Oral complications at 6months after radiation therapy for head and neck cancer.

Abstract

To examine oral complications 6months after modern radiation therapy (RT) for head and neck cancer (HNC). Prospective multicenter cohort study of patients with HNC receiving intensity-modulated radiation therapy or more advanced RT. Stimulated whole salivary flow, maximal mouth opening, oral mucositis, oral pain, oral health-related quality of life (OH-QOL), and oral hygiene practices were measured in 372 subjects pre-RT and 216 subjects at 6months from the start of RT. Mean stimulated whole salivary flow declined from 1.09 to 0.47ml/min at 6months (p<.0001). Mean maximal mouth opening reduced from 45.58 to 42.53mm at 6months (p<.0001). 8.1% of subjects had some oral mucositis at 6months, including 3.8% with oral ulceration. Mean overall pain score was unchanged. OH-QOL was reduced at 6months, with changes related to dry mouth, sticky saliva, swallowing solid foods, and sense of taste (p≤.0001). At 6months, there was greater frequency of using dental floss and greater proportion using supplemental fluoride (p<.0001). Despite advances in RT techniques, patients with HNC experience oral complications 6months after RT, with resulting negative impacts on oral function and quality of life.