Correlation analysis between risk factors and mucositis oral in head and neck cancer patients undergoing radiotherapy

Tenny Setiani Dewi; Yannie Febby Lefaan; Sri Susilawati; Adji Kusumadjati; Erry Mochamad Arief

doi:10.24198/pjd.vol34no2.39165

Correlation analysis between risk factors and mucositis oral in head and neck cancer patients undergoing radiotherapy

Tenny Setiani Dewi, Yannie Febby Lefaan, Sri Susilawati, Adji Kusumadjati, Erry Mochamad Arief

Abstract

ABSTRACT

Introduction: Radiotherapy is a cancer therapy that uses ionizing radiation to damage cancer cells. Ionizing radiation in the head and neck area can disrupt the function and integrity of the oral mucosa and cause oral mucositis. In Bandung, the prevalence and risk factors of oral mucositis in head and neck cancer (HNC) patients undergoing radiotherapy have not been studied. Some textbooks claim that the prevalence of radiotherapy-induced oral mucositis in HNC patients occurs at almost 100%. Various risk factors associated with oral mucositis have been studied, giving significantly different results. This research analyzes the correlation between risk factors and mucositis oral in head and neck cancer patients undergoing radiotherapy. Methods: This research is a cross-sectional retrospective study with secondary data from medical records of HNC patients at RSHS from January 2015 until December 2019. A consecutive sampling method was used to collect the data that match the Inclusion criteria, including diagnosis of HNC(ICD-10), receiving radiotherapy from the first cycle until the last cycle; having a complete medical record following variables (location of HNC coding by ICD-10, gender, age, education level, smoking habit, the cycle of radiotherapy, oral treatment, body mass index, and comorbid disease). All data were then analyzed using Spearman correlation. Result: 171 medical records showed 59 patients had oral mucositis after radiotherapy. 26.9% male and 7.6% female, with susceptible age 40-60 years. Analysis of the Spearman correlation, there is a significant relationship between body mass index (BMI) (ρ = 0,001), smoking habits (ρ = 0,001), and radiotherapy cycles (ρ = 0.001). Conclusion: There is a correlation between risk factors of oral mucositis in HNC patients undergoing radiotherapy in RSHS, including body mass index (BMI), smoking habits, and radiotherapy cycles.

Keywords: Head and neck cancer; oral mucositis; prevalence; risk factor; retrospective study

Keywords

Head and neck cancer; oral mucositis; prevalence; risk factor; retrospective study

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References

REFERENCES

Basile D, Nardo P Di, Corvaja C, Garattini SK, Pelizzari G, Lisanti C, et al. Mucosal injury during anti-cancer treatment : from pathobiology to bedside. J Cancer. 2019; 11(857): 1–22. DOI: 10.3390/cancers11060857

Alvarino-Martin C, Sarrion-Perez M. Prevention and treatment of oral mucositis in patients receiving chemotherapy. J Clin Exp Dent. 2014; 6(1): e74-80. DOI: 10.4317/jced.51313

Carreón-Burciaga RG, Castañeda-Castaneira E, González-González R, Molina-Frechero N, Gaona E, Bologna-Molina R. Severity of oral mucositis in children following chemotherapy and radiotherapy and its implications at a single oncology centre in durango state, Mexico. Int J Pediatr. 2018; Volume 2018: 1–5. DOI: 10.1155/2018/3252765

Sonis ST. The epidemiology and risk assessment of mucositis. In: Oral mucositis. Boston, Massachusetts: Springer Healthcare; 2012. p. 1–22. DOI: 10.1007/978-1-907673-46-7_3

Bray F, Ferlay J, Soerjomataram I. Global cancer statistics 2018 : globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries. Cancer J Clin. 2018; 68(6): 394–424. DOI: 10.3322/caac.21492.

Leeman JE, Katabi N, Wong RJ, Lee NY, Romesser PB. Cancer of the head and neck. In: Niederhuber JE, Armitage JO, Doroshow JH, Kastan MB, Tepper JE, editors. Abeloff’s Clinical Oncology. 6th Ed. Philadelphia, PA 19103: Elsevier; 2020. p. 999–1033.

Adam MLR, Winata A. Faktor-faktor keterlambatan penatalaksanaan pada pasien kanker kepala dan leher di rumah sakit umum pusat sanglah tahun 2016. E-Jurnal Med. 2017; 6(2): 1–9.

Surjadi N, Amtha R. Radiotherapy Reduced Salivary Flow Rate and Might Induced C . albicans Infection. J Dent Ind. 2012; 19(1): 1–6. DOI: 10.14693/jdi.v19i1.124

To’buangan N, A’Liyah SH, Wijayanti N, Fachiroh J. Epidemiologi, Stadium, dan Derajat Diferensiasi Kanker Kepala dan Leher. Biogenesis. 2015; 3(1): 47–52. DOI: 10.24252/bio.v3i1.566

Sonis ST. A comparison and assessment of scoring scales for mucositis. 6th Ed. In: Oral mucositis. Boston, Massachusetts: Springer Healthcare; 2012. p. 39–46.

Kodrat H, Novirianthy R. Prinsip Dasar Radioterapi. Med J Kedokt Indones. 2016; 6(XLI): 318–23.

Halperin EC, Wazer DE, Perez CA, Brady LW. Perez and Brady’s Principles and Practice of Radiation Oncology. 7th Ed. Vol. 184, Radiology. Philadelphia: Wolters Kluwer; 2019. 65–545 p.

Saedi HS, Gerami H, Soltanipour S, Habibi AF, Mirhosseyni M, Montazeri S, et al. frequency of chemoradiotherapy induced mucositis and related risk factors in patients with the head and neck cancers : A survey in the. Dent Res J (Isfahan). 2019; 16(5): 354–9.

Devaraju C, Lokanatha D, Bapsy P, Suresh A, Viswanath G, Sandhya B, et al. Risk scoring for predicting mucositis in indian patients with esophageal carcinoma receiving concurrent chemoradiotherapy. Gastrointest Cancer Res. 2019; 3(1): 4-6

Tao Z, Gao J, Qian L, Huang Y, Zhou Y, Yang L, et al. Factors associated with acute oral mucosal reaction induced by radiotherapy in head and neck squamous cell carcinoma. Medicine (Baltimore). 2017; 96(50): 1–5. DOI: 10.1097/MD.0000000000008446.

Pereira IF, Firmino RT, Meira HC, Cavalcanti B, Egito DO, Reimar V, et al. Radiation-induced Oral Mucositis in Brazilian Patients : Prevalence and Associated Factors. In Vivo (Brooklyn). 2019; 33: 605–9. DOI: 10.21873/invivo.11517.

Maria OM, Eliopoulos N, Muanza T. Radiation-Induced Oral Mucositis. Front Oncol. 2017 May 22; 7(89): 1–23. DOI: 10.3389/fonc.2017.00089.

Ibraheemi AA Al, Shamoun S. Incidence and Risk Factors of Oral Mucositis in Patients with Breast Cancer Who Receiving Chemotherapy in Al-Bashir Hospital. Int J Hematol Stem Cell Res. 2016; 10(4): 1–7.

Nur KS. Keperawatan Gerontik. In: Nur KS, editor. Kementerian kesehatan republik indonesia; 2016.

Çakmak S, Nural N. Incidence of and risk factors for development of oral mucositis in outpatients undergoing cancer chemotherapy. Int J Nurs Pract. 2019; 25(1): 1–9. DOI: 10.1111/ijn.12710.

Silviliyana M, Maylasari I, Agustina R, Dewi FWR, Sulistyowati NP. Potret Pendidikan Indonesia Statistik Pendidikan 2019. Susilo D, Harahap IE, Sinang R, editors. Badan Pusat Statistik. Jakarta, Indonesia: Badan Pusat Statistik; 2019. 73–92 p.

Pulungan AMP, Hariyanto AD, Nugroho CA, Farisi DS, Sandjaja F, Auzan M, et al. Hubungan antara perilaku merokok dengan kejadian mukositis berat pada pasien keganasan kepala dan leher yang menjalani radioterapi. Radioter Onkol Indones. 2018; 9(1): 1–4. DOI: 10.32532/jori.v9i1.62

Schaal C, Chellappan SP. Nicotine-mediated cell proliferation and tumor progression in smoking-related cancers. Mol Cancer Res. 2014; 12(1): 14–23. DOI: 10.1158/1541-7786.MCR-13-0541.

Rathore DS, MV DR, Singh DPK. EGFR scoring in head and neck squamous cell carcinoma and its association with clinicopathological variables. Int J Med Res Rev. 2017; 5(7): 731–9. DOI: 10.17511/ijmrr.2017.i07.12

Nagarajan K. Chemo-radiotherapy induced oral mucositis during IMRT for head and neck cancer - An assessment. Med Oral Patol Oral Cir Bucal. 2015; 20(3) :e273–7. DOI: 10.4317/medoral.20126.

Kawashita Y, Soutome S, Umeda M, Saito T. Oral management strategies for radiotherapy of head and neck cancer. Jpn Dent Sci Rev. 2020; 56(1): 62–7. DOI: 10.1016/j.jdsr.2020.02.001

Murdoch-Kinch CA, Zwetchkenbaum S. Dental management of the head and neck cancer patient treated with radiation therapy. J Mich Dent Assoc. 2011; 93(7): 28–37.

Pfister DG, Spencer S, Adelstein D, Adkins D, Anzai Y, Brizel DM, et al. Head and neck cancers, version 2.2020. JNCCN J Natl Compr Cancer Netw. 2020; 18(7): 873–98. DOI: 10.6004/jnccn.2020.0031.

Kurniasari FN, Surono A, Pangastuty R. Status gizi sebagai prediktor kualitas hidup pasien kanker kepala dan leher. Indones J Hum Nutr. 2015; 2(1): 60–7. DOI: 10.21776/ub.ijhn.2015.002.01.6

Zheng Z, Zhao X, Zhao Q, Zhang Y, Liu S, Liu Z, Meng L, Xin Y, Jiang X. The Effects of Early Nutritional Intervention on Oral Mucositis and Nutritional Status of Patients With Head and Neck Cancer Treated With Radiotherapy. Front Oncol. 2021 Feb 1;10:595632. DOI: 10.3389/fonc.2020.595632.

Shu Z, Zeng Z, Yu B, Huang S, Hua Y, Jin T, et al. Nutritional Status and Its Association With Radiation-Induced Oral Mucositis in Patients With Nasopharyngeal Carcinoma During Radiotherapy: A Prospective Study. Front Oncol. 2020;10(November):1–9. DOI: 10.3389/fonc.2020.594687

Jha N, Ryu JJ, Wahab R, Al-Khedhairy AA, Choi EH, Kaushik NK. Treatment of oral hyperpigmentation and gummy smile using lasers and role of plasma as a novel treatment technique in dentistry: An introductory review. Oncotarget. 2017; 8(12): 20496–509. DOI: 10.18632/oncotarget.14887.

Dawes C, Pedersen AML, Villa A, Ekström J, Proctor GB, Vissink A, et al. The functions of human saliva: A review sponsored by the World Workshop on Oral Medicine VI. Arch Oral Biol. 2015; 60(6): 863–74.DOI: 10.1016/j.archoralbio.2015.03.004.

DOI: https://doi.org/10.24198/pjd.vol34no2.39165