Prevalence of hyposalivation and associated factors in survivors of head and neck cancer treated with radiotherapy

Abstract Hyposalivation and sensation of dry mouth (xerostomia) are one of the most common adverse effects in the treatment of patients with head and neck cancer. Objective: This study evaluates the prevalence of late hyposalivation and associated factors in survivors of squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx treated with radiotherapy with or without concomitant chemotherapy. Methodology: A cross-sectional study was conducted with 88 patients who had concluded radiotherapy at least three months before the study, at a referral center for the treatment of head and neck cancer in the Southern region of Brazil. Hyposalivation was evaluated based on the stimulated salivary flow rate using the spitting method. Multivariate analysis using binary logistic regression was performed to determine the associations between hyposalivation and clinical and demographic variables. Results: Hyposalivation was found in 78.41% of the sample and the mean radiation dose was 63.01 Gy (±9.58). In the crude model of the multivariate analysis, hyposalivation was associated with higher doses of radiation (p=0.038), treatment with concomitant radiotherapy and chemotherapy (p=0.005), and time elapsed since the end of radiotherapy (p=0.025). In the adjusted model of the multivariate analysis, hyposalivation was only associated with dose and time elapsed. Patient who received higher doses of radiation had a 4.25-fold greater chance of presenting hyposalivation, whereas a longer time elapsed since the end of radiotherapy exerted a 75% protective effect against the occurrence of hyposalivation. Conclusion: Hyposalivation is a highly prevalence late-onset side effect of radiotherapy in patients treated for head and neck cancer, with a greater chance of occurrence among those who received higher doses of radiation and those who ended therapy less than 22 months before our study. Concomitant chemotherapy and radiotherapy does not seem to increase the chances of hyposalivation compared to radiotherapy alone.

Effect of the sense of coherence and associated factors in the quality of life of head and neck cancer patients

Abstract The sense of coherence (SOC) is a measure of global orientation regarding the ability of individuals to cope with stressful situations. The aim of the present study was to evaluate the association between SOC and quality of life (QoL) and clinical and sociodemographic characteristics among survivors of oral, oropharynx, hypopharynx, or larynx cancer. A cross-sectional study was conducted with 90 cancer patients in follow up at the Santa Maria University Hospital in southern Brazil who had completed conformal 3D radiotherapy at least three months earlier. QoL was assessed using the University of Washington Quality of Life (UW-QOL) questionnaire and SOC was measured using the Brazilian version of the SOC-13 questionnaire. Data on socio-demographic characteristics and the disease were obtained from patients' charts. Oral clinical conditions were also evaluated. Associations between exploratory variables and mean UW-QOL scores were evaluated through Poisson regression and the results were presented as rate ratios (RR) and 95% confidence intervals (CI). The mean overall UW-QOL score was 67.90 (± 18.71). Moderate and high SOC scores were associated with higher mean UW-QOL scores, that is, individuals with a stronger SOC demonstrated better QoL, (p < 0.05). Regarding the clinical variables, individuals with advanced stage cancer and those with hyposalivation and trismus had poorer QoL (p < 0.05). Patients with a greater SOC reported a better quality of life. Our findings show the importance of focusing on psychosocial factors, which can alleviate the impact caused by the disease and improve the QoL of these patients.

Effect of the sense of coherence and associated factors in the quality of life of head and neck cancer patients

Abstract The sense of coherence (SOC) is a measure of global orientation regarding the ability of individuals to cope with stressful situations. The aim of the present study was to evaluate the association between SOC and quality of life (QoL) and clinical and sociodemographic characteristics among survivors of oral, oropharynx, hypopharynx, or larynx cancer. A cross-sectional study was conducted with 90 cancer patients in follow up at the Santa Maria University Hospital in southern Brazil who had completed conformal 3D radiotherapy at least three months earlier. QoL was assessed using the University of Washington Quality of Life (UW-QOL) questionnaire and SOC was measured using the Brazilian version of the SOC-13 questionnaire. Data on socio-demographic characteristics and the disease were obtained from patients' charts. Oral clinical conditions were also evaluated. Associations between exploratory variables and mean UW-QOL scores were evaluated through Poisson regression and the results were presented as rate ratios (RR) and 95% confidence intervals (CI). The mean overall UW-QOL score was 67.90 (± 18.71). Moderate and high SOC scores were associated with higher mean UW-QOL scores, that is, individuals with a stronger SOC demonstrated better QoL, (p < 0.05). Regarding the clinical variables, individuals with advanced stage cancer and those with hyposalivation and trismus had poorer QoL (p < 0.05). Patients with a greater SOC reported a better quality of life. Our findings show the importance of focusing on psychosocial factors, which can alleviate the impact caused by the disease and improve the QoL of these patients.