Changes and predictors of radiation-induced oral mucositis in patients with oral cavity cancer during active treatment
Changes and predictors of radiation-induced oral mucositis in patients with oral cavity cancer during active treatment
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DOI：
10.1016/j.ejon.2014.12.001
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发表时间：
2015-06-01
影响因子：
2.8
通讯作者：
Chang, Joseph Tung-Chien
中科院分区：
文献类型：
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作者：
Chen, Shu-Ching;Lai, Yeur-Hur;Chang, Joseph Tung-Chien
目的：放射性口腔粘膜炎（OM）是口腔癌放射治疗中最严重的副作用。本研究的目的是探讨口腔癌患者积极治疗期间严重OM患病率、OM相关症状和预测因素的变化。方法和样本：采用重复测量的纵向研究设计。口腔癌患者是从台湾一家大型医疗中心的头颈部门诊放射科招募的。在三个时间点测量患者的OM相关症状。在9个时间点评估患者的口腔粘膜。结果：T5（放疗开始后5周）和T6（放疗开始后6周，RI）患者严重OM的患病率最高，化疗+放疗（CCRT）患者严重OM的患病率高于单纯放疗患者。OM相关症状的高峰出现在T8（开始RT后8周），主要症状为口腔疼痛、口干、进食困难、吞咽困难和味觉改变。CCRT、累积辐射剂量较高、吸烟和体重指数（BMI）较低的患者发生重度OM的风险较高。OM相关的症状预测的治疗类型，累积辐射剂量，和smoking.Conclusions：口腔癌患者遭受OM和OM相关的症状在积极的RI或CCRT。在积极治疗期间，需要患者特定的口腔护理和情感支持，以缓解痛苦的OM相关症状。(C)2014爱思唯尔有限公司版权所有。
Purpose: Radiation-induced oral mucositis (OM) is the most debilitating side effect of radiation treatment in oral cavity cancer. The purpose of the study was to investigate change of prevalence of severe OM, OM-related symptoms, and predictors in oral cavity cancer patients during active treatment.Methods and sample: Longitudinal study design with repeated measures was used. Patients with oral cavity cancer were recruited from a head and neck outpatient radiation department at a major medical center in Taiwan. Patients' OM-related symptoms were measured at three time points. Patients' oral mucosa was assessed at nine time points. Generalized estimating equations (GEE) were used to analyze the predictive factors of prevalence of severe OM and OM-related symptoms.Results: Patients reported highest prevalence of severe OM at T5 (5 weeks after beginning RT) and T6 (6 weeks after beginning radiation therapy, RI), with the combined chemotherapy and RT (CCRT) patients reporting a higher prevalence than those receiving RT alone. The peak of OM-related symptoms was at T8 (8 week after beginning RT), with primary symptoms of mouth pain, mouth dryness, eating difficulties, swallowing difficulties, and taste change. Patients with CCRT, a higher cumulative radiation dose, smoking, and lower body mass index (BMI) were at high risk to develop severe OM. OM-related symptoms were predicted by type of treatment, cumulative radiation dose, and smoking.Conclusions: Patients with oral cavity cancer suffer from OM and OM-related symptoms during aggressive RI or CCRT. Patient-specific oral care and emotional support are needed to relieve distressful OM-related symptoms during active treatment. (C) 2014 Elsevier Ltd. All rights reserved.