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Oral Complications of Chemotherapy and Head/Neck Radiation (PDQ®)

  • Updated: 04/23/2014

Table 1. Prevalence for Oral Complications with Cancer Therapies: Oral Care Study Group Systematic Reviews, MASCC/ISOO

Complication Reference Citation Weighted Prevalence 
Bisphosphonate osteonecrosis[3]6.1% for all studies (mean)
Studies with documented follow-up = 13.3%
Studies with undocumented follow-up = 0.7%
Epidemiological studies = 1.2%
Dysgeusia[4]CT only = 56.3% (mean)
RT only = 66.5% (mean)
Combined CT and RT = 76% (mean)
Oral fungal infection[5]Of clinical oral fungal infection (all oral candidiasis):
Pretreatment = 7.5%
During treatment = 39.1%
Posttreatment = 32.6%
Of oral candidiasis clinical infection by cancer treatment:
During HNC RT = 37.4%
During CT = 38%
Oral viral infection[6]In patients treated with CT for hematologic malignancies:
Patients with oral ulcerations/sampling oral ulcerations = 49.8%
Patients sampling oral ulcerations = 33.8%
Patients sampling independently of the presence of oral ulcerations = 0%
In patients treated with RT:
Patients with RT only/sampling oral ulcerations = 0%
Patients with RT and adjunctive CT/sampling oral ulcerations = 43.2%
Dental disease[7]For dental caries in patients treated with cancer therapy:
All studies = 28.1%
CT only = 37.3%
Post-RT = 24%
Post-CT and -RT = 21.4%
Of severe gingivitis in patients undergoing CT = 20.3%
Of dental infection/abscess in patients undergoing CT = 5.8%
Osteoradionecrosis[8]In conventional RT = 7.4%
In IMRT = 5.2%
In RT and CT = 6.8%
In brachytherapy = 5.3%
Trismus[9]For conventional RT = 25.4%
For IMRT = 5%
For combined RT and CT = 30.7%
Oral paina[10]VAS pain level (0–100) in HNC patients:
Pretreatment = 12/100
Immediately posttreatment = 33/100
1 mo posttreatment = 20/100
EORTC QLQ-C30 pain level (0–100) in HNC patients:
Pretreatment = 27/100
3 mo posttreatment = 30/100
6 mo posttreatment = 23/100
12 mo posttreatment = 24/100
Salivary gland hypofunction and xerostomia[11]Of xerostomia in HNC patients by type of RT:
All studies
Pre-RT = 6%
During RT = 93%
1–3 mo post-RT = 74%
3–6 mo post-RT = 79%
6–12 mo post-RT = 83%
1–2 y post-RT = 78%
>2 y post-RT = 85%
Conventional RT
Pre-RT = 10%
During RT = 81%
1–3 mo post-RT = 71%
3–6 mo post-RT = 83%
6–12 mo post-RT = 72%
1–2 y post-RT = 84%
>2 y post-RT = 91%
IMRT
Pre-RT = 12%
During RT = 100%
1–3 mo post-RT = 89%
3–6 mo post-RT = 73%
6–12 mo post-RT = 90%
1–2 y post-RT = 66%
>2 y post-RT = 68%

CT = chemotherapy; EORTC QLQ-C30 = European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire C30; HNC = head and neck cancer; IMRT = intensity-modulated radiation therapy; MASCC/ISOO = Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology; RT = radiation therapy; VAS = visual analog scale.
aPain is common in patients with HNCs and is reported by approximately half of patients before cancer therapy, by 81% during therapy, by 70% at the end of therapy, and by 36% at 6 months posttreatment.

References

  1. Migliorati CA, Woo SB, Hewson I, et al.: A systematic review of bisphosphonate osteonecrosis (BON) in cancer. Support Care Cancer 18 (8): 1099-106, 2010.  [PUBMED Abstract]

  2. Hovan AJ, Williams PM, Stevenson-Moore P, et al.: A systematic review of dysgeusia induced by cancer therapies. Support Care Cancer 18 (8): 1081-7, 2010.  [PUBMED Abstract]

  3. Lalla RV, Latortue MC, Hong CH, et al.: A systematic review of oral fungal infections in patients receiving cancer therapy. Support Care Cancer 18 (8): 985-92, 2010.  [PUBMED Abstract]

  4. Elad S, Zadik Y, Hewson I, et al.: A systematic review of viral infections associated with oral involvement in cancer patients: a spotlight on Herpesviridea. Support Care Cancer 18 (8): 993-1006, 2010.  [PUBMED Abstract]

  5. Hong CH, Napeñas JJ, Hodgson BD, et al.: A systematic review of dental disease in patients undergoing cancer therapy. Support Care Cancer 18 (8): 1007-21, 2010.  [PUBMED Abstract]

  6. Peterson DE, Doerr W, Hovan A, et al.: Osteoradionecrosis in cancer patients: the evidence base for treatment-dependent frequency, current management strategies, and future studies. Support Care Cancer 18 (8): 1089-98, 2010.  [PUBMED Abstract]

  7. Bensadoun RJ, Riesenbeck D, Lockhart PB, et al.: A systematic review of trismus induced by cancer therapies in head and neck cancer patients. Support Care Cancer 18 (8): 1033-8, 2010.  [PUBMED Abstract]

  8. Epstein JB, Hong C, Logan RM, et al.: A systematic review of orofacial pain in patients receiving cancer therapy. Support Care Cancer 18 (8): 1023-31, 2010.  [PUBMED Abstract]

  9. Jensen SB, Pedersen AM, Vissink A, et al.: A systematic review of salivary gland hypofunction and xerostomia induced by cancer therapies: prevalence, severity and impact on quality of life. Support Care Cancer 18 (8): 1039-60, 2010.  [PUBMED Abstract]