Oral Complications at Six Months after Radiation Therapy for Head and Neck Cancer

Abstract

Objective

Examine oral complications 6 months after modern radiation therapy (RT) for head and neck cancer (HNC).

Methods

Prospective multi-center cohort study of HNC patients receiving Intensity-Modulated Radiation Therapy (IMRT) 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 at 6 months from start of RT.

Results

Mean stimulated whole salivary flow declined from 1.09 ml/min to 0.47 ml/min at 6 months (p < 0.0001). Mean maximal mouth opening reduced from 45.58 mm to 42.53 mm at 6 months (p < 0.0001). 8.1% of subjects had some oral mucositis at 6 months, including 3.8% with oral ulceration. Mean overall pain score was unchanged. OH-QOL was reduced at 6 months, with changes related to dry mouth, sticky saliva, swallowing solid foods, and sense of taste (p ≤ 0.0001). At 6 months, there was greater frequency of using dental floss and greater proportion using supplemental fluoride (p < 0.0001).

Conclusions

Despite advances in RT techniques, HNC patients experience oral complications 6 months after RT, with resulting negative impacts on oral function and quality of life.

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