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The impact of oral rehabilitation on oral health-related quality of life in patients receiving radiotherapy for the treatment of head and neck cancer

Clinical Oral Investigations volume 21, pages 1123–1130 (2017)Cite this article

Abstract

Objectives

To analyze the influence of dental treatment on oral health-related quality of life (OHRQoL) in head and neck cancer patients.

Materials and methods

This study included the data of 116 patients who underwent radiotherapy (RT) because of head and neck cancer. For each patient, the variables age, sex, tumor site, irradiation technique, dose on the spared parotid gland, concomitant chemotherapy, and denture status were documented. OHRQoL was determined using the OHIP-G14 questionnaire. Patients were divided into subgroups according to denture status: none or fixed partial dentures (none/FPD), removable partial dentures (RPD), and full dentures (CD). OHIP summary scores were determined and tested for clinical relevant differences with respect to the different variables. The association between OHRQol and the variables was assessed using linear regression.

Results

No clinically relevant influence on OHRQoL was found for gender, irradiation technique, and chemotherapy. Patients with tumors located in the oral cavity had a significantly higher OHIP score than patients with other tumor sites (p < 0.001). None/FPD and RPD patients had higher values than those found in a normal population, but did not differ significantly from each other (p = 0.387).

Conclusions

In contrast to tumor site, teeth and type of denture seem to have a limited effect on OHRQoL in head and neck cancer patients.

Clinical significance

Prosthetic treatment in head and neck cancer patients do not lead to the same improvement in OHRQoL as found in the normal population. This might be taken into account especially if extensive dental treatment is intended.

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References

  1. Vissink A, Jansma J, Spijkervet FK, Burlage FR, Coppes RP (2003) Oral sequelae of head and neck radiotherapy. Crit Rev Oral Biol Med 14:199–212

    Article  PubMed  Google Scholar 

  2. Schweyen R, Hey J, Fränzel W, Vordermark D, Hildebrandt G, Kuhnt T (2012) Radiation-related caries: etiology and possible preventive strategies. What should the radiotherapist know? Strahlenther Onkol 188:21–28

    Article  PubMed  Google Scholar 

  3. Grötz KA (2002) Zahnärztliche Betreuung von Patienten mit tumortherapeutischer Kopf-Hals-Bestrahlung. DZZ 57:509–511

    Google Scholar 

  4. Kielbassa AM, Hinkelbein W, Hellwig E, Meyer-Lückel H (2006) Radiation-related damage to dentition. Lancet Oncol 7:326–335

    Article  PubMed  Google Scholar 

  5. Niewald M, Fleckenstein J, Mang K, et al. (2013) Dental status, dental rehabilitation procedures, demographic and oncological data as potential risk factors for infected osteoradionecrosis of the lower jaw after radiotherapy for oral neoplasms: a retrospective evaluation. Radiat Oncol 8:227

    Article  PubMed  PubMed Central  Google Scholar 

  6. Gehrig JD (1969) Should teeth be removed prior to radiation therapy? Dent Clin N Am 13:929–938

    PubMed  Google Scholar 

  7. Reißmann DR, Krautz M, Schierz O, John MT, Rudolph M, Szentpétery A (2008) Assessment of clinically significant changes in oral health: results from the German short version of the oral health impact profile (OHIP-G14). Dtsch Zahnärztl Z 63:668–679

    Google Scholar 

  8. Bjordal K, de Graeff A, Fayers PM, Hammerlid E, van Pottelsberghe C, Curran D, et al. (2000) A 12 country field study of the EORTC QLQ-C30 (version 3.0) and the head and neck cancer specific module (EORTC QLQ-H&N35) in head and neck patients. EORTC quality of life group. Eur J Cancer 36:1796–1807

    Article  PubMed  Google Scholar 

  9. Slade GD, Spencer AJ (1994) Development and evaluation of the oral health impact profile. Community Dent Health 11:3–11

    PubMed  Google Scholar 

  10. John MT, Patrick DL, Slade GD (2002) The German version of the oral health impact profile–translation and psychometric properties. Eur J Oral Sci 110:425–433

    Article  PubMed  Google Scholar 

  11. Locker D, Allen PF (2002) Developing short-form measures of oral health-related quality of life. J Public Health Dent 62:13–20

    Article  PubMed  Google Scholar 

  12. John MT, Micheelis W, Biffar R (2004) Normwerte mundgesundheitsbezogener Lebensqualität für Kurzversionen des oral health impact profile. Schweiz Monatsschr Zahnmed 117:784–791

    Google Scholar 

  13. John MT, Koepsell TD, Hujoel P, Miglioretti DL, LeResche L, Micheelis W (2004) Demographic factors, denture status and oral health-related quality of life. Community Dent Oral Epidemiol 32:125–132

    Article  PubMed  Google Scholar 

  14. John MT, Slade GD, Szentpétery A, Setz JM (2004) Oral health-related quality of life in patients treated with fixed, removable, and complete dentures 1 month and 6 to 12 months after treatment. Int J Prosthodont 17:503–511

    PubMed  Google Scholar 

  15. Hey J, Setz J, Gerlach R, Janich M, Sehlleier S, Schaller HG, et al. (2009) Parotid-gland-sparing 3D conformal radiotherapy in patients with bilateral radiotherapy of the head and neck region—results in clinical practice. Oral Oncol 45:e11–e17

    Article  PubMed  Google Scholar 

  16. Hey J, Seidel J, Schweyen R, Paelecke-Habermann Y, Vordermark D, Gernhardt C, Kuhnt T (2013) The influence of parotid gland sparing on radiation damages of dental hard tissues. Clin Oral Investig 17:1619–1625

    Article  PubMed  Google Scholar 

  17. Hey J, Setz J, Gerlach R, Vordermark D, Gernhardt CR, Kuhnt T (2009) Effect of cisplatin on parotid gland function in concomitant radiochemotherapy. Int J Radiat Oncol Biol Phys 75:1475–1480

    Article  PubMed  Google Scholar 

  18. Kuhnt T, Janich M, Götz U, Gerlach R, Chiricuta I, Hänsgen G (2006) Etablierung einer 3D-Konformationstechnik zur Radiotherapie von Kopf-Hals-Tumoren unter Berücksichtigung der Parotisschonung. Strahlenther Onkol 182:325–330

    Article  PubMed  Google Scholar 

  19. Georg D, Kroupa B, Georg P, Winkler P, Bogner J, Dieckmann K, Pötter R (2006) Inverse planning—a comparative intersystem and interpatient constraint study. Strahlenther Onkol 182:473–480

    Article  PubMed  Google Scholar 

  20. International Commission on Radiation Units and Measurements (1993) ICRU 50: Prescribing and reporting photon beam therapy.

  21. International Commission on Radiation Units and Measurements (1999) ICRU 62: Prescribing, recording and reporting photon beam therapy.

  22. International Commission on Radiation Units and Measurements (2010) ICRU 83 Prescribing, Recording, and Reporting Intensity-Modulated Photon-Beam Therapy (IMRT).

  23. Lyman JT, Wolbarst AB (1989) Optimization of radiation therapy, IV: a dose-volume histogram reduction algorithm. Int J Radiat Oncol Biol Phys 17:433–436

    Article  PubMed  Google Scholar 

  24. Asikainen P, Klemetti E, Kotilainen R, Vuillemin T, Sutter F, Voipio HM, Kullaa A (1998) Osseointegration of dental implants in bone irradiated with 40, 50 or 60 gy doses. An experimental study with beagle dogs. Clin Oral Implants Res 9:20–25

    Article  PubMed  Google Scholar 

  25. Chigurupati R, Aloor N, Salas R, Schmidt BL (2013) Quality of life after maxillectomy and prosthetic obturator rehabilitation. J Oral Maxillofac Surg 71:1471–1478

    Article  PubMed  Google Scholar 

  26. Hassel AJ, Koke U, Schmitter M, Rammelsberg P (2006) Factors associated with oral health-related quality of life in institutionalized elderly. Acta Odontol Scand 64:9–15

    Article  PubMed  Google Scholar 

  27. Bortoluzzi MC, Traebert J, Lasta R, Da Rosa TN, Capella DL, Presta AA (2012) Tooth loss, chewing ability and quality of life. Contemp Clin Dent 3:393–397

    Article  PubMed  PubMed Central  Google Scholar 

  28. Gerritsen AE, Allen PF, Witter DJ, Bronkhorst EM, Creugers NH (2010) Tooth loss and oral health-related quality of life: a systematic review and meta-analysis. Health Qual Life Outcomes 8:126

    Article  PubMed  PubMed Central  Google Scholar 

  29. Dawood A, Tanner S (2013) Sometimes the simplest interventions can make a big difference. Br Dent J 214:261–263

    Article  PubMed  Google Scholar 

  30. Hundepool AC, Dumans AG, Hofer SO, Fokkens NJ, Rayat SS, van der Meij EH, Schepman KP (2008) Rehabilitation after mandibular reconstruction with fibula free-flap: clinical outcome and quality of life assessment. Int J Oral Maxillofac Surg 37:1009–1013

    Article  PubMed  Google Scholar 

  31. Fierz J, Bürgin W, Mericske-Stern R (2013) Patients with oral tumors. Part 2: quality of life after treatment with resection prostheses. Resection prosthetics: evaluation of quality of life. Schweiz Monatsschr Zahnmed 123:180–191

    PubMed  Google Scholar 

  32. Li W, Yang Y, Xu Z, Liu F, Cheng Y, Xu L, Sun C (2013) Assessment of quality of life of patients with oral cavity cancer who have had defects reconstructed with free anterolateral thigh perforator flaps. Br J Oral Maxillofac Surg 51:497–501

    Article  PubMed  Google Scholar 

  33. Chen AM, Farwell DG, Luu Q, Vazquez EG, Lau DH, Purdy JA (2012) Intensity-modulated radiotherapy is associated with improved global quality of life among long-term survivors of head-and-neck cancer. Int J Radiat Oncol Biol Phys 84:170–175

    Article  PubMed  Google Scholar 

  34. Moroi HH, Okimoto K, Terada Y (1999) The effect of an oral prosthesis on the quality of life for head and neck cancer patients. J Oral Rehabil 26:265–273

    Article  PubMed  Google Scholar 

  35. John MT, Leresche L, Koepsell TD, Hujoel PP, Miglioretti DL, Micheelis W (2003) Oral health-related quality of life in Germany. Eur J Oral Sci 111:483–491

    Article  PubMed  Google Scholar 

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Author information

Affiliations

  1. Department of Prosthetic Dentistry, University School of Dental Medicine, Martin-Luther-University Halle-Wittenberg, Große Steinstr. 19, 06108, Halle, Germany

    Ramona Schweyen & Jeremias Hey

  2. Department of Radiotherapy, University Clinic, University Leipzig, Stephanstr. 9a, 04103, Leipzig, Germany

    Thomas Kuhnt

  3. Department of Medical Epidemiology, Biometry and Computer Science, Martin-Luther-University Halle-Wittenberg, Magdeburger Str. 8, 06112, Halle, Germany

    Andreas Wienke

  4. Department of Oral and Maxillofacial Plastic Surgery, Martin-Luther-University Halle-Wittenberg, Ernst-Grube-Str. 40, 06120, Halle, Germany

    Alexander Eckert

Authors
  1. Ramona Schweyen
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  2. Thomas Kuhnt
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  3. Andreas Wienke
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  4. Alexander Eckert
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  5. Jeremias Hey
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Corresponding author

Correspondence to Ramona Schweyen.

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Conflict of interest

The authors declare that they have no conflict of interest.

Funding

The work was not supported by any financial assistance.

Ethical approval

The study protocols were approved by the medical faculty’s ethics committee at the Martin-Luther-University Halle-Wittenberg and conducted in accordance with the Declaration of Helsinki on Ethical Principles for Medical Research.

Informed consent

For this type of study, formal consent is not required.

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Cite this article

Schweyen, R., Kuhnt, T., Wienke, A. et al. The impact of oral rehabilitation on oral health-related quality of life in patients receiving radiotherapy for the treatment of head and neck cancer. Clin Oral Invest 21, 1123–1130 (2017). https://doi.org/10.1007/s00784-016-1874-4

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  • DOI: https://doi.org/10.1007/s00784-016-1874-4

Keywords

  • Oral health-related quality of life
  • Head and neck cancer
  • Radiotherapy
  • Tumor site
  • Dental status