Higher overall survival was observed in oral cancer patients with higher adherence of oral preventive measures protocol.
The purpose of this retrospective study was to assess patient adherence to an oral preventive measures protocol and its impact on cancer treatment outcomes. [1]
The study included 133 patients, who had received radiotherapy for oral cancer. Patients were grouped according to their local tumor response after finishing radiotherapy and adherence to an oral preventive measures protocol.
Oral measures protocol included patient education and counseling about:
- Adverse effects
- Elimination of infection foci
- Restorativeprocedures
- Fluoridetherapy
- Oral rehydration
- Maintenance and supervision of oral hygiene throughout treatment
Significantly increased survival and better response to radiotherapy was observed in the patients who showed better adherence to the oral preventive measures protocol when compared to the other groups.
Radiotherapy is the main treatment for oral cancer. However, radiotherapy results in local and systemic effects which affect the patient’s quality of life, especially when major salivary glands are included in the area to be irradiated. Oral mucositis, dysphagia, odynophagia, pain, and dermatitis have been reported as causes of interruption of radiotherapy. Such interruptions can lead to tumor growth, thereby increasing the risk for local recurrence, reducing patient survival.
Early oral preventive measures are recommended as a standard of care, since the patient’s ability to maintain effective and regular oral care will be impaired due to the expected harmful consequences of the disease and treatment, mostly when combined surgery and chemoradiotherapy are used. Studies have stressed the importance of oral preventive measures on the reduction of adverse effects of oral cancer treatments. Hence, patients should adhere to an oral preventive program that covers all stages of treatment, from initial preparation until treatment follow-up.
The present study showed, for the first time, that five-year overall survival was significantly higher in patients with greater adherence to the oral preventive measures protocol, supervised by a dental team. Response to treatment was also increased and prognosis was better. The authors discussed the issue of limited cooperation between the radiotherapist and the dental team, which may result in poor consistency in the diagnosis of specific oral problems and inappropriate referral to oral health care.
[1] The effect of preventive oral care on treatment outcomes of a cohort of oral cancer patients. Morais MO, et al. Support Care Cancer 2016;24:1663-1670.
