title: Incidence of oral mucositis, its treatment and pain management in patients receiving cancer treatment at Radiation Oncology Departments in Spanish hospitals (MUCODOL Study).
abstract: OBJECTIVE
  To estimate the incidence of oral mucositis (OM) in patients receiving radiotherapy, describe the treatments used to manage pain in OM grades 3 and 4 and assess relief of pain and patient satisfaction.
  
  
  METHODS
  All patients older than 18 years consecutively attending a Radiation Oncology Department over 5 working days were included in a cross-sectional study. The data recorded were RTOG scale of OM (1, 2, 3 or 4), age and sex. In a second stage, a clinical cohort was followed for 2 months. Pain management was assessed in patients with grades 3 and 4.
  
  
  RESULTS
  Two thousand and forty-seven patients (98.5%) from 55 participating centres were eligible for the fi rst stage. The overall risk of OM was 16.4% (95% CI 14.8- 18.1); prevalence was 26.4%. In the second stage, 282 (91.6%) of the patients recruited were eligible. At the baseline visit, 95.7% of the population had OM grade 3 and 4.3% grade 4. At two months, OM was resolved in 62.3%, grade 1 in 20%, grade 2 in 10.3% and grade 3 in only 7.4% (p<0.05). 98.9% of the patients had head and neck cancer. From baseline to the two-months session, reported pain fell from 96.1% of affected patients to 39.8%(p<0.01), while chronic pain increased (19.5% vs. 38.2%, p<0.05). Verbal scale OM pain intensity indicated intense pain at baseline in 42.2% and a mean visual analogue scale (VAS) score of 5.6 (2.3). Mean VAS scores fell significantly according to pain intensity due to the OM and cancer (p<0.01).
  
  
  CONCLUSIONS
  Pain due to OM, a common complication of chemotherapy and radiation, limits nutritional intake and oral function. Analgesia protocols need to be assessed to improve the quality of life of these patients.
authors.affiliation: Radiation Oncology Department, Hospital Universitario de La Paz, Madrid, Spain. amanas.hulp@salud.madrid.org
authors.forename: Ana
authors.initials: A
authors.lastname: Mañas
authors.forename: Amalia
authors.initials: A
authors.lastname: Palacios
authors.forename: Jorge
authors.initials: J
authors.lastname: Contreras
authors.forename: Isabel
authors.initials: I
authors.lastname: Sánchez-Magro
authors.forename: Pilar
authors.initials: P
authors.lastname: Blanco
authors.forename: Cristina
authors.initials: C
authors.lastname: Fernández-Pérez
mesh_terms: D000293:Adolescent; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000150:complications / Q000532:radiotherapy*; D006801:Humans; D015994:Incidence; D008297:Male; D010146:Pain / Q000209:etiology; D059408:Pain Management; D011446:Prospective Studies; D011832:Radiation Injuries / Q000453:epidemiology* / Q000628:therapy; D018570:Risk Assessment; D013280:Stomatitis / Q000453:epidemiology* / Q000628:therapy*