Abstract 3266: Oral rinse point of care test to predict head and neck cancer

Abstract Background: One of the common side effects of radiotherapy and chemotherapy in patients with head and neck cancer is oral mucositis. This painful complication restricts the ability to eat and drink and increases the risk of oral infections. The aim of this study was to investigate the effect of doxepin oral rinse 0.5% in comparison with persica mouthwash on reducing the pain of oral mucositis in patients with head and neck cancer after radiotherapy and chemotherapy. Methods: This clinical trial was performed on 56 patients admitted in the oncology ward of Shahid Sadoughi Hospital and Shahid Ramezanzadeh radiotherapy center in Yazd, who received more than 45 gray of radiation and had mucositis and their pain score was more than 4 on the basis of the Visual Analogue Scale (VAS). Patients were randomly divided into two groups of persica and doxepin 0.5%. The data collection tool was a questionnaire including visual analogue scale for pain, taste satisfaction and possible complications. Data were analyzed by using SPSS19 software and Chi-square test. Results: There was no significant difference between the mean score of pain in doxepin and persica groups 5,15,30, 120,240 minutes and 24 hours after taking the mouthwash; just in the doxepin group, the mean of pain reduction 60 minute after taking the mouthwash was higher than persica group (P> 0.05). There was no significant difference between the mean score of burning sensation in doxepin and persica groups30,60,120,240 minutes and 24 hours after taking the mouthwash; just in the pesica group, the mean of burning sensation reduction 5,15minutes after taking the mouthwash was lower than doxepin group The level of taste satisfaction and drowsiness in the doxepin group was significantly higher than persica group. (P >0.05) Conclusion: Persica mouthwash, like doxepin mouthwash, was effective in reducing the mucositis pain in patients and just in the doxepin group reduction in pain after 60 minutes was higher than perisca group

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eOutcomes-H&N: Development of an electronic point-of-care outcomes collection system for head and neck cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.31_suppl.247 ◽

2013 ◽

Vol 31 (31_suppl) ◽

pp. 247-247

Author(s):

Elizabeth Lockhart ◽

Eric Gutierrez ◽

Padraig Richard Warde ◽

Davin Dubeau ◽

Sophie Huang ◽

...

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Survival Data ◽

Web Application ◽

Point Of Care ◽

Physician Satisfaction ◽

Treatment Modalities ◽

Collection System ◽

The Impact

247 Background: Outcomes data increases the ability to understand the impact of cancer treatment and helps ensure that we direct appropriate investments to achieve improvements in quality of care. Cancer Care Ontario (CCO) has developed an outcomes data collection system for patients with head and neck cancer treated with radiotherapy. Methods: Clinicians involved in the care of these patients agreed on 5 key clinical outcomes to collect as a part of this initiative: local failure, regional failure, distant metastasis, second primaries, and treatment toxicity. Based on the Princess Margaret Hospital Head and Neck Cancer Anthology of Outcomes process, CCO has developed a similar system to collect outcomes data at the point-of-care on a provincial scale. The population-based provincial system aims to provide practice efficiencies and allow for evolution of the system in response to user feedback and expansion to other clinical areas. Results: The system includes a secure web application and iPad mobile application to facilitate the collection and management of outcomes data for head and neck cancer patients treated with radiotherapy in Ontario. Cancer centres upload patient clinic schedule details (including patient identifiers and appointment dates) prior to clinics. A list of patient summaries, including corresponding diagnosis, radiotherapy information and previously recorded outcomes is then generated. In clinic, physicians use these lists to capture outcomes noted at the point-of-care. Data captured are then transferred in real time to a secure central database. Following initial testing, the application was piloted to assess usability, system reliability, and overall satisfaction. Initial results show high physician satisfaction and no documented issues with system availability. Feedback has identified potential improvements and will inform future modifications. Conclusions: The identification of potential variation in recurrence, toxicity and survival data will inform the areas in which quality improvement initiatives or additional investments may be needed. The intent is to leverage project learnings for future outcomes initiatives in other diseases and treatment modalities.

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Reduction of Painful Oral Mucositis by Supersaturated Calcium Phosphate Oral Rinse in Head and Neck Cancer Patients Receiving Chemotherapy and Radiation

International Journal of Radiation Oncology*Biology*Physics ◽

10.1016/j.ijrobp.2008.06.1297 ◽

2008 ◽

Vol 72 (1) ◽

pp. S406 ◽

Cited By ~ 4

Author(s):

M.L. Haas ◽

T. Mercedes ◽

M.J. Manyak

Keyword(s):

Head And Neck Cancer ◽

Calcium Phosphate ◽

Head And Neck ◽

Cancer Patients ◽

Neck Cancer ◽

Oral Mucositis ◽

Oral Rinse

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Symptomatic treatment of radiation-induced mucositis in head and neck cancer: current practice, literature review and evidence-based recommendations

Journal of Radiotherapy in Practice ◽

10.1017/s1460396904000081 ◽

2004 ◽

Vol 4 (1) ◽

pp. 47-54 ◽

Cited By ~ 1

Author(s):

C. A. Pacitti

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Pharmaceutical Preparations ◽

Symptomatic Treatment ◽

Evidence Base ◽

Limiting Factor ◽

Evidence Based ◽

Oral Rinse ◽

Management Protocol

Background: Oro-pharyngeal mucositis is a common complication of radical radiotherapy for head and neck cancer and may be the major treatment dose-limiting factor. Symptomatic treatment, however, appears variable and often ineffective.Aim: To assess current UK practice, review published literature to assess the evidence base for current mucositis interventions and develop an evidence-based protocol for local use based on this knowledge.Methods: An open-ended, qualitative questionnaire was sent to twenty UK Radiotherapy Departments to provide a sample of the current use of symptomatic treatments, including analgesia. A literature search was conducted using Medline and Cochrane databases to provide an evidence-based recommendation for the development of an effective local management protocol.Results: Sixteen departments returned completed questionnaires (80% response rate). Eleven different pharmaceutical preparations were being used for symptomatic relief, with benzydamine (Difflam Oral Rinse) and Mucaine being the most commonly prescribed (in five departments each). Eleven different analgesics were being prescribed ranging from soluble aspirin to continuous infusion of diamorphine. The conclusion of a Cochrane Collaboration systematic review of the literature found weak or no evidence for the use of current interventions as effective agents for the relief or eradication of treatment-related mucositis.Conclusions: For such a common and important treatment toxicity, there is no consistent symptomatic management and there is no good evidence-base for the use of any of the presently prescribed medications. Clinical trials have involved small samples and little replication of studies. Evidence does exist for the importance of good oral hygiene before, during and after treatment, and this has formed the basis of our new departmental protocol with discontinuation of the use of commercial mouthwashes.

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