Management of radiation-induced oral mucositis in head and neck cancer patients: a real-life survey among 25 Italian radiation oncology centers

被引：11

作者：

Bergamaschi, Luca ^{[1
]}

Vincini, Maria Giulia ^{[1
]}

Zaffaroni, Mattia ^{[1
]}

Pepa, Matteo ^{[1
]}

Angelicone, Ilaria ^{[2
]}

Astone, Antonio ^{[3
]}

Bergamini, Cristiana ^{[4
]}

Buonopane, Sergio ^{[5
]}

Conte, Mario ^{[6
]}

De Rosa, Nicola ^{[7
]}

Deantoni, Chiara ^{[8
]}

Dell'Oca, Italo ^{[8
]}

Di Gennaro, Davide ^{[9
]}

Di Muzio, Nadia ^{[8
]}

Osti, Mattia Falchetto ^{[2
]}

Federico, Manuela ^{[10
]}

Ferini, Gianluca ^{[11
]}

Franzese, Ciro ^{[12
,13
]}

Gatti, Marco ^{[14
]}

Grillo, Antonietta ^{[15
]}

Iorio, Vincenzo ^{[6
]}

Manzo, Roberto ^{[5
]}

Marmiroli, Luca ^{[16
]}

Martin, Giuseppe ^{[17
]}

Mazzuca, Federica ^{[2
]}

Molinaro, Maria Angela ^{[18
]}

Muto, Matteo ^{[19
]}

Pacelli, Roberto ^{[20
]}

Pepe, Alfonsina ^{[21
]}

Perillo, Annarita ^{[7
,22
]}

Russo, Donatella ^{[23
]}

Salerno, Francesca ^{[24
]}

Spadaro, Pietro ^{[25
]}

Viola, Anna ^{[26
]}

Iorio, Giuseppe Carlo ^{[27
]}

Muto, Paolo ^{[5
]}

Ricardi, Umberto ^{[27
]}

Alterio, Daniela ^{[1
]}

机构：

[1] European Inst Oncol IRCCS, Div Radiat Oncol, I-20141 Milan, Italy

[2] Sapienza Univ Rome, St Andrea Hosp, Radiotherapy Oncol, Rome, Italy

[3] Fatebenefratelli San Pietro Hosp, Div Med Oncol, I-00189 Rome, Italy

[4] Fdn IRCCS Ist Nazl Tumori, Head & Neck Med Oncol Unit, Milan, Italy

[5] IRCCS Fdn G Pascale, Ist Nazl Tumori, Radiat Oncol Unit, Naples, Italy

[6] Fdn Muto Onlus, Naples, Italy

[7] Ctr Aktis Diagnost & Terapia, Naples, Italy

[8] Vita Salute S Rafaele Univ, Radiotherapy Dept, IRCCS San Raffaele Sci Inst, Milan, Italy

[9] Azienda Osped Univ Ruggi Aragona, Salerno, Italy

[10] Casa Cura Macchiarella, UO Radioterapia Oncol, I-90127 Palermo, Italy

[11] REM Radioterapia, Radiat Oncol Unit, Viagrande, Italy

[12] Humanitas Clin & Res Ctr IRCCS, Radiotherapy & Radiosurg Dept, Milan, Italy

[13] Humanitas Univ, Dept Biomed Sci, Milan, Italy

[14] FPO IRCCS, Candiolo Canc Inst, Radiotherapy Unit, Turin, Italy

[15] Azienda Osped Univ Policlin, Radiat Oncol Unit, Bari, Italy

[16] Osped Fatebenefratelli S Giovanni, UOC Radioterapia, I-00186 Rome, Italy

[17] Ctr Radiol Vega, Caserta, Italy

[18] AO Pugliese Ciaccio Catanzaro, UO Nephrol, Catanzaro, Italy

[19] Azienda Osped San GiuseMoscati AV, UOC Radiotherapy, Dept Onco Hematol Dis, I-83100 Avellino, Italy

[20] Univ Naples Federico II, Sch Med, Dept Adv Biomed Sci, Naples, Italy

[21] Radioterapia Emictr, Naples, Italy

[22] San Pio Hosp, Dept Radiat Oncol, Benevento, Italy

[23] Osped Vito Fazzi, Radiatherapy Unit, Lecce, Italy

[24] ASL Roma1, UOC Radioterapia, Rome, Italy

[25] Casa Cura Villa Salus, UO Oncol & Ematol, Messina, Italy

[26] Fdn IOM, Viagrande, Catania, Italy

[27] Univ Turin, Dept Oncol, Radiat Oncol, Turin, Italy

来源：

SUPPORTIVE CARE IN CANCER | 2024年 / 32卷 / 01期

关键词：

Radiation-induced oral mucositis; Head and neck cancer; Real-life survey; CLINICAL-PRACTICE GUIDELINES; BENZYDAMINE HYDROCHLORIDE; DOUBLE-BLIND; PREVENTION; RADIOTHERAPY; CHLORHEXIDINE; PROPHYLAXIS; MULTICENTER; LASER; RISK;

D O I：

10.1007/s00520-023-08185-5

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

AimRadiation-induced oral mucositis (RIOM) is the most frequent side effect in head and neck cancer (HNC) patients treated with curative radiotherapy (RT). A standardized strategy for preventing and treating RIOM has not been defined. Aim of this study was to perform a real-life survey on RIOM management among Italian RT centers.MethodsA 40-question survey was administered to 25 radiation oncologists working in 25 different RT centers across Italy.ResultsA total of 1554 HNC patients have been treated in the participating centers in 2021, the majority (median across the centers 91%) with curative intent. Median treatment time was 41 days, with a mean percentage of interruption due to toxicity of 14.5%. Eighty percent of responders provide written oral cavity hygiene recommendations. Regarding RIOM prevention, sodium bicarbonate mouthwashes, oral mucosa barrier agents, and hyaluronic acid-based mouthwashes were the most frequent topic agents used. Regarding RIOM treatment, 14 (56%) centers relied on literature evidence, while internal guidelines were available in 13 centers (44%). Grade (G)1 mucositis is mostly treated with sodium bicarbonate mouthwashes, oral mucosa barrier agents, and steroids, while hyaluronic acid-based agents, local anesthetics, and benzydamine were the most used in mucositis G2/G3. Steroids, painkillers, and anti-inflammatory drugs were the most frequent systemic agents used independently from the RIOM severity.ConclusionGreat variety of strategies exist among Italian centers in RIOM management for HNC patients. Whether different strategies could impact patients' compliance and overall treatment time of the radiation course is still unclear and needs further investigation.

引用

页数：12

共 38 条

[1]

[Anonymous], Cancer Today

[2]

[Anonymous], TREATMENT CANC TYPE

[3]

[Anonymous], TER SUPP RAD GUID PR

[4] Low-energy He Ne laser in the prevention of radiation-induced mucositis - A multicenter phase III randomized study in patients with head and neck cancer [J].

Bensadoun, RJ ;

Franquin, JC ;

Ciais, G ;

Darcourt, V ;

Schubert, MM ;

Viot, M ;

Dejou, J ;

Tardieu, C ;

Benezery, K ;

Nguyen, TD ;

Laudoyer, Y ;

Dassonville, O ;

Poissonnet, G ;

Vallicioni, J ;

Thyss, A ;

Hamdi, M ;

Chauvel, P ;

Demard, F .

SUPPORTIVE CARE IN CANCER, 1999, 7 (04) :244-252

[5] Defining risk levels in locally advanced head and neck cancers:: A comparative analysis of concurrent postoperative radiation plus chemotherapy trials of the EORTC (#22931) and RTOG (#9501) [J].

Bernier, J ;

Cooper, JS ;

Pajak, TF ;

van Glabbeke, M ;

Bourhis, J ;

Forastiere, A ;

Ozsahin, EM ;

Jacobs, JR ;

Jassem, J ;

Ang, KK ;

Lefèbvre, JL .

HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND NECK, 2005, 27 (10) :843-850

[6] Radiotherapy mucositis in head and neck cancer: prevention by low-energy surface laser [J].

Bourbonne, Vincent ;

Otz, Joelle ;

Bensadoun, Rene-Jean ;

Dissaux, Gurvan ;

Lucia, Francois ;

Leclere, Jean-Christophe ;

Pradier, Olivier ;

Schick, Ulrike .

BMJ SUPPORTIVE & PALLIATIVE CARE, 2022, 12 (E6) :E838-E845

[7] Effect of topical morphine for mucositis-associated pain following concomitant chemoradiotherapy for head and neck carcinoma [J].

Cerchietti, LCA ;

Navigante, AH ;

Bonomi, MR ;

Zaderajko, MA ;

Menéndez, PR ;

Pogany, CE ;

Roth, BMC .

CANCER, 2002, 95 (10) :2230-2236

[8] A pilot study of chlorhexidine and benzydamine oral rinses for the prevention and treatment of irradiation mucositis in patients with head and neck cancer [J].

Cheng, Karis Kin-fong ;

Yuen, Jacqueline Ka Tsui .

CANCER NURSING, 2006, 29 (05) :423-430

[9] TOXICITY CRITERIA OF THE RADIATION-THERAPY ONCOLOGY GROUP (RTOG) AND THE EUROPEAN-ORGANIZATION-FOR-RESEARCH-AND-TREATMENT-OF-CANCER (EORTC) [J].

COX, JD ;

STETZ, J ;

PAJAK, TF .

INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS, 1995, 31 (05) :1341-1346

[10] A systematic review of interventions to mitigate radiotherapy-induced oral mucositis in head and neck cancer patients [J].

Davy, Catrina ;

Heathcote, Sharron .

SUPPORTIVE CARE IN CANCER, 2021, 29 (04) :2187-2202

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