Risk, outcomes, and costs of radiation-induced oral mucositis among patients with head-and-neck malignancies
Risk, outcomes, and costs of radiation-induced oral mucositis among patients with head-and-neck malignancies
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DOI：
10.1016/j.ijrobp.2007.01.053
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发表时间：
2007-07-15
影响因子：
7
通讯作者：
Garden, Adam S.
中科院分区：
文献类型：
--
作者：
Elting, Linda S.;Cooksley, Catherine D.;Garden, Adam S.
目的：研究的风险，结果和成本的放射性口腔粘膜炎（OM）的患者接受放疗（RT）的头部和颈部原发cancer.Methods和材料：一个回顾性队列，包括204个连续的头部和颈部癌症患者接受RT或不接受化疗在2002年形成，他们的记录进行了审查的临床和资源使用信息。排除了既往接受过治疗、患有第二原发癌或接受过姑息性放射治疗的患者。采用多因素Logistic回归分析OM发生的危险性。护理费用计算从供应商的角度来看，在2006年美元和比较患者与无OM。结果：口腔粘膜炎发生在91%的患者，在66%，这是严重的（3-4级）。口腔黏膜炎多见于口腔或口咽原发灶（比值比[OR]，44.5; 95%置信区间[CI]，5.2至> 100; p < 0.001），接受化疗的患者（OR = 7.8; 95%CI，1.5-41.6; p = 0.02），以及接受改变的分次方案治疗的患者（OR = 6.3; 95%CI，1.1-35.1; p = 0.03）。OM患者更可能出现严重疼痛（54% vs. 6%; p < 0.001）和体重减轻≥ 5%（60% vs. 17%; p < 0.001）。口腔粘膜炎与1700 - 6000美元的增量成本，根据grade.Conclusions：头部和颈部RT导致OM几乎所有的患者。口腔粘膜炎与严重疼痛、显著体重减轻、资源使用增加和过度成本相关。需要采取预防性战略。(C)2007年爱思唯尔公司
Purpose: To study the risk, outcomes, and costs of radiation-induced oral mucositis (OM) among patients receiving radiotherapy (RT) to head and neck primary cancers.Methods and Materials: A retrospective cohort consisting of 204 consecutive head-and-neck cancer patients who received RT with or without chemotherapy during 2002 was formed; their records were reviewed for clinical and resource use information. Patients who had received prior therapy, had second primary cancers, or received palliative radiation therapy were excluded. The risk of OM was analyzed by multiple variable logistic regression. The cost of care was computed from the provider's perspective in 2006 U.S. dollars and compared among patients with and without OM.Results: Oral mucositis occurred in 91% of patients; in 66% it was severe (Grade 3-4). Oral mucositis was more common among patients with oral cavity or oropharynx primaries (odds ratio [OR], 44.5; 95% confidence interval [CI], 5.2 to > 100; p < 0.001), those who received chemotherapy (OR = 7.8; 95% CI, 1.5-41.6; p = 0.02), and those who were treated with altered fractionation schedules (OR = 6.3; 95 % CI, 1.1-35.1; p = 0.03). Patients with OM were significantly more likely to have severe pain (54% vs. 6%; p < 0.001) and a weight loss of >= 5 % (60% vs. 17%; p < 0.001). Oral mucositis was associated with an incremental cost of $1700-$6000, depending on the grade.Conclusions: Head-and-neck RT causes OM in virtually all patients. Oral mucositis is associated with severe pain, significant weight loss, increased resource use, and excess cost. Preventive strategies are needed. (C) 2007 Elsevier Inc.