title: Professional oral health care reduces oral mucositis pain in patients treated by superselective intra-arterial chemotherapy concurrent with radiotherapy for oral cancer.
abstract: OBJECTIVE
  Oral mucositis (OM) is a painful complication of radiation therapy (RT) for head and neck cancer. OM can compromise nutrition, require opioid analgesics and hospitalization for pain control, and lead to interruption of treatment. Severe oral mucositis appears inevitable in superselective intra-arterial chemotherapy concurrent with radiotherapy (SSIACRT), requiring management of OM for the patient. The objective of this study was to assess the utility of professional oral health care (POHC) for the management of OM in patients undergoing SSIACRT.
  
  
  METHODS
  Thirty-three patients were enrolled in this study. The first 17 patients underwent SSIACRT before we created an oral management team, and thus did not receive POHC. The remaining 16 patients received POHC. Fever duration, duration of oral feeding difficulty, opioid usage, duration of opioid administration, duration of hospitalization, and number of hospital days from the end of irradiation to discharge were compared between these two groups.
  
  
  RESULTS
  Median total dose of morphine during SSIACRT, median number of hospital days from end of irradiation to discharge, and duration of hospitalization all differed significantly between groups (P < 0.05). Duration of opioid administration, fever duration, and duration of oral feeding difficulty did not differ significantly between groups.
  
  
  CONCLUSIONS
  These findings indicate that POHC may reduce opioid use and shorten the hospital stay. Such results might be obtained through infection control by POHC. This report appears to be the first study to evaluate the efficiency of POHC in SSIACRT for oral cancer from the perspective of mucositis pain and opioid use.
authors.affiliation: Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan. kkubota@hirosaki-u.ac.jp.
authors.forename: Kosei
authors.initials: K
authors.lastname: Kubota
authors.affiliation: Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Kobayashi
authors.affiliation: Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Sakaki
authors.affiliation: Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakagawa
authors.affiliation: Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Kon
authors.affiliation: Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan.
authors.forename: Mayu
authors.initials: M
authors.lastname: Mimura
authors.affiliation: Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan.
authors.forename: Ryohei
authors.initials: R
authors.lastname: Ito
authors.affiliation: Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Furudate
authors.affiliation: Department of Dentistry and Oral Surgery, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, 036-8562, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Kimura
mesh_terms: D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005334:Fever / Q000150:complications; D006801:Humans; D007269:Injections, Intra-Arterial; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000627:therapeutic use; D009062:Mouth Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D052016:Mucositis / Q000150:complications / Q000473:pathology / Q000517:prevention & control*; D009909:Oral Health; D009910:Oral Hygiene / Q000379:methods*; D010146:Pain / Q000150:complications / Q000188:drug therapy / Q000517:prevention & control*; D012189:Retrospective Studies; D013280:Stomatitis / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*
chemical_list: D000701:Analgesics, Opioid; D000970:Antineoplastic Agents; D009020:Morphine
keywords: Opioid; Oral cancer; Oral mucositis; Professional oral health care; Superselective intra-arterial chemotherapy concurrent with radiotherapy