e-Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2021

Patient Reported Outcomes and Clinical Manifestations of Chemotherapy and Radiation Therapy-Related Mucositis. (#334)

Michelle Kang 1 2 , Aaron Pritchard 3 , Cheryl Bedford 1 , Terry Whittle 4 , Mark Schifter 1 4 , Melissa Burns 3 , Michael Veness 3 5 , Jennifer Curnow 5 6 , Purnima Sundaresan 3 5
  1. Department of Oral Medicine, Oral Pathology and Special Needs Dentistry, Westmead Centre for Oral Health, Sydney, NSW, Australia
  2. School of Dentistry and Medical Sciences, Charles Sturt University, Orange, NSW, Australia
  3. Radiation Oncology Network, Western Sydney Local Health District, NSW, Australia
  4. Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
  5. Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
  6. Department of Haematology, Westmead Hospital, Sydney, NSW, Australia

Background: Chemotherapy (CT)-induced oral/oropharyngeal mucositis (OM) is a manifestation of widespread mucosal inflammation, whereas radiation therapy (RT)-induced OM particularly affects irradiated mucosa. There is only limited research comparing clinical OM presentations and patient-reported outcome measures (PROMs).

Aims: To document the differences between CT-induced OM and RT-induced OM, as assessed by clinical presentation and PROMs.

Methods: Study participants were 10 patients with head and neck cancer receiving RT including the oral cavity/oropharynx and 20 patients undergoing CT conditioning for allogenic haematopoietic stem cell transplantation. OM was mapped and the severity scored using a modified Oral Mucositis Assessment Scale (OMAS). PROMs were collected using modified Oral Mucositis Daily and Weekly Questionnaires (OMDQ, OMWQ).  

Results: All CT participants reported no dysfunction with activities (sleep, swallowing, drinking, eating, talking) at baseline, which peaked in dysfunction severity at treatment week 2 before returning back towards baseline by week 6. In the RT group, all activities except sleep had a higher percentage of no dysfunction at week 1 compared to baseline. By treatment week 6, most or all RT participants reported an inability to perform all functions. There was a significant relationship between RT OMAS scores and all modified OMDQ questions (p=0.00), and between selected CT OMWQ questions and OMAS scores (p<0.05).

Conclusions: Differences in the trajectory of PROMs were observed between the RT and CT groups. The modified OMAS is a valid tool demonstrating a highly significant relationship with the modified OMDQ and OMWQ. Additionally, patient-reported dysfunctions due to OM-related mouth and throat soreness had a significant relationship with the clinical manifestations of CT and RT-related OM. The OMDQ and OMWQ provide an insight into the clinical severity of RT and CT-related OM, therefore have an important role in OM management and may optimise treatment outcomes for patients.