EVALUATION OF CLINICAL RISK FACTORS FOR ORAL COMPLICATIONS OF HEAD AND NECK RADIOTHERAPY

Abstract

Objective The aim of this study was to evaluate the clinical risk factors (RF) for acute (mucositis and candidiasis) and chronic (radiation caries and xerostomia) complications of the treatment in patients undergoing intensity modulated radiotherapy (IMRT) for head and neck cancer. Study Design Retrospective and observational study with 40 patients submitted to minimum dose of 5000 cGy of IMRT. The incidence of these complications was correlated to: Patient's RF (age, DMFT), tumor RF (localization and staging), and treatment's RF (surgery, chemotherapy, and submandibular gland surgical injury). Results Cervical tumors had a lower incidence of mucositis than the other areas (P = .02); stages III-IV presented a higher incidence of Candida species infection (20.6%) than stages I-II (0%), P = .03; surgical injury of submandibular gland presented 4.8 higher risk of caries related to radiation (P = .05); none of the studied variables were associated with the risk of xerostomia. There was a strong correlation between caries and xerostomia (xerostomia: 33.3% vs 0% without xerostomia). Conclusions Risk of mucositis is reduced in radiotherapy protocols for cervical tumors, while stages III and IV presented a higher risk of candidiasis. Surgical injury of submandibular glands and xerostomia increased the risk of caries related to radiotherapy. The aim of this study was to evaluate the clinical risk factors (RF) for acute (mucositis and candidiasis) and chronic (radiation caries and xerostomia) complications of the treatment in patients undergoing intensity modulated radiotherapy (IMRT) for head and neck cancer. Retrospective and observational study with 40 patients submitted to minimum dose of 5000 cGy of IMRT. The incidence of these complications was correlated to: Patient's RF (age, DMFT), tumor RF (localization and staging), and treatment's RF (surgery, chemotherapy, and submandibular gland surgical injury). Cervical tumors had a lower incidence of mucositis than the other areas (P = .02); stages III-IV presented a higher incidence of Candida species infection (20.6%) than stages I-II (0%), P = .03; surgical injury of submandibular gland presented 4.8 higher risk of caries related to radiation (P = .05); none of the studied variables were associated with the risk of xerostomia. There was a strong correlation between caries and xerostomia (xerostomia: 33.3% vs 0% without xerostomia). Risk of mucositis is reduced in radiotherapy protocols for cervical tumors, while stages III and IV presented a higher risk of candidiasis. Surgical injury of submandibular glands and xerostomia increased the risk of caries related to radiotherapy.