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Severe oral mucositis associated with cancer therapy: impact on oral functional status and quality of life

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Abstract

Goals of work

This study determined the incidence of severe oral mucositis (OM), patients’ self-reported moderate and severe oral symptoms, and change of quality of life (QoL), as well as examined whether OM severity and pain scores predicted the impairment of oral function and QoL.

Patients and methods

A multicenter approach was used and 137 patients treated with stomatotoxic chemotherapy (45%), high-dose myeloablative chemotherapy with or without concomitant total body irradiation (12%), head and neck irradiation with or without concomitant chemotherapy (44%) completed the OM-specific QoL measure (OMQoL) once or twice weekly over a 4- or 10-week period, along with concurrent measures of OM using WHO Mucositis Grading System and oral symptoms using 10 cm visual analog scale.

Main results

The incidence of severe OM was 50% (n = 68). About 77–80% of patients with severe OM reported moderate or severe mouth or throat pain, and 66–78% reported moderate or severe oral functional problems. The oral symptoms peak and area-under-the-curve (AUC) scores of patients with severe OM (peak 5.6 to 6.8; AUC 3.8 to 5.2) were significantly higher than those without OM and those with mild OM (p < 0.01). The OMQoL subscales peak and AUC scores of patients with severe OM (peak 47.9 to 62.1; AUC −40.1 to −25.8) were significantly lower than those without OM and those with mild OM (p < 0.01). Of those with severe OM, 88–94% had a drop in the OMQoL subscale scores to at least 10 points from the baseline. Pain resulting from OM, in particular throat pain, is most predictive of oral functional impairment (standardized β = 0.53–0.83).

Conclusions

Severe OM can cause profound pain and oral functional incapability and clinical significant impairment of QoL.

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Acknowledgements

This study was supported by a grant from the Health, Welfare, and Food Bureau of Hong Kong. We thank Alta Kan, WM Ling, Maggie Tse for their efforts in coordinating the study in different sites, and the physicians and nursing staff who were involved in various aspects of this study. Our special thanks go to all patients who gave their time to this study.

Conflict of interest statement

None of the authors have any financial and personal relationships with other people or organizations that could inappropriately influence their work.

Author information

Authors and Affiliations

  1. Faculty of Medicine, The Nethersole School of Nursing, The Chinese University of Hong Kong, Room732, Esther Lee Building, Sha Tin, Hong Kong, N.T., China

    Karis Kin-Fong Cheng

  2. Department of Clinical Oncology, Prince of Wales Hospital, Hong Kong, N.T., China

    S. F. Leung

  3. Division of Hematology, Medical Oncology and Bone Marrow transplantation, Faculty of Medicine, The University of Hong Kong, Hong Kong, China

    Raymond H. S. Liang

  4. Bone Marrow Transplantation Unit, Queen Mary Hospital, Hong Kong, China

    Josepha W. M. Tai

  5. Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China

    Rebecca M. W. Yeung

  6. University of Leicester, Leicester, UK

    David R. Thompson

Authors
  1. Karis Kin-Fong Cheng
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  2. S. F. Leung
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  3. Raymond H. S. Liang
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  4. Josepha W. M. Tai
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  5. Rebecca M. W. Yeung
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  6. David R. Thompson
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Corresponding author

Correspondence to Karis Kin-Fong Cheng.

Additional information

This study was supported by the Health and Health Services Research Fund of the Health, Welfare and Food Bureau of Hong Kong.

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Cheng, K.KF., Leung, S.F., Liang, R.H.S. et al. Severe oral mucositis associated with cancer therapy: impact on oral functional status and quality of life. Support Care Cancer 18, 1477–1485 (2010). https://doi.org/10.1007/s00520-009-0771-7

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  • DOI: https://doi.org/10.1007/s00520-009-0771-7

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