Assessment of oral mucositis during concurrent chemoradiation of head and neck cancers using patient-reported measurement scale

Nallan CSK Chaitanya; Arvind Muthukrishnan; P. Karunakar; Manchala Himani; Neeharika Satya Jyothi Allam; Neha Jain

doi:10.4103/sajc.sajc_144_17

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ORIGINAL ARTICLE: Head and Neck Cancer

07 (

); 46-48

doi:

10.4103/sajc.sajc_144_17

Assessment of oral mucositis during concurrent chemoradiation of head and neck cancers using patient-reported measurement scale

Nallan CSK Chaitanya^1,, Arvind Muthukrishnan², P. Karunakar¹, Manchala Himani³, Neeharika Satya Jyothi Allam², Neha Jain¹

1 Department of Oral Medicine and Radiology, Panineeya Institute of Dental Sciences, Hyderabad, Telangana

2 Department of Oral Medicine and Radiology, Saveetha Dental College, Saveetha University, Chennai, Tamil Nadu, Indiaa

3 Department of Radiation Oncology, MNJ Institute of Oncology and Research, Hyderabad, Telangana, India

*Corresponding author: Dr. Nallan CSK Chaitanya. nallanchaitanya@gmail.com

Published: 2020-12-22

MedIntel Services Pvt Ltd. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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Abstract

Introduction: Oral mucositis (OM) is a major challenge encountered in concurrent radiochemotherapy for the treatment of head and neck cancers. The patient reported OM symptoms scale (PROMS) was administered on these patients. The objective was to develop the similar scale in an Indian language and prescribe it population undergoing cancer treatment. Materials and Methods: PROMS scale was converted to Telugu language. Fifty-one patients took part in the study. All of them answered the 10-point questions marked their responses on 100 mm visual analog scale after thorough oral examination using WHO grading by the same examiner. Results: Internal consistency of Cronbach's alpha on PROMS scale was 0.81–0.97. The questionnaire study was administered on 35 males and 16 females with the mean age of 54.9 ± 11.8. The decrease in the total PROMS score was marked on day 35 in almost all patients, with a mean value of 34.04 ± 30.2 followed by a further significant decrease on day 60 (follow-up) with a mean of 3.71 ± 7.8. The PROMS scores correlated strongly with the clinician-rated OM scores during the first 35 weeks from the baseline at 0.84 with P < 0.01 and poor correlation was at day 60, i.e. 0.32 with P < 0.05 using Spearman's Rho correlation. Conclusion: The study showed a good correlation between patient-reported items and clinical score by standard grading scale. This questionnaire may not be a sole guide in assessing the severity of OM but could be definitely used as an adjunct to clinical oral examination at assessment levels.

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References

Kushner JA, Lawrence HP, Shoval I, Kiss TL, Devins GM, Lee L, et al. Development and validation of a Patient-Reported Oral Mucositis Symptom (PROMS) scale. J Can Dent Assoc 2008;74:59.
Gussgard AM, Hope AJ, Jokstad A, Tenenbaum H, Wood R. Assessment of cancer therapy-induced oral mucositis using a patient-reported oral mucositis experience questionnaire. PLoS One 2014;9:e91733.
Epstein JB, Beaumont JL, Gwede CK, Murphy B, Garden AS, Meredith R, et al. Longitudinal evaluation of the oral mucositis weekly questionnaire-head and neck cancer, a patient-reported outcomes questionnaire. Cancer 2007;109:1914-22.
List MA, D'Antonio LL, Cella DF, Siston A, Mumby P, Haraf D, et al. The performance status scale for head and neck cancer patients and the functional assessment of cancer therapy-head and neck scale. A study of utility and validity. Cancer 1996;77:2294-301.
Stiff PJ, Erder H, Bensinger WI, Emmanouilides C, Gentile T, Isitt J, et al. Reliability and validity of a patient self-administered daily questionnaire to assess impact of oral mucositis (OM) on pain and daily functioning in patients undergoing autologous hematopoietic stem cell transplantation (HSCT). Bone Marrow Transplant 2006;37:393-401.
Murphy BA, Beaumont JL, Isitt J, Garden AS, Gwede CK, Trotti AM, et al. Mucositis-related morbidity and resource utilization in head and neck cancer patients receiving radiation therapy with or without chemotherapy. J Pain Symptom Manage 2009;38:522-32.
Rosaura GV, Maria LD, Miguel AV, Javier PR, Marta ZT. Instruments to measure the quality of life in patients with oral mucositis undergoing oncological treatment: A systematic review of the literature. Bol Med Hosp Infant Mex 2016;73:457-66.
Lalla RV, Saunders DP, Peterson DE. Chemotherapy or radiation-induced oral mucositis. Dent Clin North Am 2014;58:341-9.
Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 2002;52:69-77.
Cella D, Pulliam J, Fuchs H, Miller C, Hurd D, Wingard JR, et al. Evaluation of pain associated with oral mucositis during the acute period after administration of high-dose chemotherapy. Cancer 2003;98:406-12.
Keefe DM, Schubert MM, Elting LS, Sonis ST, Epstein JB, Raber-Durlacher JE et al. Updated clinical practice guidelines for the prevention and treatment of mucositis. Cancer. 2007. 1;109:820-31.
Vera-Llonch M, Oster G, Hagiwara M, Sonis S. Oral mucositis in patients undergoing radiation treatment for head and neck carcinoma. Cancer 2006;106:329-36.
Elad S, Bowen J, Zadik Y, Lalla RV, Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). Development of the MASCC/ISOO Clinical Practice Guidelines for Mucositis: Considerations underlying the process. Support Care Cancer 2013;21:309-12.

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[1] Kushner JA, Lawrence HP, Shoval I, Kiss TL, Devins GM, Lee L, et al. Development and validation of a Patient-Reported Oral Mucositis Symptom (PROMS) scale. J Can Dent Assoc 2008;74:59.

[2] Gussgard AM, Hope AJ, Jokstad A, Tenenbaum H, Wood R. Assessment of cancer therapy-induced oral mucositis using a patient-reported oral mucositis experience questionnaire. PLoS One 2014;9:e91733.

[3] Epstein JB, Beaumont JL, Gwede CK, Murphy B, Garden AS, Meredith R, et al. Longitudinal evaluation of the oral mucositis weekly questionnaire-head and neck cancer, a patient-reported outcomes questionnaire. Cancer 2007;109:1914-22.

[4] List MA, D'Antonio LL, Cella DF, Siston A, Mumby P, Haraf D, et al. The performance status scale for head and neck cancer patients and the functional assessment of cancer therapy-head and neck scale. A study of utility and validity. Cancer 1996;77:2294-301.

[5] Stiff PJ, Erder H, Bensinger WI, Emmanouilides C, Gentile T, Isitt J, et al. Reliability and validity of a patient self-administered daily questionnaire to assess impact of oral mucositis (OM) on pain and daily functioning in patients undergoing autologous hematopoietic stem cell transplantation (HSCT). Bone Marrow Transplant 2006;37:393-401.

[6] Murphy BA, Beaumont JL, Isitt J, Garden AS, Gwede CK, Trotti AM, et al. Mucositis-related morbidity and resource utilization in head and neck cancer patients receiving radiation therapy with or without chemotherapy. J Pain Symptom Manage 2009;38:522-32.

[7] Rosaura GV, Maria LD, Miguel AV, Javier PR, Marta ZT. Instruments to measure the quality of life in patients with oral mucositis undergoing oncological treatment: A systematic review of the literature. Bol Med Hosp Infant Mex 2016;73:457-66.

[8] Lalla RV, Saunders DP, Peterson DE. Chemotherapy or radiation-induced oral mucositis. Dent Clin North Am 2014;58:341-9.

[9] Bjelland I, Dahl AA, Haug TT, Neckelmann D. The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res 2002;52:69-77.

[10] Cella D, Pulliam J, Fuchs H, Miller C, Hurd D, Wingard JR, et al. Evaluation of pain associated with oral mucositis during the acute period after administration of high-dose chemotherapy. Cancer 2003;98:406-12.

[11] Keefe DM, Schubert MM, Elting LS, Sonis ST, Epstein JB, Raber-Durlacher JE et al. Updated clinical practice guidelines for the prevention and treatment of mucositis. Cancer. 2007. 1;109:820-31.

[12] Vera-Llonch M, Oster G, Hagiwara M, Sonis S. Oral mucositis in patients undergoing radiation treatment for head and neck carcinoma. Cancer 2006;106:329-36.

[13] Elad S, Bowen J, Zadik Y, Lalla RV, Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). Development of the MASCC/ISOO Clinical Practice Guidelines for Mucositis: Considerations underlying the process. Support Care Cancer 2013;21:309-12.

Assessment of oral mucositis during concurrent chemoradiation of head and neck cancers using patient-reported measurement scale

Abstract

Abstract

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