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Young head and neck cancer patients are at increased risk of developing oral mucositis and trismus

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Abstract

Objectives

To evaluate cancer treatment–related toxicities in young head and neck cancer (HNC) patients.

Material and methods

A total of 44 patients were included in the present retrospective cohort study, which was designed to access oral toxicities of cancer treatment in young (< 45 years of age, Group I, n = 22) and old (> 58 years of age, Group II, n = 22) HNC patients with similar tumor stage and treatment protocols. Oral mucositis (OM), xerostomia, dysphagia, dysgeusia, trismus, and radiodermatitis were assessed during days 7th, 21st, and 35th of head and neck radiotherapy (HNRT) according to previously validated scales (World Health Organization criteria and the National Cancer Institute and Common Terminology Criteria for Adverse Events version 4.0).

Results

Patients from both groups showed high incidence and severity of oral toxicities by the end of the HNRT with OM (81.9% (Group I); 63.6% (Group II)) and xerostomia (72.6% (Group I); 77.2% (Group II)) being the most prevalent toxicities. No differences regarding xerostomia, dysphagia, dysgeusia, and radiodermatitis incidences or severity could be observed between groups. However, higher incidences and severity of OM at 21st and 35th fractions (odds ratio = 2.22 and 5.71, respectively) and trismus at 21st and 35th fractions (odds ratio = 6.17 and 14.5, respectively) were observed throughout the treatment in young patients when compared to older patients (p < 0.01 and p < 0.05, respectively).

Conclusion

Young HNC patients are more affected by cancer treatment–related OM and trismus despite the similarities in clinical staging and treatment protocols with elderly patients.

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Funding

The authors received financial support of the São Paulo Research Foundation (FAPESP) (process numbers 2018/02233-6; 2016/22862-2; 2013/18402-8; and 2012/06138-1) as well as the National Council for Scientific and Technological Development (CNPq), Brazil. The authors also state that this study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior, Brasil (CAPES), Finance Code 001.

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Author notes

  1. Karina Morais-Faria and Natalia Rangel Palmier contributed equally to this work.

Authors and Affiliations

  1. Dental Oncology Service, Instituto do Câncer do Estado de São Paulo, ICESP-FMUSP, São Paulo, Brazil

    Karina Morais-Faria, Ana Carolina Prado Ribeiro, Thaís Bianca Brandão & Alan Roger Santos-Silva

  2. Oral Diagnosis Department, Semiology Area, Piracicaba Dental School, UNICAMP, 901, Av. Limeira, Areão, Piracicaba, São Paulo, 13414-903, Brazil

    Natalia Rangel Palmier, Jaqueline de Lima Correia, Marcio Ajudarte Lopes & Alan Roger Santos-Silva

  3. Clinical Oncology Service, São Paulo State Cancer Institute (ICESP), School of Medicine of the University of São Paulo, São Paulo, Brazil

    Gilberto de Castro Júnior

  4. Department of Maxillofacial Surgery, Prosthesis and Traumatology, USP, São Paulo, Brazil

    Reinaldo Brito Dias & Henrique da Graça Pinto

Authors
  1. Karina Morais-Faria
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Correspondence to Alan Roger Santos-Silva.

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Morais-Faria, K., Palmier, N.R., de Lima Correia, J. et al. Young head and neck cancer patients are at increased risk of developing oral mucositis and trismus. Support Care Cancer 28, 4345–4352 (2020). https://doi.org/10.1007/s00520-019-05241-x

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