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التهاب المخاطية الفموية لدى مرضى سرطان الراس والعنق المعالجين بالاشعاع == Oral Mucositis In Patients Undergoing Radiotherapy For Head and Neck Cancer

اسم المؤلف: مروة ایاد نوري فتاح

اسم المشرف: خضير جاسم صبيح الرواق

الموضوع العام: الطب

السنة: 2017

الموضوع الدقيق: الاشعة العلاجية

الدرجة: دبلوم عالي

الجامعة: جامعة بغداد - كلية الطب

اللغة: الانكليزية

مكان الجامعة: بغداد

الصفحات الاولى: 📎 19T1332 - p.pdf

المستخلص: Radiotherapy (RT) is indispensable in treatment of Head and Neck Cancer (HNC); in spite of its associated complications. Oral mucositis (OM) is an important complication in HNC patients undergoing RT. OM is painful, may affect nutrition and quality of life. It decreases the patient’s willingness to continue treatment, and sometimes, it is a dose - limiting toxicity. It may lead to chronic complications. It also causes additional economic impact. This study aims to identify the incidence, distribution of OM, and its effect on treatment breaks in a section of HNC patients receiving RT in Iraq.Patients and MethodsThis is an observational, descriptive cross - sectional study. It included 50 patients with primary HNC, treated with External Beam Radiotherapy at the Oncology Teaching Center/ Radiation Therapy Department at the Medical City Complex - Baghdad, from 1st. January to 30th. April, 2017. All patients were assessed for occurrence of OM. Cases of OM were graded according to the World Health Organization scale. Data were collected in relation to; age, gender, smoking, sub - site of the tumor, stage of the tumor, type of therapy, and the unplanned breaks in treatment due to OM.ResultsThe mean age of the study population was 53.3 years (+/ - 11 SD). 80% of patients were below 65 years of age. Male; female ratio was 2.6 : 1. Main sub - sites of tumors were; nasopharynx (36%), larynx (22%) then parotid (14%) and tongue (12%).Seventy six percent of patients had chemotherapy and radiotherapy. 74% were smokers during or before starting RT. 86% of patients were in stages III or IV.Incidence of OM was 72%. (16% grade 1, 40% grade 2, and 16% grade 3).OM was more in ages < 35 years and in ages >/= 65 years. Least occurrence was among (45 - 54) years age group. OM occurred in 93% of females and 64% of males.OM occurred in 79% of patients who received RT plus CT. It occurred in 75 - 77% of patients of advanced stages of tumor.5Severe OM occurred more; among RT plus CT recipients and among smokers,The majority (47%) of OM cases in this population came from nasopharynx tumors, while larynx tumors contributed the least (3%).ConclusionsOM occurred in most of the HNC patients treated by RT. It occurred more in females, patients who receive CT plus RT, in tumors of oral cavity and nasopharynx. OM related unplanned breaks may interrupt the treatment schedule. HNC imposes double burden in Iraq as it attacks the productive age group. The vast majority of HNC are diagnosed in advanced stages. Multidisciplinary approach is recommended to manage HNC patients. Psychological support and patient education on oral care are essential needs.