Pretreatment assessment and dental management of patients with nasopharyngeal carcinoma.

Patients who present with nasopharyngeal carcinoma (NPC) require through oral and dental assessment prior to treatment of the malignancy. We assessed the oral status of 57 consecutive patients with a diagnosis of NPC. In this study, identified risk factors for NPC were seen to be different in Asian versus non-Asian patients. Epstein-Barr virus seropositivity was seen in all Asian patients and in 69% of non-Asian patients (P = 0.00006), and reported alcohol use was greater in the non-Asian patients. In this study it was found that 68% of dentate patients required dental extractions primarily due to periodontal disease. Even in patients who reported receiving regular dental care (28%) extractions prior to radiation therapy were suggested. Oral complications of radiation therapy were reported by 84% of patients, with the most common being xerostomia. Clinical diagnosis of candidiasis (16%), rampant caries (10% of dentate patients) and difficulties with dentures (25% of denture wearers) were noted. In addition to pretreatment assessment, continuing oral and dental management is needed for patients with NPC.

Assessment of epidermal growth factor in oral secretions of patients receiving radiation therapy for cancer.

Biological response modifiers have been studied in animal models of oral mucositis. We assessed the presence of epidermal growth factor (EGF) in patients during radiation therapy for head and neck cancer. The findings of this preliminary study showed that it is possible to measure the presence of EGF in oral secretions during radiation therapy. EGF was shown to decrease during the course of radiation therapy, and a trend was seen with decreasing EGF and increasing oral ulceration (P = 0.10) and increasing total mucositis score (P = 0.09).