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Oral and dental health status in patients undergoing neoadjuvant chemotherapy for locally advanced head and neck cancer

  • Kanchan P. Dholam
    Affiliations
    Professor and Head of Department, Department of Dental and Prosthetic Services, Homi Bhabha National Institute, Tata Memorial Hospital, Parel, Mumbai, India
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  • Madhura R. Sharma
    Correspondence
    Reprint requests: Dr Madhura SharmaHomi Bhabha National InstituteDepartment of Dental and Prosthetic ServicesTata Memorial Centre-Advanced Centre for TrainingResearch and Education in CancerSector 22Utsaw ChowkOwe Camp RoadNavi-MumbaiMaharashtra 410210India
    Affiliations
    Assistant Dental and Prosthetic Surgeon, Department of Dental and Prosthetic Services, Tata Memorial Centre – Advanced Centre for Treatment, Research, and Education in Cancer, Homi Bhabha National Institute, Kharghar, Navi Mumbai, India
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  • Sandeep V. Gurav
    Affiliations
    Professor, Department of Dental and Prosthetic Services, Homi Bhabha National Institute, Tata Memorial Hospital, Parel, Mumbai, India
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  • Gurkaran P. Singh
    Affiliations
    Assistant Professor, Department of Dental and Prosthetic Services, Homi Bhabha National Institute, Advanced Centre for Treatment, Research, and Education in Cancer, Tata Memorial Centre, Kharghar, Navi Mumbai, India
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  • Kumar Prabhash
    Affiliations
    Professor and Head of Department, Department of Medical Oncology, Homi Bhabha National Institute, Tata Memorial Hospital, Parel, Mumbai, India
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Published:August 02, 2021DOI:https://doi.org/10.1016/j.oooo.2021.07.018

      Objective

      A prospective, longitudinal assessment of oral and dental health status was done from baseline until treatment completion in patients scheduled to receive neoadjuvant chemotherapy (NACT) for locally advanced head and neck cancer (LAHNC).

      Study Design

      One hundred fifty consecutive, treatment-naïve adult patients with biopsy-proven LAHNC scheduled to receive NACT were recruited. One hundred thirty-five patients completed all assessments at 3 designated time points: baseline (T0), midtreatment (T1), and posttreatment (T2). Variables assessed were: Oral Hygiene Index-Simplified (OHI-S) score; decayed, missing, or filled teeth (DMFT) score; mucositis grade; pain score; and grade of trismus.

      Results

      Median OHI-S scores showed a statistically significant increase (higher the score, poorer the oral hygiene) when the patients were evaluated from baseline to completion of NACT (T1 vs. T2; T0 vs. T2; P < .001), which indicated a decrease in oral health. There was no change in median DMFT score (P = .32), but a significant change was seen in all-grade mucositis over time (P < .001). Median pain scores and trismus grades decreased significantly (P < .001) over time.

      Conclusions

      There was a decrease in oral health status without any change in dental health seen in patients undergoing NACT. Mucositis was initially noted as an aftermath of chemotherapy, which resolved with time.
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