Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
Johns Hopkins Singapore, International Medical Clinic, Tan Tock Seng Hospital, Singapore, Singapore.
Support Care Cancer. 2018 Jul;26(7):2191-2200. doi: 10.1007/s00520-018-4050-3. Epub 2018 Jan 31.
This descriptive cross-sectional survey aims to assess the level of concordance between the perspectives of oncologists and those of patients regarding oral mucositis (OM) symptoms, and the impact of OM on various aspects of daily living and concurrent cancer management.
Oncologists involved in OM management (n = 105), and patients who developed OM during cancer treatment (n = 175), were recruited from seven Asian countries. Oncologists completed a face-to-face, quantitative interview; patients completed a face-to-face interview, and a self-reported questionnaire.
Oncologists and patients ranked treatment-induced OM among the three most important toxicities of cancer therapy requiring intervention. The most frequent OM symptoms reported by patients were oral ulcers (74%), dry mouth (73%), and difficulty swallowing (62%). Oncologists expected mild OM symptoms to last slightly longer than 1 week, whereas patients reported mild symptoms for more than 2 weeks. In mild-to-moderate OM, oncologists underestimated patients' pain experience. Overall, only 45% of oncologists said they would initiate OM prophylaxis when cancer therapy started. Of the 87% of patients who said they used their prescribed medications, only 16% reported using prophylactically prescribed medication. While oncologists' concerns related to the delays and interruptions of cancer treatment, patients tended to focus on the effects of OM on eating, drinking, and talking.
Oncologists' and patients' perceptions about treatment-induced OM differ. To overcome discordant perspectives, there is a need to raise general awareness and improve proactive management of OM. As noted in recent guidelines, supportive cancer care is critical for ensuring optimal therapy and for improving the patient's experience.
本描述性横断面调查旨在评估肿瘤学家和患者对口腔黏膜炎（OM）症状的看法的一致性程度，以及 OM 对日常生活和同期癌症管理的各个方面的影响。
从七个亚洲国家招募了参与 OM 管理的肿瘤学家（n=105）和在癌症治疗期间发生 OM 的患者（n=175）。肿瘤学家完成了面对面的定量访谈；患者完成了面对面的访谈和自我报告的问卷。
肿瘤学家和患者将治疗引起的 OM 列为癌症治疗中需要干预的三种最重要的毒性之一。患者报告的最常见的 OM 症状是口腔溃疡（74%）、口干（73%）和吞咽困难（62%）。肿瘤学家预计轻度 OM 症状将持续略超过 1 周，而患者报告轻度症状持续超过 2 周。在轻度至中度 OM 中，肿瘤学家低估了患者的疼痛体验。总体而言，只有 45%的肿瘤学家表示在癌症治疗开始时会启动 OM 预防。在 87%表示使用规定药物的患者中，只有 16%报告预防性使用了规定的药物。虽然肿瘤学家关注癌症治疗的延迟和中断，但患者往往更关注 OM 对进食、饮水和说话的影响。
肿瘤学家和患者对治疗引起的 OM 的看法存在差异。为了克服观点不一致，需要提高对 OM 的认识并改善对 OM 的主动管理。正如最近的指南所指出的，支持性癌症护理对于确保最佳治疗和改善患者体验至关重要。
