The impact of timing and modalities of dental prophylaxis on the risk of 5-fluorouracil-related oral mucositis in patients with head and neck cancer: a nationwide population-based cohort study

被引：5

作者：

Huang, Yi-Fang ^{[1
,2
,3
]}

Liu, Shih-Ping ^{[4
,5
,6
]}

Muo, Chih-Hsin ^{[7
]}

Chen, Hsuan-Ju ^{[7
]}

Liao, Yu-Fang ^{[3
,8
,9
,10
]}

Chiu, Kuan-Ming ^{[11
,12
,13
]}

Chen, Cheng-Chang ^{[1
]}

Tsai, Chun-Hao ^{[14
,15
]}

Hong, Hsiang-Hsi ^{[3
,16
]}

Chang, Chung-Ta ^{[2
,17
]}

机构：

[1] Chang Gung Mem Hosp, Dept Gen Dent, Linkou 33305, Taiwan

[2] Taipei Med Univ, Coll Oral Med, Sch Dent, Taipei 11031, Taiwan

[3] Chang Gung Univ, Grad Inst Dent & Craniofacial Sci, Coll Med, Taoyuan 40402, Taiwan

[4] China Med Univ & Hosp, Ctr Translat Med, Taichung 40402, Taiwan

[5] China Med Univ, Coll Med, Program Aging, Taichung 40402, Taiwan

[6] Asia Univ, Dept Social Work, Taichung 41354, Taiwan

[7] China Med Univ Hosp, Management Off Hlth Data, Taichung 40402, Taiwan

[8] Chang Gung Mem Hosp, Dept Craniofacial Orthdnt, Taipei 10507, Taiwan

[9] Chang Gung Mem Hosp, Craniofacial Ctr, Taoyuan 33378, Taiwan

[10] Chang Gung Mem Hosp, Craniofacial Res Ctr, Linkou 33305, Taiwan

[11] Far Eastern Mem Hosp, Cardiovasc Ctr, Div Cardiovasc Surg, New Taipei 22056, Taiwan

[12] Oriental Inst Technol, Dept Nursing, New Taipei 22056, Taiwan

[13] Yuan Ze Univ, Dept Elect Engn, Taoyuan 32003, Taiwan

[14] China Med Univ Hosp, Dept Orthped, Taichung 40402, Taiwan

[15] China Med Univ, Grad Inst Clin Med, Taichung 40402, Taiwan

[16] Chang Gung Mem Hosp, Dept Periodontol, Linkou 5,Fuxing St, Taoyuan 33305, Taiwan

[17] Far Eastern Mem Hosp, Dept Emergency Med, 21,Sec 2, Nanya S Rd, New Taipei 22056, Taiwan

来源：

SUPPORTIVE CARE IN CANCER | 2021年 / 29卷 / 06期

关键词：

Dental prophylaxis; 5-Fluorouracil-related oral mucositis; Head and neck cancer; Chlorohexidine; Scaling; Fluoride gel application; SUPPORTIVE CARE; OSTEORADIONECROSIS; CHLORHEXIDINE; COMPLICATIONS; MECHANISMS; PROPOSAL; CARIES; BLOOD;

D O I：

10.1007/s00520-020-05825-y

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Purpose This study investigated the impact of dental prophylaxis on 5-fluorouracil (5-FU)-related oral mucositis (OM) according to the head and neck cancer (HNC) locations and treatment times. Methods A total of 13,969 HNC participants, including 482 5-FU-related OM subjects and 13,487 comparisons were enrolled from the Longitudinal Health Insurance Database for Catastrophic Illness Patients of Taiwan between 2000 and 2008. All subjects were stratified into subgroups based on the times to perform chlorhexidine use, scaling, and fluoride application before 5-FU administration. The dental prophylaxis related to 5-FU-related OM was estimated by multiple logistic regression and represented with odds ratio (OR) and 95% confidence interval (CI). Results Fluoride gel application and scaling significantly impacted on OM development (p < 0.001), and the joint effect of fluoride gel and scaling induced 5-FU-related OM (OR = 3.46, 95% CI = 2.39-5.01). The risk of OM was raised 2.25-fold as scaling within 3 weeks before 5-FU-related chemotherapy (95% CI = 1.81-2.81), and a 3.22-fold increased risk of OM while fluoride gel was applied during 5-FU-related treatment (95% CI = 1.46-7.13). Conclusion Dental prophylaxis significantly affected 5-FU-related OM in the HNC population. A short interval between dental scaling or fluoride application and 5-FU administration may be associated with higher prevalence of OM. Scaling simultaneously combined with chlorohexidine promoted 5-FU-related OM in specific HNC patients excluding the oral cancer and nasopharyngeal cancer population. Proper timing of the prophylactic dental treatments prior to 5-FU therapy could reduce the risk to develop 5-FU-related OM.

引用

页码：3163 / 3171

页数：9

共 29 条

[21] Evaluating the supportive care costs of severe radiochemotherapy-induced mucositis and pharyngitis - Results from a Northwestern University costs of cancer program pilot study with head and neck and nonsmall cell lung cancer patients who received care at a county hospital, a Veterans Administration Hospital, or a comprehensive cancer care center [J].