Management of Oral Mucositis during Radiotherapy for Head and Neck Cancer

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  • SOUTOME Sakiko
    Perioperative Oral Management Center, Nagasaki University Hospital
  • FUNAHARA Madoka
    Kyushu Dental University School of Oral Health Sciences
  • KAWASHITA Yumiko
    Perioperative Oral Management Center, Nagasaki University Hospital
  • UMEDA Masahiro
    Department of Clinical Oral Oncology, Nagasaki University Graduate School of Biomedical Sciences

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Other Title
  • 頭頸部がん放射線治療時の口腔粘膜炎に対するマネジメント
  • トウケイブ ガン ホウシャセン チリョウジ ノ コウコウ ネンマクエン ニ タイスル マネジメント

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Abstract

<p> Severe oral mucositis is one of the frequent adverse events in patients with head and neck cancer undergoing radiotherapy. However, a method to prevent oral mucositis has yet to be established. We describe the methods to treat oral stomatitis during head and neck cancer radiotherapy based on the MASCC/ISOO Guideline, and the authors’ findings regarding them. Further, concerning mouthwash use and topical steroid administration, related information and basic ideas of the authors are described.</p><p> We have performed the following management: 1) extraction of infected teeth before the start of radiotherapy; 2) spacer placement; 3) oral care; 4) administration of pilocarpine hydrochloride; 5) topical administration of dexamethasone ointment with olive oil; 6) skin care, consisting of cleaning and moisturizing; and 7) topical application of fluoride. Together, these approaches comprised a preventive bundle against adverse events following radiotherapy. Several years have passed since perioperative oral management become covered by public medical insurance in Japan, and it has become available at many hospitals. The prevention of adverse events during radiotherapy has come to be required for dentistry, but standardization of the management method and validation of evidence on effectiveness are future tasks. We consider it important to establish a method to reduce the severity of radiation oral mucositis by multicenter cooperative clinical research.</p>

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