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Lim ESY, Ong Y, Chou Y, Then CK. Interconnected influences of tumour and host microbiota on treatment response and side effects in nasopharyngeal cancer. Crit Rev Oncol Hematol 2024; 202:104468. [PMID: 39103130 DOI: 10.1016/j.critrevonc.2024.104468] [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: 04/07/2024] [Revised: 07/31/2024] [Accepted: 07/31/2024] [Indexed: 08/07/2024] Open
Abstract
This study elucidates the intricate relationship between nasopharyngeal carcinoma (NPC), a significant malignancy predominant in Asia with notable global incidence and mortality rates, and the host microbiota, including those of tumour, nasal, nasopharyngeal, oral, oropharyngeal, and gut communities. It underscores how the composition and diversity of microbiota are altered in NPC, delving into their implications for disease pathogenesis, treatment response, and the side effects of therapies. A consistent reduction in alpha diversity across oral, nasal, and gut microbiomes in NPC patients compared to healthy individuals signals a distinct microbial signature indicative of the diseased state. The study also shows unique microbial changes tied to different NPC stages, indicating a dynamic interplay between disease progression and microbiota composition. Patients with specific microbial profiles exhibit varied responses to chemotherapy and immunotherapy, underscoring the potential for treatment personalisation based on microbiota analysis. Furthermore, the side effects of NPC treatments, such as oral mucositis, are intensified by shifts in microbial communities, suggesting a direct link between microbiota composition and treatment tolerance. This nexus offers opportunities for interventions aimed at modulating the microbiota to alleviate side effects, improve quality of life, and potentially enhance treatment efficacy. Highlighting the dual potential of microbiota as both a therapeutic target and a biomarker for NPC, this review emphasises its significance in influencing treatment outcomes and side effects, heralding a new era in NPC management through personalised treatment strategies and innovative approaches.
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Affiliation(s)
- Eugene Sheng Yao Lim
- Jeffery Cheah School of Medicine and Health Sciences, Monash University, Malaysia
| | - Yenyi Ong
- Jeffery Cheah School of Medicine and Health Sciences, Monash University, Malaysia
| | - Yang Chou
- Department of Otolaryngology, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.
| | - Chee Kin Then
- Department of Radiation Oncology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
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He LL, Xiao S, Jiang CH, Wu XW, Liu W, Fan CG, Ye X, Zhao Q, Wu WQ, Li YX, Wang H, Liu F. A randomized, controlled trial to investigate cognitive behavioral therapy in prevention and treatment of acute oral mucositis in patients with locoregional advanced nasopharyngeal carcinoma undergoing chemoradiotherapy. Front Oncol 2023; 13:1143401. [PMID: 37350940 PMCID: PMC10282775 DOI: 10.3389/fonc.2023.1143401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 05/15/2023] [Indexed: 06/24/2023] Open
Abstract
Purpose Oral mucositis is a common side effect of concurrent chemoradiotherapy (CCRT). This study aimed to determine whether cognitive behavioral therapy (CBT) could help prevent oral mucositis during chemoradiation therapy for locoregional advanced nasopharyngeal carcinoma (LA-NPC). Methods and materials Between July 15, 2020, and January 31, 2022, a randomized controlled phase II trial was conducted. Eligible patients (N=282, 18-70 years old) with pathologically diagnosed LA-NPC were randomly assigned to receive CBT or treatment as usual (TAU) during CCRT (computer-block randomization, 1:1). The primary endpoints were the incidence and latency of oral mucositis. Results The incidence of oral mucositis was significantly lower in the CBT group (84.8%; 95% confidence interval [CI], 78.7%-90.9%) than in the TAU group (98.6%; 95% CI, 96.6%-100%; P<0.001). The median latency period was 26 days and 15 days in the CBT and TAU groups, respectively (hazard ratio, 0.16; 95% CI, 0.12-0.22; P<0.001). CBT significantly reduced ≥ grade 3 oral mucositis (71.9% vs. 22.5%, P<0.001), dry mouth (10.8% vs. 3.7%, P=0.021), dysphagia (18% vs. 5.1%, P=0.001), and oral pain (10% vs. 3.6%, P=0.034) compared with TAU. Patients receiving CBT and TAU during CCRT had similar short-term response rates. Conclusions CBT reduced the occurrence, latency, and severity of oral mucositis in patients with LA-NPC during CCRT.
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Affiliation(s)
- Li-li He
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Shuai Xiao
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Cui-hong Jiang
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Xiang-wei Wu
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Wen Liu
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Chang-gen Fan
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Xu Ye
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Qi Zhao
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Wen-qiong Wu
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Yan-xian Li
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Hui Wang
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
- Hunan Key Laboratory of Translational Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
| | - Feng Liu
- Department of Radiation Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, Hunan, China
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Yang G, Feng D, Li F, Luo B, Zhu J, Yang Q, Zheng L, Dong Q, Chen M, Xu Z, Li L, Chen P, Sun J. A randomized, controlled phase II trial of maxillofacial and oral massage in attenuating severe radiotherapy-induced oral mucositis and lipid metabolite changes in nasopharyngeal carcinoma. Radiother Oncol 2021; 163:76-82. [PMID: 34343545 DOI: 10.1016/j.radonc.2021.07.024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 07/16/2021] [Accepted: 07/25/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE This randomized controlled phase II study investigated the efficacy, safety and underlying mechanism of maxillofacial and oral massage (MOM) in nasopharyngeal carcinoma (NPC) patients receiving intensity-modulated radiotherapy. METHODS A total of 158 NPC patients were randomly assigned 1:1 to routine oral care and medication (the control group) or that with additional MOM (the treatment group). The primary endpoint was the incidence of severe radiotherapy-induced oral mucositis (SRTOM). In addition, the time of initiation and duration of RTOM and SRTOM, adverse events, dynamic changes of lipid metabolites in peripheral blood were analyzed. RESULTS Seventy-six patients in the treatment group and seventy-nine in the control group completed the trial. The incidence of SRTOM in the treatment group was lower than the control (26.3% vs. 46.8%, P = 0.008). The median initiation time to RTOM and SRTOM was significantly longer in the treatment group than the control (RTOM:12 vs 10 days, hazard ratio [HR] 0.52, P < 0.001; SRTOM: 28.5 vs 19 days, HR 0.5579, P = 0.002). While the median duration time of RTOM and SRTOM in the treatment group was shorter (RTOM: 20.7 vs 24.7 days, P = 0.001; SRTOM: 8.05 vs 13.08 days, P < 0.001). Only 1.3% of patients obtained grade 3 or higher adverse events during MOM. The anti-inflammatory lipids increased significantly after MOM, especially with 10.6 Gy or higher. CONCLUSION MOM significantly attenuated the incidence of SRTOM in NPC patients. The adverse events of MOM were slight and tolerant. MOM enhanced anti-inflammatory lipid metabolites, which might be an underlying mechanism.
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Affiliation(s)
- Guangrong Yang
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, China; Department of Oncology, Qijiang Hospital, First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Dan Feng
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Feng Li
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Bangyu Luo
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Jianbo Zhu
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Qiao Yang
- Department of Ultrasound, The 941(st) Hospital, PLA Joint Logistic Support Force, Xining, China
| | - Linpeng Zheng
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Qiang Dong
- Department of General Medicine, Qijiang Hospital, First Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Mingjing Chen
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Zihan Xu
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Lingchen Li
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Ping Chen
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, China.
| | - Jianguo Sun
- Cancer Institute, Xinqiao Hospital, Army Medical University, Chongqing, China.
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Silva PGDB, Lemos JVM, Borges MMF, do Rêgo TJR, Dantas TS, Leite CHB, Lima MVA, Cunha MDPSS, Sousa FB. Prognostic factors on surgically and non-surgically treated oral squamous cell carcinoma: Advances in survival in fifteen years of follow up. J Clin Exp Dent 2021; 13:e240-e249. [PMID: 33680326 PMCID: PMC7920565 DOI: 10.4317/jced.57477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/23/2020] [Indexed: 12/24/2022] Open
Abstract
Background Retrospectively to evaluate the influence of radiochemotherapy (RCT) in the treatment of surgically and non-surgically treated Oral Squamous Cell Carcinoma (OSCC).
Material and Methods We analysed 934 patients treated in Hospital Haroldo Juaçaba (2000-2014; 15 years of study) by extraction of data type of cancer, localization of tumour, sex, age, race, education level, risk factors (smoking and alcohol use), year of diagnosis, TNM stage, therapeutic approach, health system used (public or private) and overall survival (OS). Surgically and non-surgically treated OSCC were compared by chi-square and Fisher’s exact tests, and their prognostic factors were analysed by log-rank Mantel-Cox plus Cox regression tests (SPSS 20.0, p<0.05).
Results Non-surgically treated OSCC patients had a lower OS than surgically treated OSCC patients (p<0.001), but an increase in OS was shown in both groups. Although the 2010-2014 period (p=0.003), education level (p=0.032), tongue/mouth floor/palate localization (p=0.023) and TNM stage (p<0.05) were important in non-surgically treated OSCC OS, the major prognostic factors were node metastasis (p=0.003) and non-use of RCT (p=0.039) (multivariate analysis). In surgically treated OSCC patients, higher OS was shown in the 2010-2014 period (p<0.001), females (p=0.012), non-drinkers (p=0.011), non-smokers (p=0.009) and those with lower TNM stage (p<0.05), but the major prognostic factor was the 2010-2014 period (p=0.004) (multivariate analysis), which was directly associated with an increase in RCT indication (p<0.001).
Conclusions The increase in RCT improved the OS in this large cohort of surgically and non-surgically treated OSCC patients. Key words:Mouth neoplasms, neck, radiotherapy, drug therapy, combination.
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Affiliation(s)
- Paulo-Goberlânio-de Barros Silva
- PhD, Department of Dentistry, Unichristus, Fortaleza, Ceará, Brazil.,PhD, Department of Oncology Research, Hospital Haroldo Juaçaba, Fortaleza, Ceará, Brazil
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Pentoxifylline, tocopherol, and sequestrectomy are effective for the management of advanced osteoradionecrosis of the jaws-a case series. Support Care Cancer 2020; 29:3311-3317. [PMID: 33106977 DOI: 10.1007/s00520-020-05847-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 10/21/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The aim of the present study was to evaluate the efficacy of pentoxifylline and tocopherol for the management of osteoradionecrosis of the jaws. METHODS Twenty-five patients diagnosed with osteoradionecrosis of the jaws treated with pentoxifylline 400 mg + tocopherol 400 mg three times daily (tid) were evaluated. Clinical records and image tests were reviewed. All patients were previously submitted to head and neck radiation therapy and presented with a clinical and radiographic diagnosis of osteoradionecrosis of the jaws. RESULTS Following therapy with pentoxifylline and tocopherol, 76% (19/25) of the patients showed complete mucosal healing, in which 47.3% (9/19) did not undergo sequestrectomy. From this particular group, 77.7% (7/9) were in stage I and 33.3% (3/9) used the protocol for up to 3 months. Among those who underwent to sequestrectomy, complete mucosal healing was observed in 52.7% (10/19). Among these, 60% (6/10) were in stage I and 100% of the patients were using the protocol for more than 3 months. In all other patients, partial healing of the mucosa was observed since they presented advanced disease. These represented 24% of the sample (6/25), 66.6% (4/6) were in stage III, and 60% (4/6) used the protocol for over 6 months. CONCLUSION Pentoxifylline and tocopherol may provide effective management of osteoradionecrosis of the jaws, and the association with sequestrectomy may avoid major surgical procedures.
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Fan L, Li J, Xiang M, Yuan L, Zhang Y, Feng G, Du X. Attitudes of radiation oncologists to percutaneous endoscopic gastrostomy in patients with head and neck cancer and eating difficulties: A survey in China. J Int Med Res 2018; 46:1709-1716. [PMID: 29512428 PMCID: PMC5991233 DOI: 10.1177/0300060518756244] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 01/09/2018] [Indexed: 11/17/2022] Open
Abstract
Objective To investigate the attitudes of radiation oncologists towards using percutaneous endoscopic gastrostomy (PEG) to solve nutritional problems in patients with head and neck cancer (HNC) undergoing radiotherapy. Methods A self-reported questionnaire was developed and used to assess the willingness of radiation oncologists from 26 hospitals throughout several provinces in China to use the nutritional method. Results Of the 433 radiation oncologists who were contacted and returned questionnaires, 361 were completed correctly and used in the study (83.4% completion rate). Years of working and degree of understanding PEG were significantly related to the willingness of oncologists to use PEG in patients with HNC. Radiation oncologists who were willing to accept PEG training were more willing to use PEG. Main reasons for unwillingness to use PEG were poor understanding of the operation or cost and fear of side effects causing medical disputes. Conclusions The findings of the survey suggest that attitudes of radiation oncologists in China towards using PEG in patients with HNC requiring nutritional support may be improved by providing accessible training in the technique.
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Affiliation(s)
- Lingli Fan
- Department of Oncology, Mianyang Central Hospital, Mianyang, Sichuan, China
| | - Jie Li
- Department of Oncology, Mianyang Central Hospital, Mianyang, Sichuan, China
| | - Miao Xiang
- Department of Oncology, Mianyang Central Hospital, Mianyang, Sichuan, China
| | - Li Yuan
- Department of Oncology, Mianyang Central Hospital, Mianyang, Sichuan, China
| | - Yu Zhang
- Department of Oncology, Mianyang Central Hospital, Mianyang, Sichuan, China
| | - Gang Feng
- Department of Oncology, Mianyang Central Hospital, Mianyang, Sichuan, China
| | - Xiaobo Du
- Department of Oncology, Mianyang Central Hospital, Mianyang, Sichuan, China
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Zheng B, Zhu X, Liu M, Yang Z, Yang L, Lang J, Shi M, Wu G, He X, Chen X, Xi X, Zhao D, Zhu G. Randomized, Double-Blind, Placebo-Controlled Trial of Shuanghua Baihe Tablets to Prevent Oral Mucositis in Patients With Nasopharyngeal Cancer Undergoing Chemoradiation Therapy. Int J Radiat Oncol Biol Phys 2017; 100:418-426. [PMID: 29353657 DOI: 10.1016/j.ijrobp.2017.10.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Revised: 09/27/2017] [Accepted: 10/05/2017] [Indexed: 01/15/2023]
Abstract
PURPOSE Oral mucositis is a common unpreventable complication associated with chemoradiation therapy. Shuanghua Baihe tablets have been approved by the Chinese Food and Drug Administration for treating recurrent oral mucosa ulceration. This study assessed whether Shuanghua Baihe tablets could prevent oral mucositis during chemoradiation therapy for locally advanced nasopharyngeal carcinoma. METHODS AND MATERIALS This multicenter, randomized, double-blind, placebo-controlled trial was conducted at 11 hospitals in China between January 22, 2014, and September 21, 2015. Eligible patients (N=240, 18-70 years old) with pathologically diagnosed locally advanced nasopharyngeal carcinoma were randomly assigned (computer-block randomization; 1:1) to receive Shuanghua Baihe tablets or a placebo (4 tablets, 3 times a day, for 7 weeks) at the initiation of chemoradiation therapy. Administration of Shuanghua Baihe tablets could be ended if grade 3 or higher oral mucositis developed and patients were unwilling to continue taking the drug. The primary endpoints were oral mucositis incidence and latency. RESULTS The incidence of oral mucositis during this study was significantly lower in the Shuanghua Baihe group (85.0%; 95% confidence interval [CI], 78.6%-91.4%) than in the placebo group (96.6%; 95% CI, 93.4%-99.9%; P=.0028). The median latency period was 28 days in the Shuanghua Baihe group and 14 days in the placebo group (hazard ratio, 0.17; 95% CI, 0.12-0.23; P<.0001). Compared with placebo, Shuanghua Baihe tablets significantly reduced the oral mucositis severity scores recorded by the investigators (Oral Mucositis Score, 24.0 [range, 0.0-67.8] vs 57.5 [range, 0.0-98.0]; P<.0001), full-time nurses (Oral Assessment Guide score, 462.0 [range, 392.0-664.7] vs 520.4 [range, 392.0-714.0]; P<.0001), and patients (score for soreness of mouth and throat, 4.0 [range, 0-10] vs 6.0 [range, 0-10]; P<.0001). No serious adverse events were observed, and the incidence of mild or moderate gastrointestinal adverse events associated with Shuanghua Baihe tablets was 3.3%. The short-term response rate was similar in patients receiving Shuanghua Baihe tablets and those receiving placebo during chemoradiation therapy during this study. CONCLUSIONS Shuanghua Baihe tablets reduced the occurrence, latency, and severity of oral mucositis in patients with nasopharyngeal cancer during chemoradiation therapy treatment.
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Affiliation(s)
- Baomin Zheng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, China
| | - Xiaodong Zhu
- Key Laboratory of High-Incidence-Tumor Prevention & Treatment (Guangxi Medical University), Ministry of Education, Department of Radiation Oncology, Cancer Hospital of Guangxi Medical University, Nanning, China
| | - Mengzhong Liu
- Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Zhenzhou Yang
- Daping Hospital and the Research Institute of Surgery of the Third Military Medical University, Chongqing, China
| | - Ling Yang
- Fujian Provincial Cancer Hospital, Fuzhou, China
| | - Jinyi Lang
- Department of Radiation Oncology, Sichuan Cancer Center, Sichuan Cancer Hospital and Institute, School of Medicine University of Electronic Science and Technology of China, Chengdu, China
| | - Mei Shi
- Xijing Hospital of the First Affiliated Hospital of The Fourth Military Medical University, Xi'an, China
| | - Gang Wu
- Cancer Center of Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xia He
- Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China
| | | | - Xuping Xi
- Hunan Cancer Hospital, Changsha, China
| | - Dan Zhao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, China
| | - Guangying Zhu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Radiation Oncology, Peking University Cancer Hospital and Institute, Beijing, China.
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Araújo SNM, Luz MHBA, da Silva GRF, Andrade EMLR, Nunes LCC, Moura RO. Cancer patients with oral mucositis: challenges for nursing care. Rev Lat Am Enfermagem 2017; 23:267-74. [PMID: 26039297 PMCID: PMC4459000 DOI: 10.1590/0104-1169.0090.2551] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2014] [Accepted: 01/27/2015] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE: to analyze nursing care provided to cancer patients with oral mucositis based on
the Nursing Process (NP). METHOD: this exploratory, descriptive, cross-sectional and quantitative study was
conducted with 213 patients undergoing chemotherapy and/or radiotherapy in two
cancer facilities: one philanthropic and one private service. RESULTS: the participants were mainly female, aged 45.8 years old on average, with up to
11 years of schooling and income of up to one times the minimum wage. Severe
mucositis was related to chemotherapy associated with radiotherapy. Only 25.3% of
the patients reported having received guidance from nurses during their treatment
concerning self-care. The perceptions of patients regarding quality of care did
not significantly differ between the private and public facilities. The basic
human needs mainly affected were comfort, eating, and hygiene. Based on this
finding, one NP was established listing the diagnoses, interventions and expected
results to establish an ideal, though individualized, standard of nursing care to
be provided to these patients. CONCLUSION: to understand oral mucositis is crucial to establish nursing care that includes
prevention based on the implementation of an oral care plan.
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REOLON LZ, RIGO L, CONTO FD, CÉ LC. Impacto da laserterapia na qualidade de vida de pacientes oncológicos portadores de mucosite oral. REVISTA DE ODONTOLOGIA DA UNESP 2017. [DOI: 10.1590/1807-2577.09116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Resumo Introdução O uso da laserterapia em pacientes oncológicos com mucosite oral tem efeitos biológicos por meio de processos fotofísicos e bioquímicos que aumentam o metabolismo celular, estimulando a atividade mitocondrial, atuando como analgésicos, anti-inflamatórios e reparadores da lesão da mucosa. Objetivo Averiguar a qualidade de vida dos pacientes com mucosite oral induzida pelos tratamentos antineoplásicos previamente à aplicação de laserterapia e posterior à regressão das lesões orais. Metodologia Trata-se de um ensaio quase-experimental com 18 pacientes oncológicos em atendimento hospitalar que desenvolveram mucosite oral. Utilizou-se um questionário sociodemográfico e o questionário de Qualidade de Vida (UW-QOL) aplicado antes das sessões com laser de baixa potência e após a regressão das lesões. Os testes estatísticos utilizados foram o teste t de Student e o teste Quiquadrado, admitindo ser significativo o p<0,05. Resultado A faixa etária mais prevalente foi entre 65 e 74 anos, etnia branca, sexo masculino, casado, frequentou o ensino fundamental, usuários do SUS e moradores de cidades diversas. O diagnóstico oncológico mais frequente foi a Leucemia aguda, sendo a quimioterapia o tratamento em 100% dos casos e em 50%, a radioterapia. A média dos escores de qualidade de vida dos pacientes foi 456,2, anterior ao início do tratamento com laserterapia, e 678,3, posterior à intervenção. Conclusão A qualidade de vida melhorou após as sessões de laserterapia, sendo que as mudanças mais significativas ocorreram nos domínios ligados à dor, aparência, deglutição, mastigação, fala, paladar e salivação, sendo o laser de baixa potência uma ferramenta adequada no manejo da mucosite oral.
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Pegoraro DR, Zanchet B, Guariente CDO, Rocha JDP, Batista JS. Analysis of the frequency and degree of temporomandibular disorder in patients with head and neck cancer undergoing radiotherapy. FISIOTERAPIA EM MOVIMENTO 2016. [DOI: 10.1590/0103-5150.029.002.ao15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Introduction: Head and neck cancer is responsible for an increasing incidence of primary malignant neoplasm cases worldwide. Radiotherapy is one of the treatments of choice for this type of cancer, but it can cause adverse effects, such as temporomandibular disorder. The objective of this study was to characterize the degree and frequency of temporomandibular disorder in patients with head and neck cancer undergoing radiotherapy. Method: This research was quantitative, descriptive and exploratory. The sample consisted of 22 patients that answered assessment questions and the Helkimo anamnestic questionnaire, modified by Fonseca (1992). The data were collected from May to October 2014, and statistically analyzed using the Chi-square test, with a significance level of p ≤ 0.05. Results: Of the 22 patients, 86.4 % were male, with a mean age of 58.86 ± 9.41 years. Temporomandibular disorder was present in 31.8% of the subjects, based on the assessment prior to radiotherapy, and in 59.1% in the post-treatment assessment. Among all questions, the most frequent was "Do you use only one side of the mouth to chew?" with 22.7% "yes" answers, both at the first assessment and at the post treatment. Conclusion: According to the results of this study, temporomandibular disorder is a disease that is present with a high prevalence in people diagnosed with head and neck cancer undergoing radiotherapy.
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The effect of topical application of royal jelly on chemoradiotherapy-induced mucositis in head and neck cancer: a preliminary study. Int J Otolaryngol 2014; 2014:974967. [PMID: 25400667 PMCID: PMC4221863 DOI: 10.1155/2014/974967] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 10/06/2014] [Accepted: 10/06/2014] [Indexed: 12/04/2022] Open
Abstract
Purpose. One of the common side effects experienced by head and neck cancer patients on chemoradiotherapy is mucositis. Severe mucositis may be controllable by limiting cancer therapy, but it has resulted in decreasing the completion rate of chemoradiotherapy. The efficacy of royal jelly (RJ) as prophylaxis against chemoradiotherapy-induced mucositis was evaluated through clinical scoring of oral and pharyngeal mucositis. Methods. In this randomized, single-blind (physician-blind), clinical trial, 13 patients with head and neck cancer requiring chemoradiation were randomly assigned to two groups. Seven patients assigned to the study group received RJ, and 6 patients were assigned to the control group. RJ group patients took RJ three times per day during treatment. The patients in both groups were evaluated twice a week for the development of mucositis using Common Terminology Criteria for Adverse Events version 3.0. Results. A significant reduction in mucositis was seen among RJ-treated patients compared with controls (P < 0.001). Conclusion. This study demonstrated that prophylactic use of RJ was effective in reducing mucositis induced by chemoradiotherapy in head and neck cancer patients. However, further studies are needed because of the small sample size and the absence of double blinding.
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Souza MCFD, Peres MADA, Martins GDCS, Almeida Filho AJD. Update of the professional habitus from the nurses at the national cancer institute (1980-1990). TEXTO & CONTEXTO ENFERMAGEM 2014. [DOI: 10.1590/0104-07072014001270013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Social historical study, whose goals are: to characterize the practice areas of nurses from the National Cancer Institute, where there was a need to incorporate new knowledge in oncology and discuss the symbolic gains for nurses. The primary sources were oral and written documents, analyzed according to Pierre Bourdieu's concepts of habitus and scientific capital. It was evident that, in the 1980s, the position of the Institute in the field of cancer care in Brazil, made the nurses acquire new knowledge in the areas of cancer surgery, clinical oncology and bone marrow transplantation. The nursing competences and procedures were reorganized and new patient care routines were structured. It is concluded that the strategies to occupy this space were developed through the sharing of scientific knowledge, with visibility of the scientific capital in the field of oncology and highly specialized care, getting national recognition.
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Galbiatti ALS, Padovani-Junior JA, Maníglia JV, Rodrigues CDS, Pavarino ÉC, Goloni-Bertollo EM. Head and neck cancer: causes, prevention and treatment. Braz J Otorhinolaryngol 2013; 79:239-47. [PMID: 23670332 PMCID: PMC9443822 DOI: 10.5935/1808-8694.20130041] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2012] [Accepted: 08/10/2012] [Indexed: 11/25/2022] Open
Abstract
Abstract Although head and neck carcinoma ranks fifth among cancer types, patient survival rates have not changed significantly over the past years. Objective To determine the risk factors, causes, therapies, and prevention measures for head and neck cancer. Method Risk factors, causes, therapies, and preventive measures for this disease were searched on databases PUBMED, MEDLINE, and SciELO. Results Alcohol and tobacco are still atop risk factors. Other factors may influence the development of head and neck carcinoma. Surgery is the main treatment option, and the addition of radiotherapy following surgery is frequent for patients in the early stages of the disease. Other therapies target specific genetic molecular components connected to tumor development. Disease preventive measures include smoking cessation, limiting alcohol intake, preventing exposure to tobacco smoke and environmental carcinogenic agents, early detection of infection by HPV, maintaining oral health, good eating habits, and managing stress. Conclusion Additional research is needed for a more thorough understanding of the development of head and neck carcinomas and to shed light on new ways to improve therapeutic approaches and interventions.
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Affiliation(s)
- Ana Lívia Silva Galbiatti
- Research Unit for Molecular Biology and Genetics (UPGEM), São José do Rio Preto Medical School, Brazil
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