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

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.

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.

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.

Clinical and sociodemographic factors that affect the quality of life of survivors of head and neck cancer.

OBJECTIVE: The present cross-sectional study evaluated the quality of life of patients treated with 3-D conformal radiotherapy for cancer of the mouth, oropharynx, hypopharynx, or larynx and investigated possible associations with clinical and sociodemographic variables using multivariate analysis. METHODS: The sample was composed of 90 patients who had completed treatment at least 3 months earlier. Data were collected from April 2016 to May 2017. The patients were clinically evaluated with regard to stimulated salivary flow, trismus, and radiation caries. Sociodemographic data and data related to the disease (stage, location of primary tumor, and radiation dose) were collected from the patient charts. Quality of life was assessed using the Brazilian version of the University of Washington Quality of Life (UW-QOL) questionnaire. Poisson logistic regression was performed to determine the mean ratio and test associations with the clinical and sociodemographic variables. RESULTS: The mean total of the UW-QOL was 814.88 (± 224.58). Patient age, staging of cancer, hyposalivation, and trismus were associated with quality of life. Patients with tumors in the advanced stage, those with hyposalivation and those with trismus respectively had 11% (CI 0.80-0.98), 12% (CI 0.79-0.99), and 15% (CI 0.77-0.94) lower UW-QOL scores, indicating poorer quality of life. CONCLUSION: Survivors of head and neck cancer experience a negative impact on quality of life associated with trismus, hyposalivation, advanced stage tumors, and a younger patient age. The present findings underscore the importance of a specific approach focused on these aspects to ensure better quality of life in the long term.

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.

Association between trismus and dysphagia-related quality of life in survivors of head and neck cancer in Brazil.

OBJECTIVES: The aim of this study was to evaluate the association between trismus and other radiation-associated conditions with dysphagia-related quality of life in patients who have undergone radiotherapy of the head and neck. STUDY DESIGN: This cross-sectional study included 88 patients who had squamous cell carcinoma of the oral cavity, oropharynx, hypopharynx, or larynx and had been treated with 3-dimensional (3-D) conformal radiotherapy, which had been completed at least 3 months earlier. Clinical data were obtained from medical records. Trismus, hyposalivation, and radiation caries were evaluated clinically. Dysphagia-related quality of life (DRQoL) was investigated by using the M. D. Anderson Dysphagia Inventory (MDADI). Binary logistic regression was performed to determine associations between DRQoL and both demographic and clinical variables. RESULTS: The mean total MDADI score was 67.33 ± 15.47, and the physical domain was the most affected (60.28 ± 19.00). Patients with cancer of the mouth and oropharynx had worse scores (P = .001). Trismus was associated with poorer DRQoL in all domains of the MDADI (P = .001) and with a greater chance of moderate to profound swallowing limitation (P = .024). CONCLUSIONS: Trismus and tumors located in the mouth and oropharynx were associated with poor swallowing function, exerting a negative impact on DRQoL.

Is Adhesive Bond Strength Similar in Primary and Permanent Teeth? A Systematic Review and Meta-analysis.

PURPOSE: To systematically review the literature on laboratory studies to determine whether the bond strength of adhesives to primary teeth is similar to that to permanent teeth. MATERIALS AND METHODS: This systematic review was conducted according to PRISMA and registered in PROSPERO (CRD42014015160). A comprehensive literature search was conducted considering in vitro studies published up to June 2015 in the PubMed/MEDLINE database, with no limit on year of publication. Two reviewers independently selected papers, extracted data and assessed the risk of bias. From 422 eligible studies, 42 were fully analyzed. Thirty-seven studies were ultimately included in the systematic review and meta-analysis. A global comparison was performed with a random-effects model at a significance level of p < 0.05, expressed by the difference of means between the groups. The mean bond strengths and standard deviations were tabulated and statistical analyses were conducted in RevMan 5.1 (The Cochrane Collaboration). RESULTS: There was a significant difference between groups, with permanent teeth presenting higher bond strength than primary teeth (p = 0.0005). When the enamel and dentin substrates were considered separately, dentin presented the same trend (p = 0.002), while for enamel there was no significant difference between the dentitions (p = 0.11). The majority of the studies had a high bias risk. CONCLUSION: Adhesives have higher bond strengths when applied to permanent than to primary teeth. This difference was also valid when the comparison was made between permanent and primary dentin.