Oral status during radiotherapy and chemotherapy: a descriptive study of patient experiences and the occurrence of oral complications

Abstract.

The aim of the present study was to describe patients' experiences of their oral status and their relation to oral complications during radiotherapy and chemotherapy. The sample consisted of 41 consecutive patients admitted for radiotherapy with >40 Gy including the oral cavity for tumours within the head and neck area, or for chemotherapy of haematological malignancies. At the start of radiotherapy or the second/third cycle of chemotherapy, patients rated their experiences of oral symptoms on a 100-mm visual analogue scale with end-points "no oral discomfort" and "worst imaginable oral discomfort". Mucositis was assessed and unstimulated whole saliva was collected. Patients were examined regularly at every 10 Gy increase of radiotherapy or once a week during chemotherapy, and after completion of the radiotherapy or the chemotherapy cycle. In addition, patients given radiotherapy rated their experiences of oral symptoms 1 month after treatment. Patients receiving radiotherapy experienced a significant increase in oral symptoms over time. One month after treatment several oral symptoms were still present. The severity of mucositis increased over time. The unstimulated salivary secretion rate showed a rapid decrease after the start of radiotherapy, followed by a slow recovery. Patients who received chemotherapy reported fewer oral symptoms, with a peak 1–2 weeks after the start of treatment, and their mucositis score showed a parallel pattern of development. Their unstimulated salivary secretion rate did not change over time. There was good agreement between patient experiences and observations recorded by dental staff.