Oral complications at 6 months after radiation therapy for head and neck cancer

Abstract

Objective To examine oral complications 6 months after modern radiation therapy (RT) for head and neck cancer (HNC). Methods Prospective multicenter cohort study of patients with HNC receiving intensity‐modulated radiation therapy or more advanced RT. Stimulated whole salivary flow, maximal mouth opening, oral mucositis, oral pain, oral health‐related quality of life (OH‐QOL), and oral hygiene practices were measured in 372 subjects pre‐RT and 216 subjects at 6 months from the start of RT. Results Mean stimulated whole salivary flow declined from 1.09 to 0.47 ml/min at 6 months (p < .0001). Mean maximal mouth opening reduced from 45.58 to 42.53 mm at 6 months (p < .0001). 8.1% of subjects had some oral mucositis at 6 months, including 3.8% with oral ulceration. Mean overall pain score was unchanged. OH‐QOL was reduced at 6 months, with changes related to dry mouth, sticky saliva, swallowing solid foods, and sense of taste (p ≤ .0001). At 6 months, there was greater frequency of using dental floss and greater proportion using supplemental fluoride (p < .0001). Conclusions Despite advances in RT techniques, patients with HNC experience oral complications 6 months after RT, with resulting negative impacts on oral function and quality of life.