Faculty of Medicine, The Nethersole School of Nursing, The Chinese University of Hong Kong, Room732, Esther Lee Building, Sha Tin, Hong Kong, NT, China.
Support Care Cancer. 2010 Nov;18(11):1477-85. doi: 10.1007/s00520-009-0771-7. Epub 2009 Nov 15.
This study determined the incidence of severe oral mucositis (OM), patients' self-reported moderate and severe oral symptoms, and change of quality of life (QoL), as well as examined whether OM severity and pain scores predicted the impairment of oral function and QoL.
A multicenter approach was used and 137 patients treated with stomatotoxic chemotherapy (45%), high-dose myeloablative chemotherapy with or without concomitant total body irradiation (12%), head and neck irradiation with or without concomitant chemotherapy (44%) completed the OM-specific QoL measure (OMQoL) once or twice weekly over a 4- or 10-week period, along with concurrent measures of OM using WHO Mucositis Grading System and oral symptoms using 10 cm visual analog scale.
The incidence of severe OM was 50% (n = 68). About 77-80% of patients with severe OM reported moderate or severe mouth or throat pain, and 66-78% reported moderate or severe oral functional problems. The oral symptoms peak and area-under-the-curve (AUC) scores of patients with severe OM (peak 5.6 to 6.8; AUC 3.8 to 5.2) were significantly higher than those without OM and those with mild OM (p < 0.01). The OMQoL subscales peak and AUC scores of patients with severe OM (peak 47.9 to 62.1; AUC -40.1 to -25.8) were significantly lower than those without OM and those with mild OM (p < 0.01). Of those with severe OM, 88-94% had a drop in the OMQoL subscale scores to at least 10 points from the baseline. Pain resulting from OM, in particular throat pain, is most predictive of oral functional impairment (standardized β = 0.53-0.83).
Severe OM can cause profound pain and oral functional incapability and clinical significant impairment of QoL.
本研究旨在确定严重口腔黏膜炎（OM）的发生率、患者自我报告的中重度口腔症状以及生活质量（QoL）的变化，并探讨 OM 严重程度和疼痛评分是否能预测口腔功能和 QoL 的损害。
采用多中心方法，137 例接受口腔毒性化疗（45%）、大剂量骨髓清除性化疗联合或不联合全身照射（12%）、头颈部照射联合或不联合化疗（44%）的患者在 4 或 10 周的时间内每周接受 1 次或 2 次 OM 特异性 QoL 测量（OMQoL），同时使用世界卫生组织（WHO）口腔黏膜炎分级系统和 10cm 视觉模拟量表（VAS）同步测量 OM 及口腔症状。
严重 OM 的发生率为 50%（n=68）。约 77-80%的重度 OM 患者报告有中重度的口咽疼痛，66-78%报告有中重度口腔功能问题。重度 OM 患者的口腔症状峰值和曲线下面积（AUC）评分（峰值 5.6-6.8；AUC 3.8-5.2）显著高于无 OM 患者和轻度 OM 患者（p<0.01）。重度 OM 患者的 OMQoL 子量表峰值和 AUC 评分（峰值 47.9-62.1；AUC-40.1 至-25.8）显著低于无 OM 患者和轻度 OM 患者（p<0.01）。重度 OM 患者中有 88-94%的患者 OMQoL 子量表评分较基线下降至少 10 分。OM 引起的疼痛，特别是咽喉痛，是口腔功能障碍最具预测性的因素（标准化β=0.53-0.83）。
严重 OM 可导致严重疼痛和口腔功能丧失，以及显著的 QoL 受损。
