Abstract
A broader understanding of oral and ocular late effects in head and neck cancer (HNC) patients who underwent intensity-modulated radiotherapy (IMRT) may provide valuable information in follow-up and improve quality of life. Twenty-nine HNC patients treated at least 6 months earlier and 30 age-matched controls were recruited. After completing several questionnaires: Oral Health Impact Profile-14 (OHIP-14), Shortened Xerostomia Inventory (SXI), Ocular Surface Disease Index (OSDI) and McMonnies Dry Eye questionnaire (MDEQ), participants underwent oral and ocular examinations. Oral examination included clinical oral dryness score (CODS) and secretion rates of unstimulated and stimulated saliva (UWS, SWS). Ocular examination included tear film break-up time, Schirmer test and ocular surface staining. The patients had more problems related to dry mouth than controls based on CODS and SXI, and more complaints of dry eye disease based on OSDI and MDEQ. UWS and SWS rates and oral health related quality of life were significantly lower in the patient group. Subjective oral dryness (SXI) correlated significantly with subjective ocular dryness (OSDI and MDEQ). Our study demonstrates that HNC patients treated with IMRT experience late effects in terms of xerostomia and ocular dryness underlining the importance of interdisciplinary approach in the evaluation and follow-up of HNC patients.
Highlights
RT-induced toxicity can be classified as acute or late (> 3 months after completing treatment)
Unstimulated whole saliva (UWS) and stimulated whole saliva (SWS) secretion rates were significantly reduced in the Head and neck cancer (HNC) patient group compared to the controls, and xerostomia was the most commonly reported late effect in the patients in this study
Previous studies report a decline in SWS secretion rate from a baseline established prior to RT28,29
Summary
RT-induced toxicity can be classified as acute (during or shortly after treatment) or late (> 3 months after completing treatment). Many of the oral late effects following RT are challenging for patients, and may have a significant impact on their quality of life (QoL)[1,4,6,7,8,9,10,11]. Late effects of RT on the eyes and periorbital tissues after RT treatment of HNC have not been investigated to the same extent as the oral late effects. We investigated the oral and ocular late effects in HNC patients who had received IMRT, with the aim of achieving a broader understanding of these late effects and possibly improve care and follow-up of these patients in the future
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