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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Acknowledgments
The authors thank Drs. Takeshi Kodaira, Yusuke Onozawa, Chiyoko Makita, Tomomi Hikosaka, Yukihiko Oshima, and Akiko Todaka for patient enrollment and Mr. Akihiro Sudo for oral care equipment management. This study was supported by a grant from the National Cancer Center Research and Development Fund (23-A-30) and by Sunstar Inc. Equipment for oral care was supplied by Sunstar Inc.
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Tomoya Yokota serves in an advisory role for AstraZeneca, Merck Serono, and Bristol-Myers Squibb, and has received lecture fees from Merck Serono. Toru Eguchi is an employee of Sunstar Inc. Sunstar Inc. had no control over the interpretation, writing, or publication of this work.
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Yokota, T., Tachibana, H., Konishi, T. et al. Multicenter phase II study of an oral care program for patients with head and neck cancer receiving chemoradiotherapy. Support Care Cancer 24, 3029–3036 (2016). https://doi.org/10.1007/s00520-016-3122-5
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DOI: https://doi.org/10.1007/s00520-016-3122-5