The Journal of prosthetic dentistry · 2025
Longitudinal assessment of trismus in patients with advanced stage oral and oropharyngeal cancer.
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Dholam Kanchan P, Somani Priyanka, Gurav Sandeep, Dugad Jinesh, Kharade Pankaj, Rane Pallavi P, Singh Gurkaran Preet
Аннотация
STATEMENT OF PROBLEM: Trismus is a common treatment-related effect experienced by patients undergoing treatment for head and neck cancer. However, literature on the time-course relationship between the clinical parameters and magnitude of trismus in this cohort is sparse.
PURPOSE: The purpose of this clinical study was to evaluate longitudinal change in maximum incisal opening (MIO) and its interaction with tumor site and treatment modality in patients undergoing treatment for advanced stage oral and oropharyngeal cancer The secondary aim was to study change in dental caries experience and health-related quality of life (HRQoL).
MATERIAL AND METHODS: Seventy consecutive, adult, treatment-naïve patients with biopsy-proven squamous cell carcinoma (SCC) of the oral cavity and/or oropharynx were recruited in a longitudinal, convenience-cohort study from July 2022 to January 2023 at a tertiary care cancer center (Tata Memorial Hospital) in India. The patients received treatment as per the plan determined by a multidisciplinary tumor board. Study assessments were done at 3 time points: before treatment (T0), immediately after treatment (T1), and 6 months after treatment (T2). A linear mixed-effects model with aligned rank transformation (ART) was used to analyze the effects of time, site, and treatment, along with their interactions, on the primary outcome variable MIO. The Wilcoxon signed-rank test was used to compare corresponding HRQoL domains (α=.05).
RESULTS: Irrespective of tumor site and treatment modality, a significant longitudinal change was found in MIO and caries score (P<.001). Patients with oral tumors demonstrated worse outcomes than those with oropharyngeal lesions (P=.008). A high prevalence of immediate post-treatment trismus was noted in patients undergoing multimodality treatment (83%).
CONCLUSIONS: Patients undergoing treatment for advanced-stage oral and oropharyngeal cancer experience a varying burden of trismus and dental caries. Timely oral care by a dental oncologist, as an integral member of a multidisciplinary team, is essential to alleviate problems and restore quality of life.
PURPOSE: The purpose of this clinical study was to evaluate longitudinal change in maximum incisal opening (MIO) and its interaction with tumor site and treatment modality in patients undergoing treatment for advanced stage oral and oropharyngeal cancer The secondary aim was to study change in dental caries experience and health-related quality of life (HRQoL).
MATERIAL AND METHODS: Seventy consecutive, adult, treatment-naïve patients with biopsy-proven squamous cell carcinoma (SCC) of the oral cavity and/or oropharynx were recruited in a longitudinal, convenience-cohort study from July 2022 to January 2023 at a tertiary care cancer center (Tata Memorial Hospital) in India. The patients received treatment as per the plan determined by a multidisciplinary tumor board. Study assessments were done at 3 time points: before treatment (T0), immediately after treatment (T1), and 6 months after treatment (T2). A linear mixed-effects model with aligned rank transformation (ART) was used to analyze the effects of time, site, and treatment, along with their interactions, on the primary outcome variable MIO. The Wilcoxon signed-rank test was used to compare corresponding HRQoL domains (α=.05).
RESULTS: Irrespective of tumor site and treatment modality, a significant longitudinal change was found in MIO and caries score (P<.001). Patients with oral tumors demonstrated worse outcomes than those with oropharyngeal lesions (P=.008). A high prevalence of immediate post-treatment trismus was noted in patients undergoing multimodality treatment (83%).
CONCLUSIONS: Patients undergoing treatment for advanced-stage oral and oropharyngeal cancer experience a varying burden of trismus and dental caries. Timely oral care by a dental oncologist, as an integral member of a multidisciplinary team, is essential to alleviate problems and restore quality of life.