Trismus and reduced quality of life in patients with oral squamous cell carcinoma, who received post-operative radiotherapy alone or combined with chemotherapy
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30 juin 2017
À propos de cet article
Publié en ligne: 30 juin 2017
Pages: 29 - 36
Reçu: 07 juin 2017
Accepté: 23 août 2017
DOI: https://doi.org/10.1515/fco-2015-0023
Mots clés
© 2017 Evangelos Galitis, Vyron Droukas, Michail Tzakis, Vassileios Psarras, Dimitra Galiti, Eythymios Kyrodimos, Miltiadis Trichas, Amanda Psyrri, Nikolaos Papadogeorgakis, Maria Kouri, Evelina Belli, Vasileios Kouloulias
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Oral radiation toxicity, end of radiotherapy, n = 10_
| n | Oral mucositis (EORTC/RTOG) | Pain (VAS) | Xerostomia (VAS) | Loss of weight (Kg) |
|---|---|---|---|---|
| 1. | II | 6 | 6 | |
| 2. | 0 | 0 | 0 | 0 |
| 3. | III | 8 | 8 | |
| 4. | III | 7 | 6 | 4 |
| 5. | III | 8 | 8 | 9 |
| 6. | III | 10 | 10 | |
| 7. | III | 9 | 8 | |
| 8. | II | 5 | 5 | 3 |
| 9. | III | 10 | 10 | 10 |
| 10. | II | 3 | 0 | 0 |
Maximum mouth opening (MMO), in mm, before and after radiotherapy_
| n | Before radiotherapy, n = 10 | End of radiotherapy, n = 7 | Three months after radiotherapy, n = 2 |
|---|---|---|---|
| 1. | 24 | 18 | |
| 2. | 47 | ||
| 3. | 50 | 43 | |
| 4. | 36 | 23 | |
| 5. | 63 | 44 | 62 |
| 6. | 35 | 25 | 31 |
| 7. | 48 | 44 | |
| 8. | 60 | ||
| 9. | 63 | 41 | |
| 10. | 35 | ||
Epidemiological characteristics of the patients, n = 10_
| n | Gender/Age (years) | Disease stage/Site | Smoker Yes/No/Ex smoker | RT/ChemoRT | Total RT dose(Gray) |
|---|---|---|---|---|---|
| 1. | M/54 | T2N0M0/Palate | Ex smoker | RT2 | 67,5 |
| 2. | M/71 | T2N0M0/Buccal mucosa-skin infiltration | Yes | RT2 | 61,6 |
| 3. | M/77 | /Tongue, recurrence | - | RT1 | - |
| 4. | M/77 | T4N0M0/Mandible | No | ChemoRT2 | 60,75 |
| 5. | M/37 | /Floor of mouth, recurrence | No | ChemoRT1 | - |
| 6. | M/72 | /Tongue | No | ChemoRT1 | 60 |
| 7. | M/58 | T2N0M0/Tongue, recurrence-lymph nodes | Yes | Paclitaxel-Gemcitabine/RT2 | 70 |
| 8. | M/87 | T4N1M0/Buccal mucosa | No | RT2 | 61.6 |
| 9. | M/65 | T3N2M0/Posterior tongue | No | Cisplatin-Platinol weekly/RT2 | 67,5 |
| 10. | F/40 | T1N1M0/Tongue | No | Cisplatin-Platinol weekly/RT2 | 66 |
| Mean age 63,8 | Mean total dose 64,3 Gy |
Quality of life EORTC QLQ Head and Neck35, main symptoms with score 3-4, before, at the end, and 3 months after radiotherapy_
| Symptom | Before radiotherapy, n = 10 | End of radiotherapy, n = 8 | 3 months after radiotherapy, n = 2 |
|---|---|---|---|
| Pain in the mouth, jaw, neck | 2 | 8 | 2 |
| Choked when swallowing | 3 | ||
| Problems opening the mouth wide | 2 | 2 | |
| Problems swallowing solid food | 4 | 7 | 1 |
| Problems swallowing pureed food | 1 | 6 | |
| Problems swallowing liquids | 3 | 5 | |
| Problems in conversation | 3 | 6 | |
| Dry mouth | 3 | 5 | 2 |
| Sticky saliva | 4 | 7 | 2 |
| Problems with your sense of smell | 1 | ||
| Problems with sense of taste | 4 | 7 | 1 |
| Coughing | 1 | 1 | 1 |
| Problems with social activities | 1 | 2 | |
| Feeling sick | 3 | ||
| Less physically attractive as a result of disease or treatment | 1 | 4 | |
| Problems talking to other people in public places | 1 | ||
| Hoarseness | 1 | 2 | |
| Problems with teeth | 2 | 1 | |
| Reduced interest for life/sex | 5 | 7 | 1 |
Quality of Life EORTC QLQ-C30, main symptoms with score 3 and 4, before, at the end, and 3 months after radiotherapy
| Symptom | Before radiotherapy, n = 10 | End of radiotherapy, n = 8 | 3 months after radiotherapy, n = 2 |
|---|---|---|---|
| Fatigue | 5 | 6 | 1 |
| Pain | 4 | 5 | 1 |
| Limitation at work | 4 | 4 | |
| Feeling weak | 3 | 4 | 1 |
| Feeling sad | 3 | 5 | |
| Family problems | 3 | 4 | |
| Trouble sleeping | 2 | 3 | |
| Anorexia | 2 | 4 | |
| Financial difficulties | 2 | 2 | 1 |
| Feeling tense | 1 | 3 | |
| Feeling irritable | 1 | 3 | |
| Constipation | 1 | 3 | |
| Nausea/Vomiting | 3 | ||
| Depression | 2 | ||
| Total number of symptoms | 31 (3,1 / patient) | 51 (6,3 / patient) | |
| Very poor-poor:1-2 | 1 | 2 | |
| Low-moderate:3-4 | 4 | 5 | 1 |
| Good-excellent:5-7 | 5 | 1 | 1 |