Patient and oncologist perceptions regarding symptoms and impact on quality-of-life of oral mucositis in cancer treatment: results from the Awareness Drives Oral Mucositis PercepTion (ADOPT) study.

PURPOSE: This descriptive cross-sectional survey aims to assess the level of concordance between the perspectives of oncologists and those of patients regarding oral mucositis (OM) symptoms, and the impact of OM on various aspects of daily living and concurrent cancer management. METHODS: Oncologists involved in OM management (n = 105), and patients who developed OM during cancer treatment (n = 175), were recruited from seven Asian countries. Oncologists completed a face-to-face, quantitative interview; patients completed a face-to-face interview, and a self-reported questionnaire. RESULTS: Oncologists and patients ranked treatment-induced OM among the three most important toxicities of cancer therapy requiring intervention. The most frequent OM symptoms reported by patients were oral ulcers (74%), dry mouth (73%), and difficulty swallowing (62%). Oncologists expected mild OM symptoms to last slightly longer than 1 week, whereas patients reported mild symptoms for more than 2 weeks. In mild-to-moderate OM, oncologists underestimated patients' pain experience. Overall, only 45% of oncologists said they would initiate OM prophylaxis when cancer therapy started. Of the 87% of patients who said they used their prescribed medications, only 16% reported using prophylactically prescribed medication. While oncologists' concerns related to the delays and interruptions of cancer treatment, patients tended to focus on the effects of OM on eating, drinking, and talking. CONCLUSIONS: Oncologists' and patients' perceptions about treatment-induced OM differ. To overcome discordant perspectives, there is a need to raise general awareness and improve proactive management of OM. As noted in recent guidelines, supportive cancer care is critical for ensuring optimal therapy and for improving the patient's experience.

A randomized, double-blind trial on the use of 1% hydrocortisone cream for the prevention of acute radiation dermatitis.

BACKGROUND: To determine whether the application of 1% hydrocortisone cream during radiation therapy can prevent the occurrence of moist desquamation. METHODS: Fifty adult female breast carcinoma patients were randomized after modified radical mastectomy and chemotherapy to receive prophylactic placebo cream (n = 27) or 1% hydrocortisone cream (n = 23) during radiation therapy. The patients, caregiver and assessor were all blinded to the treatment received. Occurrence of moist desquamation, severity of acute radiation dermatitis (ARD) and hyperpigmentation were evaluated weekly until the end of radiotherapy. RESULTS & CONCLUSION: Five patients in each group developed moist desquamation; however, its extent and severity were milder in the steroid group. Mean ARD scores were also lower in the steroid group (0.713 vs. 0.874, p = 0.024). A lower incidence of Grades 1 and 2 radiation dermatitis was also noted in the steroid group at weeks 2 and 4, respectively, indicating prophylactic use of steroids delayed the onset of radiodermatitis.

Globe positioning in the orbit among Filipinos scanned at the Philippine General Hospital from November 2009 to February 2010

OBJECTIVE: To determine normal Filipino values of globe positioning in the orbit using Computed Tomography. METHODS: 58 individuals were divided into age groups below 20 and 20 and above. CT images with constant settings were obtained. The distance between the lateral orbital rims (A), the shortest distance between line A and the corneal center (B), medial and lateral orbital rims (C),and the distance between line C and the corneal apex crossing the center of the lens (D) were measured, and the BIA and D/C ratios calculated. The mean, median, and range in millimeters were grouped in terms of age, sex,and laterality. RESULTS: Between the age groups, there was a significant difference in the average values of A, B,and C, but not the B/A and D/C ratios. Gender comparison for group 2 showed statistical difference in the average values of Band C,but not the A, D, BIA and D/C ratios. All the parameters in both groups showed no significant difference when the right and left eyes were compared. CONCLUSION: Age group comparison showed statistically significant difference in the average values of A, B,and C which may be attributable to growth changes. Gender comparison in group 2 showed significant difference in Band C. Males had a greater degree of protrusion than females. The right and left eye showed no significant difference in any of the measured parameters. Throughout the study, both BIA and D/C ratios showed no significant difference among gender and age suggesting that such ratios may be used as an index for setting normal globe positioning in the orbit.