OBJECTIVE To evaluate the occurrence and severity of oral complications, number of radiotherapy (RT) interruptions and quality of life (QoL) in a population of head and neck cancer patients receiving a preventive oral care program (POCP) and photobiomodulation therapy (PBMT). METHODS Prospective cohort of 61 head and neck cancer patients undergoing radiochemotherapy were monitored and submitted to a POCP that included oral hygiene and plaque control, removal of infection foci, dental restorations, periodontal therapy, fluorotherapy, oral hydration, and denture removal at night, combined with daily PBMT. Outcomes included occurrence of adverse effects such as severity of oral mucositis (OM) and oral symptoms (pain, solid and fluid dysphagia, odynophagia, dysgeusia), quality of life impacts, and interruptions of radiotherapy (RT) due to symptoms. Disease-free and overall survival rates were evaluated. RESULTS There was a significant improvement in oral health conditions between initial assessment and the two longitudinal assessments (p < 0.05), which indicates that the POCP was effective for plaque control and reduction of gingival inflammation. All participants were free of OM at the beginning of the RT regimen and only 45.9% after the 7th session, and few patients ranked the highest score of OM. For all symptoms related to OM, there was a progressive increase of severity until the 14th RT session, which remained stable until the completion of the RT regimen. The same effect was observed for the quality of life measures. Discontinued RT due to OM occurred in only three patients (5%), and the maximum duration was 10 days. The overall survival rate was 77% and disease-free survival was 73.8%. Lower survival time was observed for patients with no response to RT (p < 0.01). CONCLUSIONS The findings of this study suggest a positive effect of an oral preventive care program for head and neck cancer patients submitted to RT. The PBMT associated with a rigorous POCP resulted in satisfactory control of oral adverse effects, reduction of quality of life impacts, and interruption of RT regimen due to severe OM.

中文翻译：

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一项针对预防性口腔护理方案的头颈癌患者口腔不良反应的前瞻性研究。

目的评估接受预防性口腔护理计划（POCP）和光生物调节疗法（PBMT）的头颈癌患者群体中口腔并发症的发生和严重程度，放疗（RT）中断次数和生活质量（QoL）。方法对61例接受放射化学疗法治疗的头颈癌患者的前瞻性队列进行监测，并将其提交给POCP，包括口腔卫生和菌斑控制，感染灶的清除，牙齿修复，牙周治疗，荧光疗法，口服水合和夜间义齿清除，综合每日PBMT。结果包括不良反应的发生，例如口腔粘膜炎（OM）的严重程度和口腔症状（疼痛，固体和液体吞咽困难，吞咽困难，消化不良），生活质量影响以及症状引起的放疗中断（RT）。评估无病生存率和总生存率。结果在初步评估和两次纵向评估之间，口腔健康状况有了显着改善（p <0.05），这表明POCP可有效控制斑块并减少牙龈炎症。在RT方案开始时，所有参与者均无OM，在第7届会议后仅45.9％，并且很少有患者获得OM最高评分。对于所有与OM相关的症状，直到第14次RT疗程，严重程度都会逐渐增加，直到RT疗程完成才保持稳定。在生活质量测量中观察到了相同的效果。仅3名患者（5％）发生了因OM导致的RT中断，最长持续时间为10天。总体生存率为77％，无病生存率为73.8％。对RT无反应的患者观察到较低的生存时间（p <0.01）。结论本研究的结果表明口服预防性护理计划对接受RT治疗的头颈癌患者有积极作用。与严格的POCP相关的PBMT可以令人满意地控制口服不良反应，降低生活质量的影响以及由于严重OM而中断RT方案。