Yang Dongye, Zhou Feng, Fu Xinyu, Hou Jinsong, Lin Liting, Huang Qiuyu, Yeh Chao Hsing
Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
Center for Adverse Drug Reaction Monitoring of Chengdu, Sichuan, China.
Int J Nurs Sci. 2019 Jun 3;6(3):278-282. doi: 10.1016/j.ijnss.2019.05.006. eCollection 2019 Jul 10.
Osteoradionecrosis of the jaws (ORNJ) is among the most serious oral complications of head and neck cancer treatment with radiation therapy. This study aimed to examine the level of symptom distress and interference of ORNJ in head and neck cancer patients in China.
A cross-sectional study was conducted to profile patient reported symptom severity. Ninety-five hospitalized ORNJ patients were recruited. Participants completed the MD Anderson Symptom Inventory-Head and Neck Module-Chinese version.
The percentage of participants who reported that they experienced at least one type of symptom was 97.9%, and 85.2% patients reported interference. The 10 most severe symptoms were as follows: limited mouth opening, problem with teeth/gums, difficulty swallowing/chewing, dry mouth, oral malodor, difficulty with voice/speech, dental ulcer, tinnitus/ear obstruction, skin pain/burning/rash, and difficulty hearing. The problem of limited mouth opening was more severe in patients with longer time to onset of ORNJ after radiotherapy. The interference of patients positively correlated with core symptoms ( = 0.612), head and neck symptoms ( = 0.709), and ORNJ symptoms ( = 0.440) ( < 0.01). The longer time to the onset of ORNJ after radiotherapy was positively and significantly correlated with symptom distress ( = 0.479, < 0.001), and mouth opening correlated negatively with symptom distress ( = -0.298, = 0.003).
ORNJ patients suffered mainly from limited mouth opening and other maxillofacial symptoms. The problem of limited mouth opening was more severe in patients with longer time to onset of ORNJ after radiotherapy. ORNJ patients commonly had symptom distress, which influenced their quality of life.
颌骨放射性骨坏死(ORNJ)是头颈部癌放射治疗最严重的口腔并发症之一。本研究旨在调查中国头颈部癌患者中ORNJ的症状困扰程度及其干扰情况。
开展一项横断面研究以分析患者报告的症状严重程度。招募了95例住院的ORNJ患者。参与者完成了中文版的MD安德森症状问卷头颈模块。
报告至少经历过一种症状的参与者比例为97.9%,85.2%的患者报告存在干扰情况。最严重的10种症状如下:张口受限、牙齿/牙龈问题、吞咽/咀嚼困难、口干、口臭、声音/言语困难、口腔溃疡、耳鸣/耳部堵塞、皮肤疼痛/灼烧/皮疹以及听力困难。放疗后ORNJ发病时间较长的患者张口受限问题更严重。患者的干扰情况与核心症状(r = 0.612)、头颈症状(r = 0.709)和ORNJ症状(r = 0.440)呈正相关(P < 0.01)。放疗后ORNJ发病时间越长,与症状困扰呈正相关且具有显著意义(r = 0.479,P < 0.001),而张口度与症状困扰呈负相关(r = -0.298,P = 0.003)。
ORNJ患者主要受张口受限和其他颌面症状困扰。放疗后ORNJ发病时间较长的患者张口受限问题更严重。ORNJ患者普遍存在症状困扰,这影响了他们的生活质量。