Wang Wen-Chen, Chen Yuk-Kwan, Lin Li-Min
Department of Oral Pathology, School of Dentistry, Kaohsiung Medical University, Kaohsiung Medical University Hospital, Taiwan.
Auris Nasus Larynx. 2008 Jun;35(2):230-4. doi: 10.1016/j.anl.2007.08.007. Epub 2007 Oct 31.
The aim of this study is to present our experiences of the oral care of a cohort of nasopharyngeal carcinoma (NPC) patients before receiving radiation therapy in our institution.
A total of 181 (141 males and 40 females) pre-radiation therapy NPC patients who underwent regular recall dental examination and treatment according to a standard protocol of our Dental Department were collected.
One hundred and twelve (68.71%) did not have disease recurrence and only 12 patients (7.36%) had metastasis. The rate of expire was 14.92%. The average number of carious tooth was 2.45 (range: 0-16) whereas the mean number extracted tooth was 2.65 (range: 0-14). One hundred and sixty-four patients were recorded to have suffered from oral mucositis. About 7% patients had oral mucositis in the 1st week, but about 50% of patients developed oral mucositis from the 2nd week to the 3rd week after the beginning of radiotherapy. One hundred and thirty-three patients had records of oral infection. About 67% of the patients suffered from candidiasis during radiotherapy. Xerostomia was found in almost 80% of patients during radiation therapy. The mean number of carious tooth of the patient population during/after radiation therapy was significantly higher than the patient population before radiation therapy (7.18+/-7.10 vs. 2.45+/-2.85; chi2=46.32, p<0.0001). Eighty-four patients were regularly followed-up and the rate of lost follow-up was about 53.6%. One hundred and eighteen patients had custom-made fluoride trays fabricated. As comparing patients with fluoride trays to those without, the former had a significantly higher rate of dental follow-up compliance (chi2=48.56, p<0.0001).
The data and protocol presented in this study would enhance the care and life quality of the NPC patients. Our study showed that a pre-radiotherapy dental care regimen should be conducted simultaneously with the patient's treatment plan to treat the disease. Fluoride tray fabrication is recommended for dentate NPC patients receiving radiation therapy, as it may enhance compliance with dental follow-up.
