Abstract
The aim of this study was to evaluate the early acute side effects following radiation and chemotherapy in patients with head and neck cancer (HNC), namely: to ascertain main patient complaints; to investigate saliva properties and to determine the microecology of the oral cavity in patient with HNC before and after radiation and chemotherapy. Eighteen patients with HNC which were prescribed gamma therapy on two buccal submandibular fields combined with close-focus roentgenotherapy and methotrexate as a cytostatic were examined. It was established that 3 weeks after the radio- and chemotherapy 100 % of patients pointed at xerostomia, dysgeusia, disturbances during speech, burning, pricking and itching in oral cavity. After cancer treatment the speed of salivation decreased two times and pH was 15 % lower than before radio and chemotherapy. Anti-cancer treatment caused significant decrease of lysozyme level (34 % lower) and secretory immunoglobulin A (1,5 times lower) in patients with HNC. After radio and chemotherapy different fungi of Candida genus from oral cavity were inoculated in high concentrations (from 4,0 ± 0.07 to 6,9 ± 0.07 lg CFU/ml), such as С. Аlbicans, C. Kruzei, С. Tropicalis, C. Stellatoidea.Thus significant negative changes from the side of speed and character of salivation, decrease of saliva pH, depression of both non-specific and specific components of immune defense and high contamination of oral mucosa with fungi of Candida genus considerably worsenpost-cancer rehabilitation.
Highlights
During last years the continuous increase of cancer rate in different regions of the world is observed
3 weeks after the radio- and chemotherapy 100 % of patients pointed at xerostomia, presenting the complaints: excessive thirst and consumption of liquid, deglutitive problems, frequent use of remedies supporting the humidity in oral cavity, dysgeusia, disturbances during speech, labial fissures, problems in wearing prostheses, burning, pricking and itching in oral cavity
Assessment of hygienic condition of the oral cavity in patients after radio- and chemotherapy is 2,5 ± 0.23 according to Green-Vermillion index; it is the evidence of unsatisfactory state of hygiene and complications in individual oral care in patients after cancer treatment
Summary
During last years the continuous increase of cancer rate in different regions of the world is observed. Every year about 400 000 cases of head and neck cancer (HNC) are diagnosed in the world (Bonifazi et al, 2011) and among this cases the first place takes the cancer of oral mucosa that is 8,8 % per 100 000 of population of Ukraine (Bondarenko, 2011). The most effective methods of treatment of cancerous diseases are radical ones which include surgical treatment, radiotherapy and chemotherapy (Chissov & Davydov, 2008). Despite their high antitumoral potential these methods cause significant pathologic changes in different body organs and systems. There are about 400 000 patients each year in Ukraine that suffer from complications after cancer treatment manifested in oral mucosa (Katchmar et al, 1997)
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