Supervisors info:
Δρ Ουρανία Νικολάτου - Γαλίτη: Καθηγήτρια και Διευθύντρια Κλινικής Νοσοκομειακής Οδοντιατρικής, Οδοντιατρική Σχολή Πανεπιστημίου Αθηνών
Δρ Κωνσταντίνος Τσιχλάκης: Καθηγητής και Διευθυντής, Κλινική Διαγνωστικής και Ακτινολογίας Στόματος, Οδοντιατρική Σχολή Πανεπιστημίου Αθηνών
Δρ Νικόλαος Παπαδογεωργάκης: Καθηγητής και Διευθυντής, Κλινική Στοματικής και Γναθοπροσωπικής Χειρουργικής, Οδοντιατρικής Σχολής του ΕΚΠΑ
Summary:
Oral complications and quality of life in lung cancer patients with cachexia.
Chatzichalepli Ch.1, Nicolatou – Galitis O.1, Tsiklakis K2, Papadogeorgakis N.3
1Dentist - Postgraduate student, Clinic of Hospital Dentistry, Dental School of Athens, Greece
2Professor & Head, Clinic of Hospital Dentistry, Dental School of Athens, Greece
3Professor & Head, Department of Oral Diagnosis & Radiology, Dental School of Athens, Greece
4Professor & Head, Department of Oral & Maxillofacial Surgery, Dental School of Athens, Greece
Introduction: Oral complications from cancer therapies are very common in cancer patients. Patients with advanced lung cancer and cachexia receiving chemotherapeutic agents, targeted therapies and antiosteoclastic agents could appear with side effects in the oral cavity resulting in deterioration of their quality of life.
Purpose: The purpose of this study is to report the oral complications and evaluate the quality of life of patients with lung cancer and cachexia.
Patients and Methods: Patients with lung cancer and cancer cachexia were chosen to participate in the study. The patients were hospitalized in the Oncology Unit of the Third Department of Internal Medicine of the General Hospital for Thoracic Diseases "Sotiria". Initially, epidemiological data, subtype of disease (NSCLC / SCLC) and antineoplastic therapy were recorded for each patient. Secondly, clinical examination of the oral cavity was performed recording the following: i) levels of oral hygiene under simplified oral hygiene index (OHI-S), ii) findings from teeth and periodontium and iii) findings from oral mucosa and jawbones. Then the patients completed the OH-17 and C30 quality of life questionnaires of the European Organisation for Research and Treatment of Cancer (EORTC). A follow up within the period of two months was carried out following the exact same procedure as the first examination.
Results: Twenty-one patients (17/4: men / women) with lung cancer and cachexia, and the average age of 68.5 years participated in the initial examination. Eighteen patients (86%) had NSCLC and three (14%) SCLC. The mean average of the simplified oral hygiene index was 3. Three patients (14.3%) experienced caries, periodontal three problems with tooth mobility and inflammation of periodontal tissues (14.3%) and two patients (23.8%) caries and periodontal problems simultaneously. The findings of the mucosa and jaw were osteonecrosis of the jaws: 1 patient (4.8%), oral candidiasis: 3 (14.3%), xerostomia: 4 (19.1%) and mucositis: 8 (38.1%).
The main results of the questionnaire OH-17 included the following: subjective feeling of xerostomia: 18 patients (85.7%), difficulty in enjoying meals: 18 patients (85.7%), taste alterations: 13 patients (61.9%) while twelve (57.1%) reported sticky saliva and 11 patients (52.4%) problems in food consumption. Other symptoms such as lip sores / syncheilitis, sensitivity of the oral mucosa and gingival bleeding were reported from 9.5% up to 38.1% of patients.
The main symptoms reported by questionnaire C30 for quality of life have been the following: fatigue had 19 patients (90.5%), sadness: 17 patients (81%), the physical pain: 16 patients (76.2%), anorexia 15 patients (61.9%) and depression: 13 patients (61.9%).
The follow up was carried out withiin two months in eight (38.1%) out of 21 patients. Eleven (52.4%) died shortly after the initial examination, one (4.8%) did not come back in the hospital and one was hospitalized in a serious condition (4.8%). Of all the patients in the follow up seven (87.5%) had NSCLC and one (12.5%) SCLC. The average of the simplified oral hygiene index (OHI-S) was 4.6. Two patients (25%) appeared with decay and periodontal problems. Findings from the mucosa and jawbones were mucositis in a patient (12.5%) and xerostomia (12.5%) in another patient. The results of the OH-17 questionnaire showed that seven patients had difficulty to enjoy their meals (87.5%), four patients experienced dry mouth (50%), four (50 %) difficulties in enjoying food as well as four had taste alterations (50%). Also three patients (37.5%) had oral sensitivity, gingival pain and teeth problems. The C30 questionnaire’s main findings were fatigue in seven patients (87.5%), anorexia in six patients (75%) while five patients (62.5%) stated that they had sadness and four patients (50%) had nerves. Depression was reported by 4 patients (50%) and physical pain 4 patients (50%).
Conclusion: The oral complications were common in both examinations and in combination with the subjective symptoms of the oral cavity could lead to deteriorations of the quality of life in patients with lung cancer and cachexia.
Keywords:
oral complications, cancer, lung cancer cancer cachexia, osteonecrosis of the jaw, oral health & quality of life, mucositis
