Liu Meizi, An Ran, Wu Zitong, Dai Leping, Zeng Qiaomiao, Chen Wenfeng
Teaching and Research Section of Clinical Nursing, Xiangya Hospital Central South University, Changsha, Hunan, China.
Xiang Ya Nursing School, Central South University, Changsha, Hunan, China.
Ear Nose Throat J. 2025 May;104(5):NP257-NP269. doi: 10.1177/01455613241228211. Epub 2024 Feb 9.
Oral mucositis (OM) is a common and severe side effect of radiotherapy in head and neck cancer (HNC). The study aimed to investigate the longitudinal changes in OM and its influencing factors in patients with HNC during radiotherapy.
This was a retrospective longitudinal observational study. From July 2022 to March 2023, patients with HNC undergoing radiation therapy were enrolled. OM, oral hygiene, oral infections, oral pain, feeding route, and laboratory indicators were measured at 7 times. The influencing factors of OM were analyzed using generalized estimation equations (GEEs).
A total of 160 patients were included in this study. The prevalence of severe OM at T0, T1, T2, T3, T4, T5, and T6 was 0, 0, 2.5%, 9.4%, 26.9%, 24.4%, and 26.9%, respectively. The prevalence of grade 1-2 OM at T0, T1, T2, T3, T4, T5, and T6 was 0, 16.3%, 53.1%, 65.1%, 61.9%, 70.7%, and 71.3%, respectively. Duration of diagnosis, clinical stage, N stage, M stage, surgery, diabetes, radiotherapy dose, oral hygiene, oral infection, oral pain, feeding route, and lymphocyte impacted OM significantly in the GEEs multivariate model.
OM occurs in almost all patients with HNC who undergo radiotherapy. Changes in the severity of OM are a dynamic process, with the severity increasing with the cumulative radiotherapy dose. Specialist oral evaluation and oral care are needed to alleviate the severity of OM in HNC patients.
口腔黏膜炎（OM）是头颈部癌（HNC）放疗常见且严重的副作用。本研究旨在调查HNC患者放疗期间OM的纵向变化及其影响因素。
这是一项回顾性纵向观察研究。纳入2022年7月至2023年3月接受放射治疗的HNC患者。在7个时间点测量OM、口腔卫生、口腔感染、口腔疼痛、进食途径和实验室指标。使用广义估计方程（GEEs）分析OM的影响因素。
本研究共纳入160例患者。T0、T1、T2、T3、T4、T5和T6时重度OM的发生率分别为0、0、2.5%、9.4%、26.9%、24.4%和26.9%。T0、T1、T2、T3、T4、T5和T6时1-2级OM的发生率分别为0、16.3%、53.1%、65.1%、61.9%、70.7%和71.3%。在GEEs多变量模型中，诊断持续时间、临床分期、N分期、M分期、手术、糖尿病、放疗剂量、口腔卫生、口腔感染、口腔疼痛、进食途径和淋巴细胞对OM有显著影响。
几乎所有接受放疗的HNC患者都会发生OM。OM严重程度的变化是一个动态过程，其严重程度随放疗累积剂量增加而增加。需要专业的口腔评估和口腔护理来减轻HNC患者OM的严重程度。
