of Craniofacial Orthodontics, Chang Gung Memorial Hospital, Taipei, 10507, Taiwan
- Craniofacial Center, Chang Gung Memorial Hospital, Taoyuan, 33378, Taiwan
- Craniofacial Research Center, Chang Gung Memorial Hospital, Linkou, 33305, Taiwan
| | - Kuan-Ming Chiu
- Division of Cardiovascular Surgery, Cardiovascular Center, Far-Eastern Memorial Hospital, New Taipei, 22056, Taiwan
- Department of Nursing, Oriental Institute of Technology, New Taipei, 22056, Taiwan
- Department of Electrical Engineering, Yuan Ze University, Taoyuan, 32003, Taiwan
| | - Cheng-Chang Chen
- Department of General Dentistry, Chang Gung Memorial Hospital, Linkou, 33305, Taiwan
| | - Chun-Hao Tsai
- Department of Orthopedics, China Medical University Hospital, Taichung, 40402, Taiwan
- Graduate Institute of Clinical Medicine, China Medical University, Taichung, 40402, Taiwan
| | - Hsiang-Hsi Hong
- Graduate Institute of Dental and Craniofacial Science, College of Medicine, Chang Gung University, Taoyuan, 33302, Taiwan.
- Department of Periodontology, Chang Gung Memorial Hospital, Linkou No. 5, Fuxing St., Guishan District, Taoyuan City, 33305, Taiwan.
| | - Chung-Ta Chang
- School of Dentistry, College of Oral Medicine, Taipei Medical University, Taipei, 11031, Taiwan.
- Department of Emergency Medicine, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Rd., Banciao Dist., New Taipei City, 22056, Taiwan.
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21
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Mubaraki S, Pani SC, Alseraihy A, Abed H, Alkhayal Z. The efficacy of two different oral hygiene regimens on the incidence and severity of oral mucositis in pediatric patients receiving hematopoietic stem cell transplantation: A prospective interventional study. SPECIAL CARE IN DENTISTRY 2020; 40:566-573. [PMID: 32964512 PMCID: PMC7821098 DOI: 10.1111/scd.12525] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 09/02/2020] [Accepted: 09/06/2020] [Indexed: 11/30/2022]
Abstract
Aims This prospective interventional study aimed to assess the efficacy of supersaturated calcium phosphate rinse and the use of an extra‐soft toothbrush twice a day when added to the existing oral hygiene protocol regimen (0.12% chlorhexidine gluconate + 3% sodium bicarbonate + nystatin 5000 U/mL) in reducing the severity of oral mucositis among pediatric patients receiving chemotherapy for the hematopoietic stem cell transplant. Methods Forty‐five patients that received chemotherapy for the hematopoietic stem cell transplant were randomly allocated to three groups of 15 patients each. Group A was advised to follow the existing oral hygiene protocol regimen (Control), group B was advised to brush their teeth twice daily using an extra‐soft toothbrush and to follow the control regimen, and lastly group C was advised to use supersaturated calcium phosphate rinse and to follow the control regimen. Oral mucositis was recorded according to World Health Organization criteria from the day of admission (day 1) to the day of discharge (day 28). The incidence of oral mucositis between the three groups was compared using the Kruskall‐Wallis test while the severity of oral mucositis between the three groups was compared using a one‐way ANOVA test. Results The results of the study showed no significant difference in the incidence of oral mucositis between the three groups; however, there was a lower severity of oral mucositis in the supersaturated calcium phosphate rinse group when compared to the control group or the group who used an extra‐soft toothbrush with the control regimen. Conclusion Although marginally fewer cases and lower severity of oral mucositis was observed in the group using supersaturated calcium phosphate rinse, the lack of statistical significance suggests that the evidence for their use is not conclusive. The results of this study also showed that the introduction of an extra‐soft toothbrush into the oral hygiene regimen did not significantly reduce the incidence of oral mucositis and may actually be responsible for an increase in the severity of oral mucositis.
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Affiliation(s)
- Sarah Mubaraki
- Department of Preventive Dentistry, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia
| | - Sharat Chandra Pani
- Department of Preventive Dentistry, Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia.,Department of Pediatric Dentistry and Orthodontics, The University of Western Ontario, London, Canada
| | - Amal Alseraihy
- Department of Pediatric Hematology∖Oncology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Hassan Abed
- Department of Sedation and Special Care Dentistry, Guy's & St Thomas' Foundation Trust, London, UK.,Faculty of Dentistry, Department of Basic and Clinical Oral Sciences, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Zikra Alkhayal
- Department of Dentistry, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
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22
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Koga S, Ogino Y, Fujikawa N, Ueno M, Kotaki Y, Koyano K. Oral health-related quality of life and oral hygiene condition in patients with maxillofacial defects: A retrospective analysis. J Prosthodont Res 2020; 64:397-400. [PMID: 32063541 DOI: 10.1016/j.jpor.2019.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 10/03/2019] [Accepted: 11/15/2019] [Indexed: 11/19/2022]
Abstract
PURPOSE The purpose of this study was to evaluate the effect of oral rehabilitation (maxillofacial prosthetic intervention and oral hygiene instruction) on oral health-related Quality of Life (OHRQoL) and oral hygiene condition in patients with maxillofacial defects and to explore the correlation between them in these patients. METHODS Twenty-five patients with maxillofacial defects who had been treated since April 2016 to March 2018 were included in this study. The scores of the Oral Health Impact Profile (OHIP) and O'Leary's Plaque Control Record (PCR) were also identified as the scores of OHRQoL and oral hygiene condition, respectively. Statistical analyses were performed to compare between the scores of "pre" and "post" prosthetic treatment and to evaluate patient-related factors influencing these variables (age, the number of residual teeth and occlusal supports, and occlusal units (OUs)). The effect of combined chemo-radiotherapy (CRT) on each score was also assessed statistically. Furthermore, the correlation of OHIP and PCR scores was explored statistically. RESULTS Both oral rehabilitations could significantly improve OHIP and PCR scores. Significant correlations of the change of OHIP scores with age and OUs were detected. CRT had no significant effect on OHIP and PCR scores. No correlations between OHIP and PCR were observed. CONCLUSIONS Although oral rehabilitation such as maxillofacial prosthetic treatment and oral hygiene instruction would be highly effective for improvement of OHRQoL and oral hygiene condition in patients with maxillofacial defects, there was no correlation between them.
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Affiliation(s)
- Sayuri Koga
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi Higashi-ku Fukuoka, 812-8582, Japan
| | - Yoichiro Ogino
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi Higashi-ku Fukuoka, 812-8582, Japan.
| | - Natsue Fujikawa
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi Higashi-ku Fukuoka, 812-8582, Japan
| | - Machiko Ueno
- Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi Higashi-ku Fukuoka, 812-8582, Japan
| | - Yuki Kotaki
- Department of Medical Technology, Kyushu University Hospital, 3-1-1 Maidashi Higashi-ku Fukuoka, 812-8582, Japan
| | - Kiyoshi Koyano
- Section of Fixed Prosthodontics, Division of Oral Rehabilitation, Faculty of Dental Science, Kyushu University, 3-1-1 Maidashi Higashi-ku Fukuoka, 812-8582, Japan
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23
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Vettori E, Costantinides F, Nicolin V, Rizzo R, Perinetti G, Maglione M, Di Lenarda R. Factors Influencing the Onset of Intra- and Post- Operative Complications Following Tooth Exodontia: Retrospective Survey on 1701 Patients. Antibiotics (Basel) 2019; 8:antibiotics8040264. [PMID: 31847095 PMCID: PMC6963553 DOI: 10.3390/antibiotics8040264] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 01/13/2023] Open
Abstract
Complications after tooth extraction may occur because of several factors correlated to the patient's medical history, surgical site or type of intervention. The aim of this retrospective cohort study was to evaluate type and frequency of complications after exodontic surgery, its correlation with antibiotic administration and between patient's related systemic factors. From June 2015 until February 2016 1701 exodontic interventions, for a total of 2322 extracted teeth, were carried out at the Unit of Oral Surgery in Trieste. Descriptive statistic, and backward multiple logistic regressions were performed to identify the variables associated with the presence of post-operative alveolitis or any other post-operative complication. The presence of coagulopathy and smoking habit were related to high risk of post-operative alveolitis (OR = 5.51, p = 0.035 and OR = 2.5, p = 0.029, respectively). Tooth fracture was found to be correlated with higher probability of post-operative alveolitis (p = 0.001) and concomitant chemotherapy put at a higher risk post-operative complications, including alveolitis (OR = 29.5, p = 0.018). According to the present results, antibiotic consumption did not seem to reduce the incidence of post-operative infective complications (alveolitis). A careful analysis of medical history, the adequate surgical technique, and the correct instructions in post-surgical behavior, prevent the insurgence of intra and post-operative complications.
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24
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Vesty A, Gear K, Biswas K, Mackenzie BW, Taylor MW, Douglas RG. Oral microbial influences on oral mucositis during radiotherapy treatment of head and neck cancer. Support Care Cancer 2019; 28:2683-2691. [PMID: 31650293 DOI: 10.1007/s00520-019-05084-6] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 09/16/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE Oral mucositis (OM) remains a significant complication developed by many patients undergoing radiotherapy (RT) to the head and neck region. Emerging data suggest oral microbes may contribute to the onset and severity of this acute side effect. METHODS In this study, saliva and oral swabs from head and neck cancer patients undergoing RT were collected. We employed molecular microbiological techniques to study the bacterial communities present in saliva, and both the bacterial and fungal communities present on the buccal mucosa and lateral tongue. Changes in microbiota composition with increasing radiation dose and the presence of mucositis were examined. RESULTS The data suggest that the salivary microbiota remain stable during RT and are consistently dominated by Streptococcus, Prevotella, Fusobacterium and Granulicatella. Obligate and facultative anaerobic Gram-negative bacilli (GNB) Bacteroidales G2, Capnocytophaga, Eikenella, Mycoplasma and Sneathia, as well as anaerobic GNB in the periopathogenic genera Porphyromonas and Tannerella, were all positively correlated with ≥ grade 2 OM. Significant increases in the relative abundances of Bacteroidales G2, Fusobacterium and Sneathia were identified in buccal mucosa swabs at sites of ≥ grade 2 OM (p < 0.05). Furthermore, the abundance of several GNB (Fusobacterium, Haemophilus, Tannerella, Porphyromonas and Eikenella) on the buccal mucosa may influence patient susceptibility to developing OM. Candida was widely detected in buccal mucosa swabs, regardless of mucositis status. CONCLUSIONS Our findings support previously hypothesized associations between oral health and the pathogenesis of OM, highlighting the importance of oral health interventions for head and neck cancer patients.
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Affiliation(s)
- Anna Vesty
- Department of Surgery, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, 1023, New Zealand.
| | - Kim Gear
- Department of Otorhinolaryngology, Auckland City Hospital, Auckland, 1023, New Zealand
| | - Kristi Biswas
- Department of Surgery, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, 1023, New Zealand
| | - Brett Wagner Mackenzie
- Department of Surgery, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, 1023, New Zealand
| | - Michael W Taylor
- School of Biological Sciences, The University of Auckland, Auckland, 1010, New Zealand.,Maurice Wilkins Centre for Molecular Biodiscovery, The University of Auckland, Auckland, 1010, New Zealand
| | - Richard G Douglas
- Department of Surgery, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, 1023, New Zealand
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25
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Niikura N, Nakatukasa K, Amemiya T, Watanabe K, Hata H, Kikawa Y, Taniike N, Yamanaka T, Mitsunaga S, Nakagami K, Adachi M, Kondo N, Shibuya Y, Hayashi N, Naito M, Kashiwabara K, Yamashita T, Umeda M, Mukai H, Ota Y. Oral Care Evaluation to Prevent Oral Mucositis in Estrogen Receptor-Positive Metastatic Breast Cancer Patients Treated with Everolimus (Oral Care-BC): A Randomized Controlled Phase III Trial. Oncologist 2019; 25:e223-e230. [PMID: 32043762 PMCID: PMC7011665 DOI: 10.1634/theoncologist.2019-0382] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 08/23/2019] [Indexed: 11/17/2022] Open
Abstract
Background The incidence of oral mucositis (any grade) after everolimus treatment is 58% in the general population and 81% in Asian patients. This study hypothesized that professional oral care (POC) before everolimus treatment could reduce the incidence of everolimus‐induced oral mucositis. Materials and Methods This randomized, multicenter, open‐label, phase III study evaluated the efficacy of POC in preventing everolimus‐induced mucositis. Patients were randomized into POC and control groups (1:1 ratio) and received everolimus with exemestane. Patients in the POC group underwent teeth surface cleaning, scaling, and tongue cleaning before everolimus initiation and continued to receive weekly POC throughout the 8‐week treatment period. Patients in the control group brushed their own teeth and gargled with 0.9% sodium chloride solution or water. The primary endpoint was the incidence of all grades of oral mucositis. We targeted acquisition of 200 patients with a 2‐sided type I error rate of 5% and 80% power to detect 25% risk reduction. Results Between March 2015 and December 2017, we enrolled 175 women from 31 institutions, of which five did not receive the protocol treatment and were excluded. Over the 8 weeks, the incidence of grade 1 oral mucositis was significantly different between the POC group (76.5%, 62 of 82 patients) and control group (89.7%, 78 of 87 patients; p = .034). The incidence of grade 2 (severe) oral mucositis was also significantly different between the POC group (34.6%, 28 of 82 patients) and control group (54%, 47 of 87 patients; p = .015). As a result of oral mucositis, 18 (22.0%) patients in the POC group and 28 (32.2%) in the control group had to undergo everolimus dose reduction. Conclusion POC reduced the incidence and severity of oral mucositis in patients receiving everolimus and exemestane. This might be considered as a treatment option of oral care for patients undergoing this treatment. Clinical trial identification number: NCT 02069093. Implications for Practice The Oral Care‐BC trial that prophylactically used professional oral care (POC), available worldwide, did not show a greater than 25% difference in mucositis. The 12% difference in grade 1 or higher mucositis and especially the ∼20% difference in grade 2 mucositis are likely clinically meaningful to patients. POC before treatment should be considered as a treatment option of oral care for postmenopausal patients who are receiving everolimus and exemestane for treatment of hormone receptor‐positive, HER2‐negative advanced breast cancer and metastatic breast cancer. However, POC was not adequate for prophylactic oral mucositis in these patients, and dexamethasone mouthwash prophylaxis is standard treatment before everolimus. Oral mucositis is a clinically significant complication of mucotoxic cancer therapy. This article focuses on the effect of dental intervention, before everolimus treatment, on oral mucositis.
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Affiliation(s)
- Naoki Niikura
- Department of Breast and Endocrine Surgery, Tokai University School of MedicineTokyoJapan
| | - Katsuhiko Nakatukasa
- Department of Breast and Endocrine Surgery, Kyoto Prefectural University of MedicineKyotoJapan
| | - Takeshi Amemiya
- Department of Dentistry and Oral and Maxillofacial Surgery, Kyoto Prefectural University of MedicineKyotoJapan
| | | | - Hironobu Hata
- Department of Dentistry, Hokkaido Cancer CenterSapporoJapan
| | - Yuichiro Kikawa
- Department of Breast Surgery, Kobe City Medical Center General HospitalKobeJapan
| | - Naoki Taniike
- Department of Dentistry and Oral and Maxillofacial Surgery, Kobe City Medical Center General HospitalKobeJapan
| | - Takashi Yamanaka
- Department of Breast and Endocrine Surgery, Kanagawa Cancer CenterYokohamaJapan
| | - Sachiyo Mitsunaga
- Department of Dentistry and Oral and Maxillofacial Surgery, Kanagawa Cancer CenterYokohamaJapan
| | - Kazuhiko Nakagami
- Department of Breast and Endocrine Surgery, Shizuoka General HospitalShizuokaJapan
| | - Moriyasu Adachi
- Department of Oral and Maxillofacial Surgery, Shizuoka General HospitalShizuokaJapan
| | - Naoto Kondo
- Department of Breast and Endocrine Surgery, Nagoya City University HospitalNagoyaJapan
| | - Yasuyuki Shibuya
- Department of Dentistry and Oral and Maxillofacial Surgery, Nagoya City University HospitalNagoyaJapan
| | - Naoki Hayashi
- Department of Breast Surgical Oncology, St. Luke's International HospitalTokyoJapan
| | - Mariko Naito
- Department of Oral Epidemiology, Graduate School of Biomedical and Health Sciences, Hiroshima UniversityHiroshimaJapan
| | - Kosuke Kashiwabara
- Department of Biostatistics, School of Public Health, the University of TokyoTokyoJapan
| | - Toshinari Yamashita
- Department of Breast and Endocrine Surgery, Kanagawa Cancer CenterYokohamaJapan
| | - Masahiro Umeda
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical SciencesNagasakiJapan
| | - Hirofumi Mukai
- Department of Breast and Medical Oncology, National Cancer Center Hospital EastKashiwaJapan
| | - Yoshihide Ota
- Department of Dentistry and Oral and Maxillofacial Surgery, Tokai University School of MedicineTokyoJapan
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26
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Hong CHL, Gueiros LA, Fulton JS, Cheng KKF, Kandwal A, Galiti D, Fall-Dickson JM, Johansen J, Ameringer S, Kataoka T, Weikel D, Eilers J, Ranna V, Vaddi A, Lalla RV, Bossi P, Elad S. Systematic review of basic oral care for the management of oral mucositis in cancer patients and clinical practice guidelines. Support Care Cancer 2019. [DOI: 10.1007/s00520-019-04848-4%0a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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27
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Systematic review of basic oral care for the management of oral mucositis in cancer patients and clinical practice guidelines. Support Care Cancer 2019; 27:3949-3967. [DOI: 10.1007/s00520-019-04848-4] [Citation(s) in RCA: 79] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2019] [Accepted: 04/30/2019] [Indexed: 11/27/2022]
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28
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中国抗癌协会肺癌专业委员会. [EGFR-TKI ADR Management Chinese Expert Consensus]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2019; 22:57-81. [PMID: 30827323 PMCID: PMC6397940 DOI: 10.3779/j.issn.1009-3419.2019.02.01] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
ErbB receptor tyrosine kinase inhibitors (EGFR-TKI), gefitinib, erlotinib, icotinib and aftinib, which are approved as a frontline treatment for patients with non-small cell lung cancer (NSCLC) who have tumors harboring EGFR mutations in China. And osimertinib was approved in second line setting for patients with EGFRT 790M-positive NSCLC. Rash, paronychia, diarrhea, stomatitis, liver dysfunction and (interstitial lung disease, ILD) are frequently observed in patients treated with EGFR-TKI. Chinese Society of Lung Cancer, Chinese Anti-Cancer Association, organized Chinese experts to develop the Chinese expert consensus on EGFR-TKI adverse event (AE) management based on domestic diagnosis and treatment of ADR and also incorporating international updated theory and recommendations.
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Affiliation(s)
- 中国抗癌协会肺癌专业委员会
- />200030 上海,上海交通大学附属上海市胸科医院肿瘤科Department of Oncology, Shanghai Chest Hospital Afliated to Shanghai Jiaotong University, Shanghai 200030, China
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29
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Wu IJ, Chang TS, Hwang SL, Chen MY. Effects of oral hygiene programme and home phone counselling for hepatitis C patients receiving antiviral treatment. J Adv Nurs 2018; 75:1010-1017. [PMID: 30375059 DOI: 10.1111/jan.13896] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 08/23/2018] [Accepted: 10/02/2018] [Indexed: 12/12/2022]
Abstract
AIMS To explore the effectiveness of an oral hygiene programme combined with home phone counselling on hepatitis C patients during antiviral treatment. BACKGROUND Hepatitis C virus infection is the leading cause of liver diseases. Evidence indicates that the antiviral treatment for hepatitis C virus infection has been successful, albeit its many side effects, such as discomfort symptoms of oral ulcers, which, in turn, leads to discontinued treatment. Inappropriate oral hygiene may worsen the side effects and increase the risk of dropping out of the treatment. DESIGN A quasi-experimental pre-post-test design was used. METHODS The oral hygiene programme was based on a standardized protocol of oral health care combined with home phone counselling. The participants were recruited from an outpatient clinic between August 2016 and July 2017. The generalized estimating equation was used for repeated measures of oral health behaviour, oral health status and discomfort symptoms. FINDINGS Thirty-four participants completed this study. The findings indicated that the oral hygiene programme significantly improved tooth brushing, use of dental floss and oral comfort. The result showed that the participants' oral health status significantly improved in 3 months. CONCLUSIONS This pilot study supports the finding that an oral hygiene programme can reduce oral discomfort, improve oral hygiene behaviour, and enhance the oral health status of hepatitis C patients receiving treatment. This is a simple and low-cost programme, which can be performed at home easily and boosts the completion of antiviral treatment.
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Affiliation(s)
- I-Jung Wu
- Department of Nursing, Chang Jung Christian University, Tainan, Taiwan
| | - Te-Sheng Chang
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, Taiwan.,College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Su-Lun Hwang
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan
| | - Mei-Yen Chen
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan.,Department of Nursing, Chang Gung University, Taoyuan, Taiwan.,Department of Cardiology, Chang Gung Memorial Hospital, Chiayi, Taiwan
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30
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Saito K, Isayama H, Nakai Y, Takahara N, Ishigaki K, Takeda T, Hakuta R, Saito T, Uchino R, Kishikawa T, Hamada T, Mizuno S, Sasaki T, Kogure H, Matsubara S, Yamamoto N, Ijichi H, Tateishi K, Tada M, Koike K. A phase II trial of gemcitabine, S-1 and LV combination (GSL) therapy in patients with advanced pancreatic cancer. Invest New Drugs 2018; 37:338-344. [PMID: 30411217 DOI: 10.1007/s10637-018-0691-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Accepted: 10/25/2018] [Indexed: 01/30/2023]
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31
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Inter-rater reliability of the Oral Assessment Guide for oral cancer patients between nurses and dental hygienists: the difficulties in objectively assessing oral health. Support Care Cancer 2018; 27:1673-1677. [DOI: 10.1007/s00520-018-4412-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 08/08/2018] [Indexed: 01/17/2023]
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32
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Fitzgerald R, Gallagher J. Oral health in end-of-life patients: A rapid review. SPECIAL CARE IN DENTISTRY 2018; 38:291-298. [DOI: 10.1111/scd.12316] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 06/18/2018] [Accepted: 07/06/2018] [Indexed: 11/28/2022]
Affiliation(s)
- Richard Fitzgerald
- King's College London Dental Institute; Denmark Hill Campus; Bessemer Road London SE5 9RS UK
| | - Jennifer Gallagher
- King's College London Dental Institute; Denmark Hill Campus; Bessemer Road London SE5 9RS UK
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Prevention of the Chemotherapy-Induced Oral Mucositis in Esophageal Cancer by Use of Hangeshashinto (TJ-14). Int Surg 2018. [DOI: 10.9738/intsurg-d-17-00114.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective:
Oral mucositis and diarrhea are adverse effects (AEs) of chemotherapy and chemoradiotherapy (CR/CRT) that commonly occur in patients of esophageal cancer (EC). We investigated whether Hangeshashinto (TJ-14)—a Japanese traditional medicine—could control oral mucositis, pain, incidence of esophagitis, and diarrhea in patients who underwent CT/CRT for EC.
Methods:
We enrolled 39 patients (36 men, 3 women) who underwent docetaxel- or cisplatin-based CT/CRT for EC between July 2012 and June 2014, of whom 19 used TJ-14 dissolved in water as an oral rinse 3 times a day over the first 2 courses of their treatment, and 20 (the control group) received no particular prophylaxis against mucositis. Their AEs, including mucositis, were evaluated according to the Common Terminology Criteria for Adverse Events (CTCAE) version 4.0.
Results:
Although incidences of oral mucositis, appetite loss, nausea, constipation, and vomiting did not significantly differ between the TJ-14 group and controls, diarrhea incidence was significantly lower in the TJ-14 group by the second treatment course (P = 0.0261 by per protocol set analyses).
Conclusions:
TJ-14 significantly decreases diarrhea caused by CT/CRT in patients treated for EC, although TJ-14 cannot prevent of causing oral mucositis.
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Nuñez-Aguilar J, Fernández-Olavarría A, Oliveros-López LG, Torres-Lagares D, Serrera-Figallo MA, Gutiérrez-Corrales A, Gutiérrez-Pérez JL. Evolution of oral health in oral cancer patients with and without dental treatment in place: Before, during and after cancer treatment. J Clin Exp Dent 2018; 10:e158-e165. [PMID: 29670734 PMCID: PMC5899789 DOI: 10.4317/jced.54608] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Accepted: 01/12/2018] [Indexed: 11/30/2022] Open
Abstract
Background This study aims to evaluate the influence of two dental treatment protocols, outpatient non-regulated treatment versus supervised hospital treatment, on the oral health of patients undergoing oral cancer (only radiochemotherapy treatment, not surgical) treatment. Material and Methods The study used a quasi-experimental approach justified on ethical grounds. A total of 41 patients were included in the control group (outpatient non-regulated treatment) and 40 patients in the experimental group (in-hospital supervised treatment). The patients were treated only with chemotherapy (not surgical treatment was made) for oral cancer. This decision was taken by the oncology committee of the hospital without being influenced by this study. Data regarding plaque index, daily brushing habits, appearance of new cavities, need for extractions, appearance of candidiasis and use of prosthetics in both groups were collected at three points throughout the study: before starting cancer treatment, during treatment and after treatment. The values obtained using the Student’s t-test and chi-squared were compared. Results Based on similar patient backgrounds, throughout cancer treatment the intervention under study resulted in a decrease in plaque index, necessary extractions, and incidence of decay, as well as an increase in daily brushing among other improvements in oral health observed in the experimental group versus the control group. Conclusions From our data, we can confirm that supervised dental treatment performed during oral cancer treatment produced an improvement in the oral health of patients with oral cancer. Key words:Oral cancer, dental treatment, quality of life, oncology, dentistry.
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Affiliation(s)
| | | | | | - Daniel Torres-Lagares
- PhD, DDS, MSc. Professor of Oral Surgery. Chairman of Oral Surgery. Department of Stomatology. University of Seville
| | | | | | - Jose-Luis Gutiérrez-Pérez
- PhD, DMD, Professor of Oral Surgery. Chairman of Oral Surgery. Department of Stomatology. University of Seville
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Ribeiro da Silva VC, da Motta Silveira FM, Barbosa Monteiro MG, da Cruz MMD, Caldas Júnior ADF, Pina Godoy G. Photodynamic therapy for treatment of oral mucositis: Pilot study with pediatric patients undergoing chemotherapy. Photodiagnosis Photodyn Ther 2018; 21:115-120. [DOI: 10.1016/j.pdpdt.2017.11.010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 11/20/2017] [Accepted: 11/21/2017] [Indexed: 12/26/2022]
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Abstract
: An evidence-based practice change at a radiation oncology center in a large academic medical center was designed to reduce the severity of oral mucositis in adults receiving radiation treatment for head and neck cancer. In the intervention described, patients were given newly created oral care kits and educational materials to improve their oral hygiene. Evaluations were conducted at three points during the project (before radiation treatment, during week 4 to 5 of treatment, and one month after treatment). At week 4 to 5-when the severity of oral mucositis is expected to peak-patients reported improved oral hygiene practices and reduced oral mucositis severity. The authors conclude that the use of these oral care kits and educational materials lessened the effects of oral mucositis during and after radiation treatment.
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Eslami H, Pouralibaba F, Falsafi P, Bohluli S, Najati B, Negahdari R, Ghanizadeh M. Efficacy of Hypozalix spray and propolis mouthwash for prevention of chemotherapy-induced oral mucositis in leukemic patients: A double-blind randomized clinical trial. J Dent Res Dent Clin Dent Prospects 2016; 10:226-233. [PMID: 28096948 PMCID: PMC5237669 DOI: 10.15171/joddd.2016.036] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 12/06/2016] [Indexed: 11/09/2022] Open
Abstract
Background. Oral mucositis is the chief complication of head and neck chemotherapy. This study was conducted to evaluate Hypozalix artificial saliva and propolis mouthwash efficacy for the prevention of chemotherapy-induced oral mucositis in leukemic patients. Methods. The present double-blind clinical trial was carried out on 72 patients undergoing chemotherapy. The patients were assigned to 3 groups. In the control group, CHX mouthwash and fluconazole were used by the subjects. In groups 1 and 2, Hypozalix and propolis mouthwashes were added to the combination therapy used in the control group. The results were compared between the three groups after 14 days. Results. Mean score A was significantly higher than mean score B in children (P = 0.001). In contrast, mean score A was significantly lower than mean score B in young adults (P = 0.003). Conclusion. Use of Hypozalix spray or propolis mouthwash in association with CHX mouthwash and fluconazole simultaneously at the start of chemotherapy resulted in a decrease in chemotherapy complications after 14 days. In many cases the use of propolis mouthwash yielded better results and the patients exhibited a greater tendency to continue to use it.
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Affiliation(s)
- Hosein Eslami
- Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Firouz Pouralibaba
- Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parisa Falsafi
- Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sepideh Bohluli
- Department of Oral Medicine, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Babak Najati
- Orthodontics Research Center, Department of Orthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ramin Negahdari
- Department of Prosthodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Milad Ghanizadeh
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
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Ferrell BR, Temel JS, Temin S, Alesi ER, Balboni TA, Basch EM, Firn JI, Paice JA, Peppercorn JM, Phillips T, Stovall EL, Zimmermann C, Smith TJ. Integration of Palliative Care Into Standard Oncology Care: American Society of Clinical Oncology Clinical Practice Guideline Update. J Clin Oncol 2016; 35:96-112. [PMID: 28034065 DOI: 10.1200/jco.2016.70.1474] [Citation(s) in RCA: 1275] [Impact Index Per Article: 159.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Purpose To provide evidence-based recommendations to oncology clinicians, patients, family and friend caregivers, and palliative care specialists to update the 2012 American Society of Clinical Oncology (ASCO) provisional clinical opinion (PCO) on the integration of palliative care into standard oncology care for all patients diagnosed with cancer. Methods ASCO convened an Expert Panel of members of the ASCO Ad Hoc Palliative Care Expert Panel to develop an update. The 2012 PCO was based on a review of a randomized controlled trial (RCT) by the National Cancer Institute Physicians Data Query and additional trials. The panel conducted an updated systematic review seeking randomized clinical trials, systematic reviews, and meta-analyses, as well as secondary analyses of RCTs in the 2012 PCO, published from March 2010 to January 2016. Results The guideline update reflects changes in evidence since the previous guideline. Nine RCTs, one quasiexperimental trial, and five secondary analyses from RCTs in the 2012 PCO on providing palliative care services to patients with cancer and/or their caregivers, including family caregivers, were found to inform the update. Recommendations Inpatients and outpatients with advanced cancer should receive dedicated palliative care services, early in the disease course, concurrent with active treatment. Referral of patients to interdisciplinary palliative care teams is optimal, and services may complement existing programs. Providers may refer family and friend caregivers of patients with early or advanced cancer to palliative care services.
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Affiliation(s)
- Betty R Ferrell
- Betty R. Ferrell, City of Hope Medical Center, Duarte, CA; Jennifer S. Temel and Jeffrey M. Peppercorn, Massachusetts General Hospital; Tracy A. Balboni, Dana-Farber Cancer Institute, Boston, MA; Sarah Temin, American Society of Clinical Oncology, Alexandria; Erin R. Alesi, Virginia Commonwealth University Health System, Richmond, VA; Ethan M. Basch, University of North Carolina at Chapel Hill, Chapel Hill, NC; Janice I. Firn, University of Michigan Health System, Ann Arbor, MI; Judith A. Paice, Northwestern University, Evanston, IL; Tanyanika Phillips, CHRISTUS St Frances Cabrini Hospital, Alexandria, LA; Ellen L. Stovall, National Coalition for Cancer Survivorship, Silver Spring; Thomas J. Smith, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; and Camilla Zimmermann, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Jennifer S Temel
- Betty R. Ferrell, City of Hope Medical Center, Duarte, CA; Jennifer S. Temel and Jeffrey M. Peppercorn, Massachusetts General Hospital; Tracy A. Balboni, Dana-Farber Cancer Institute, Boston, MA; Sarah Temin, American Society of Clinical Oncology, Alexandria; Erin R. Alesi, Virginia Commonwealth University Health System, Richmond, VA; Ethan M. Basch, University of North Carolina at Chapel Hill, Chapel Hill, NC; Janice I. Firn, University of Michigan Health System, Ann Arbor, MI; Judith A. Paice, Northwestern University, Evanston, IL; Tanyanika Phillips, CHRISTUS St Frances Cabrini Hospital, Alexandria, LA; Ellen L. Stovall, National Coalition for Cancer Survivorship, Silver Spring; Thomas J. Smith, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; and Camilla Zimmermann, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Sarah Temin
- Betty R. Ferrell, City of Hope Medical Center, Duarte, CA; Jennifer S. Temel and Jeffrey M. Peppercorn, Massachusetts General Hospital; Tracy A. Balboni, Dana-Farber Cancer Institute, Boston, MA; Sarah Temin, American Society of Clinical Oncology, Alexandria; Erin R. Alesi, Virginia Commonwealth University Health System, Richmond, VA; Ethan M. Basch, University of North Carolina at Chapel Hill, Chapel Hill, NC; Janice I. Firn, University of Michigan Health System, Ann Arbor, MI; Judith A. Paice, Northwestern University, Evanston, IL; Tanyanika Phillips, CHRISTUS St Frances Cabrini Hospital, Alexandria, LA; Ellen L. Stovall, National Coalition for Cancer Survivorship, Silver Spring; Thomas J. Smith, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; and Camilla Zimmermann, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Erin R Alesi
- Betty R. Ferrell, City of Hope Medical Center, Duarte, CA; Jennifer S. Temel and Jeffrey M. Peppercorn, Massachusetts General Hospital; Tracy A. Balboni, Dana-Farber Cancer Institute, Boston, MA; Sarah Temin, American Society of Clinical Oncology, Alexandria; Erin R. Alesi, Virginia Commonwealth University Health System, Richmond, VA; Ethan M. Basch, University of North Carolina at Chapel Hill, Chapel Hill, NC; Janice I. Firn, University of Michigan Health System, Ann Arbor, MI; Judith A. Paice, Northwestern University, Evanston, IL; Tanyanika Phillips, CHRISTUS St Frances Cabrini Hospital, Alexandria, LA; Ellen L. Stovall, National Coalition for Cancer Survivorship, Silver Spring; Thomas J. Smith, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; and Camilla Zimmermann, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Tracy A Balboni
- Betty R. Ferrell, City of Hope Medical Center, Duarte, CA; Jennifer S. Temel and Jeffrey M. Peppercorn, Massachusetts General Hospital; Tracy A. Balboni, Dana-Farber Cancer Institute, Boston, MA; Sarah Temin, American Society of Clinical Oncology, Alexandria; Erin R. Alesi, Virginia Commonwealth University Health System, Richmond, VA; Ethan M. Basch, University of North Carolina at Chapel Hill, Chapel Hill, NC; Janice I. Firn, University of Michigan Health System, Ann Arbor, MI; Judith A. Paice, Northwestern University, Evanston, IL; Tanyanika Phillips, CHRISTUS St Frances Cabrini Hospital, Alexandria, LA; Ellen L. Stovall, National Coalition for Cancer Survivorship, Silver Spring; Thomas J. Smith, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; and Camilla Zimmermann, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Ethan M Basch
- Betty R. Ferrell, City of Hope Medical Center, Duarte, CA; Jennifer S. Temel and Jeffrey M. Peppercorn, Massachusetts General Hospital; Tracy A. Balboni, Dana-Farber Cancer Institute, Boston, MA; Sarah Temin, American Society of Clinical Oncology, Alexandria; Erin R. Alesi, Virginia Commonwealth University Health System, Richmond, VA; Ethan M. Basch, University of North Carolina at Chapel Hill, Chapel Hill, NC; Janice I. Firn, University of Michigan Health System, Ann Arbor, MI; Judith A. Paice, Northwestern University, Evanston, IL; Tanyanika Phillips, CHRISTUS St Frances Cabrini Hospital, Alexandria, LA; Ellen L. Stovall, National Coalition for Cancer Survivorship, Silver Spring; Thomas J. Smith, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; and Camilla Zimmermann, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Janice I Firn
- Betty R. Ferrell, City of Hope Medical Center, Duarte, CA; Jennifer S. Temel and Jeffrey M. Peppercorn, Massachusetts General Hospital; Tracy A. Balboni, Dana-Farber Cancer Institute, Boston, MA; Sarah Temin, American Society of Clinical Oncology, Alexandria; Erin R. Alesi, Virginia Commonwealth University Health System, Richmond, VA; Ethan M. Basch, University of North Carolina at Chapel Hill, Chapel Hill, NC; Janice I. Firn, University of Michigan Health System, Ann Arbor, MI; Judith A. Paice, Northwestern University, Evanston, IL; Tanyanika Phillips, CHRISTUS St Frances Cabrini Hospital, Alexandria, LA; Ellen L. Stovall, National Coalition for Cancer Survivorship, Silver Spring; Thomas J. Smith, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; and Camilla Zimmermann, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Judith A Paice
- Betty R. Ferrell, City of Hope Medical Center, Duarte, CA; Jennifer S. Temel and Jeffrey M. Peppercorn, Massachusetts General Hospital; Tracy A. Balboni, Dana-Farber Cancer Institute, Boston, MA; Sarah Temin, American Society of Clinical Oncology, Alexandria; Erin R. Alesi, Virginia Commonwealth University Health System, Richmond, VA; Ethan M. Basch, University of North Carolina at Chapel Hill, Chapel Hill, NC; Janice I. Firn, University of Michigan Health System, Ann Arbor, MI; Judith A. Paice, Northwestern University, Evanston, IL; Tanyanika Phillips, CHRISTUS St Frances Cabrini Hospital, Alexandria, LA; Ellen L. Stovall, National Coalition for Cancer Survivorship, Silver Spring; Thomas J. Smith, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; and Camilla Zimmermann, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Jeffrey M Peppercorn
- Betty R. Ferrell, City of Hope Medical Center, Duarte, CA; Jennifer S. Temel and Jeffrey M. Peppercorn, Massachusetts General Hospital; Tracy A. Balboni, Dana-Farber Cancer Institute, Boston, MA; Sarah Temin, American Society of Clinical Oncology, Alexandria; Erin R. Alesi, Virginia Commonwealth University Health System, Richmond, VA; Ethan M. Basch, University of North Carolina at Chapel Hill, Chapel Hill, NC; Janice I. Firn, University of Michigan Health System, Ann Arbor, MI; Judith A. Paice, Northwestern University, Evanston, IL; Tanyanika Phillips, CHRISTUS St Frances Cabrini Hospital, Alexandria, LA; Ellen L. Stovall, National Coalition for Cancer Survivorship, Silver Spring; Thomas J. Smith, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; and Camilla Zimmermann, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Tanyanika Phillips
- Betty R. Ferrell, City of Hope Medical Center, Duarte, CA; Jennifer S. Temel and Jeffrey M. Peppercorn, Massachusetts General Hospital; Tracy A. Balboni, Dana-Farber Cancer Institute, Boston, MA; Sarah Temin, American Society of Clinical Oncology, Alexandria; Erin R. Alesi, Virginia Commonwealth University Health System, Richmond, VA; Ethan M. Basch, University of North Carolina at Chapel Hill, Chapel Hill, NC; Janice I. Firn, University of Michigan Health System, Ann Arbor, MI; Judith A. Paice, Northwestern University, Evanston, IL; Tanyanika Phillips, CHRISTUS St Frances Cabrini Hospital, Alexandria, LA; Ellen L. Stovall, National Coalition for Cancer Survivorship, Silver Spring; Thomas J. Smith, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; and Camilla Zimmermann, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Ellen L Stovall
- Betty R. Ferrell, City of Hope Medical Center, Duarte, CA; Jennifer S. Temel and Jeffrey M. Peppercorn, Massachusetts General Hospital; Tracy A. Balboni, Dana-Farber Cancer Institute, Boston, MA; Sarah Temin, American Society of Clinical Oncology, Alexandria; Erin R. Alesi, Virginia Commonwealth University Health System, Richmond, VA; Ethan M. Basch, University of North Carolina at Chapel Hill, Chapel Hill, NC; Janice I. Firn, University of Michigan Health System, Ann Arbor, MI; Judith A. Paice, Northwestern University, Evanston, IL; Tanyanika Phillips, CHRISTUS St Frances Cabrini Hospital, Alexandria, LA; Ellen L. Stovall, National Coalition for Cancer Survivorship, Silver Spring; Thomas J. Smith, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; and Camilla Zimmermann, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Camilla Zimmermann
- Betty R. Ferrell, City of Hope Medical Center, Duarte, CA; Jennifer S. Temel and Jeffrey M. Peppercorn, Massachusetts General Hospital; Tracy A. Balboni, Dana-Farber Cancer Institute, Boston, MA; Sarah Temin, American Society of Clinical Oncology, Alexandria; Erin R. Alesi, Virginia Commonwealth University Health System, Richmond, VA; Ethan M. Basch, University of North Carolina at Chapel Hill, Chapel Hill, NC; Janice I. Firn, University of Michigan Health System, Ann Arbor, MI; Judith A. Paice, Northwestern University, Evanston, IL; Tanyanika Phillips, CHRISTUS St Frances Cabrini Hospital, Alexandria, LA; Ellen L. Stovall, National Coalition for Cancer Survivorship, Silver Spring; Thomas J. Smith, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; and Camilla Zimmermann, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
| | - Thomas J Smith
- Betty R. Ferrell, City of Hope Medical Center, Duarte, CA; Jennifer S. Temel and Jeffrey M. Peppercorn, Massachusetts General Hospital; Tracy A. Balboni, Dana-Farber Cancer Institute, Boston, MA; Sarah Temin, American Society of Clinical Oncology, Alexandria; Erin R. Alesi, Virginia Commonwealth University Health System, Richmond, VA; Ethan M. Basch, University of North Carolina at Chapel Hill, Chapel Hill, NC; Janice I. Firn, University of Michigan Health System, Ann Arbor, MI; Judith A. Paice, Northwestern University, Evanston, IL; Tanyanika Phillips, CHRISTUS St Frances Cabrini Hospital, Alexandria, LA; Ellen L. Stovall, National Coalition for Cancer Survivorship, Silver Spring; Thomas J. Smith, Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD; and Camilla Zimmermann, Princess Margaret Cancer Centre, Toronto, Ontario, Canada
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Haresaku S, Mariño R, Naito T, Morgan MV. The opinions and attitudes of dental school academic staff towards oral healthcare education for older adults. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2016; 20:167-173. [PMID: 26083002 DOI: 10.1111/eje.12157] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/19/2015] [Indexed: 06/04/2023]
Abstract
The term 'oral health care for older adults' has various interpretations, and its meaning is not clear among dental school academic staff. Additionally, there are no theoretical or practical stand-alone courses on oral health care for older adults in Japanese dental schools. To improve oral health care education, we investigated the opinions and attitudes toward oral health care education for older adults among academic staff in dental schools. Data were collected in seven dental schools from May to September 2013 via an online questionnaire survey. Five-hundred-fifty-eight academics (428 male, 130 female) participated (response rate 57%). The average number of years since they had completed a university degree was 20.2 (SD 10.2) years. The majority (Over 90%) of participants perceived that oral health care should be provided in nursing facilities, hospitals, and at home. Its treatments and instructions should include, not only methods of keeping good oral hygiene, but also improvement of oral function such as swallowing training and salivary glands massage. The majority (84.2%) suggested oral health care education should be combined as a one-credit, stand-alone course. Findings indicate that dental academics have an understanding the need for a course in oral health care for older adults. Participants supported the need for further development of education in oral health care for older adults' in Japan, as a separate course on its own right. However there were some different views about content by teaching field. The need for a national core program for teaching oral health care education was suggested.
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Affiliation(s)
- S Haresaku
- Department of Preventive and Public Health Dentistry, Fukuoka Dental College, Fukuoka, Japan
- Oral Health Cooperative Research Centre, Melbourne Dental School, University of Melbourne, Melbourne, Vic., Australia
| | - R Mariño
- Oral Health Cooperative Research Centre, Melbourne Dental School, University of Melbourne, Melbourne, Vic., Australia
| | - T Naito
- Section of Geriatric Dentistry, Department of Geriatric Dentistry, Fukuoka Dental College, Fukuoka, Japan
| | - M V Morgan
- Oral Health Cooperative Research Centre, Melbourne Dental School, University of Melbourne, Melbourne, Vic., Australia
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Niikura N, Ota Y, Hayashi N, Naito M, Kashiwabara K, Watanabe KI, Yamashita T, Mukai H, Umeda M. Evaluation of oral care to prevent oral mucositis in estrogen receptor-positive metastatic breast cancer patients treated with everolimus (Oral Care-BC): randomized controlled phase III trial. Jpn J Clin Oncol 2016; 46:879-82. [PMID: 27365521 DOI: 10.1093/jjco/hyw077] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 05/22/2016] [Indexed: 11/14/2022] Open
Abstract
This is a randomized, multi-center, open-label, phase III study to evaluate the efficacy of professional oral care in preventing oral mucositis induced by everolimus in postmenopausal estrogen receptor-positive metastatic breast cancer. Patients will be randomized into professional oral care and control groups (1:1 ratio). All patients will receive everolimus with exemestane and will continue everolimus until disease progression. In the professional oral care group, patients will receive teeth surface cleaning, scaling and tongue cleaning before starting everolimus, and will continue to receive professional oral care weekly from oral surgeons throughout the 8 week treatment. In the control group, patients will brush their own teeth and gargle with 0.9% sodium chloride solution or water. The primary endpoint is the incidence of all grades of oral mucositis. Target accrual is 200 patients with a two-sided type I error rate of 5% and 80% power to detect 25% risk reduction.
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Affiliation(s)
- Naoki Niikura
- Departments of Breast and Endocrine Surgery, Tokai University School of Medicine, Ishehara
| | - Yoshihide Ota
- Dentistry and Oral and Maxillofacial Surgery, Tokai University School of Medicine, Ishehara
| | - Naoki Hayashi
- Department of Breast Surgical Oncology, St. Luke's International Hospital, Tokyo
| | - Mariko Naito
- Department of Preventive Medicine, Nagoya University Graduate School of Medicine, Nagoya
| | - Kosuke Kashiwabara
- Department of Biostatistics, School of Public Health, The University of Tokyo, Tokyo
| | | | - Toshinari Yamashita
- Department of Breast Surgical Oncology, Cancer and Infectious Diseases Center Tokyo Metropolitan Komagome Hospital, Tokyo
| | - Hirofumi Mukai
- Department of Breast and Medical Oncology, National Cancer Center Hospital East, Kashiwa
| | - Masahiro Umeda
- Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Multicenter phase II study of an oral care program for patients with head and neck cancer receiving chemoradiotherapy. Support Care Cancer 2016; 24:3029-36. [PMID: 26887378 DOI: 10.1007/s00520-016-3122-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 02/09/2016] [Indexed: 10/22/2022]
Abstract
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 chemoradiotherapy 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 endpoint 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. TRIAL REGISTRATION NUMBER UMIN000006660.
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Kubota K, Kobayashi W, Sakaki H, Nakagawa H, Kon T, Mimura M, Ito R, Furudate K, Kimura H. Professional oral health care reduces oral mucositis pain in patients treated by superselective intra-arterial chemotherapy concurrent with radiotherapy for oral cancer. Support Care Cancer 2015; 23:3323-9. [PMID: 25987235 DOI: 10.1007/s00520-015-2774-x] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2014] [Accepted: 05/12/2015] [Indexed: 11/28/2022]
Abstract
PURPOSE Oral mucositis (OM) is a painful complication of radiation therapy (RT) for head and neck cancer. OM can compromise nutrition, require opioid analgesics and hospitalization for pain control, and lead to interruption of treatment. Severe oral mucositis appears inevitable in superselective intra-arterial chemotherapy concurrent with radiotherapy (SSIACRT), requiring management of OM for the patient. The objective of this study was to assess the utility of professional oral health care (POHC) for the management of OM in patients undergoing SSIACRT. METHODS Thirty-three patients were enrolled in this study. The first 17 patients underwent SSIACRT before we created an oral management team, and thus did not receive POHC. The remaining 16 patients received POHC. Fever duration, duration of oral feeding difficulty, opioid usage, duration of opioid administration, duration of hospitalization, and number of hospital days from the end of irradiation to discharge were compared between these two groups. RESULTS Median total dose of morphine during SSIACRT, median number of hospital days from end of irradiation to discharge, and duration of hospitalization all differed significantly between groups (P < 0.05). Duration of opioid administration, fever duration, and duration of oral feeding difficulty did not differ significantly between groups. CONCLUSIONS These findings indicate that POHC may reduce opioid use and shorten the hospital stay. Such results might be obtained through infection control by POHC. This report appears to be the first study to evaluate the efficiency of POHC in SSIACRT for oral cancer from the perspective of mucositis pain and opioid use.
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Affiliation(s)
- Kosei Kubota
- Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan.
| | - Wataru Kobayashi
- Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
| | - Hirotaka Sakaki
- Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
| | - Hiroshi Nakagawa
- Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
| | - Takao Kon
- Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
| | - Mayu Mimura
- Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
| | - Ryohei Ito
- Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
| | - Ken Furudate
- Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
| | - Hiroto Kimura
- Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan
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