Trismus and reduced quality of life in patients with oral squamous cell carcinoma, who received post-operative radiotherapy alone or combined with chemotherapy
Published Online: Jun 30, 2017
Page range: 29 - 36
Received: Jun 07, 2017
Accepted: Aug 23, 2017
DOI: https://doi.org/10.1515/fco-2015-0023
Keywords
© 2017 Evangelos Galitis, Vyron Droukas, Michail Tzakis, Vassileios Psarras, Dimitra Galiti, Eythymios Kyrodimos, Miltiadis Trichas, Amanda Psyrri, Nikolaos Papadogeorgakis, Maria Kouri, Evelina Belli, Vasileios Kouloulias
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Background
Patients, who receive radiotherapy (RT) for head and neck cancer, develop chronic functional abnormalities and survive with reduced quality of life.
Purpose
We aimed to study patients with oral cancer, who received post-operative radiotherapy or chemoradiotherapy.
Patients
Ten patients (mean age 63.8 years) were included.
Methods
Oral mucositis, pain and xerostomia, maximum mouth opening (MMO) and functional abnormalities before and after RT were recorded. The 35 mm MMO or less was accepted as trismus. Patients completed the EORTC QLQ C-30 and Head/Neck35 questionnaires.
Results
Mean RT dose was 64.3 Gray. Six patients received chemoradiotherapy. Severe mucositis, pain and xerostomia were recorded in 6 and 5 patients respectively. MMO was reduced in all patients. The mean MMO (34 mm) reached the level of trismus. The total number of symptoms increased from 3.1 to 6.3 in C-30 and from 3.1 to 8.8 per patient in the H/N35. Severe fatigue, pain, limitations at work, weakness, sad feelings, family problems, sleeping problems, anorexia, financial difficulties, tense/irritable, constipation, nausea, vomiting and depression were most often reported with C-30. Most patients reported low to moderate quality of life. Severe oral, jaw and neck pain, swallowing problems, taste alterations, sticky saliva, dry mouth, coarseness, dental problems, feeling sick and reduced interest in life/sex were the most common symptoms reported with N/H35.
Conclusions
The observed trismus, 2- to 3-fold increase of symptoms and poorer quality of life highlighted the need for support of oral cancer patients, who receive postoperative radiotherapy or chemoradiotherapy.