Incidence of oral mucositis, its treatment and pain management in patients receiving cancer treatment at Radiation Oncology Departments in Spanish hospitals (MUCODOL Study).

ABSTRACT

OBJECTIVE: To estimate the incidence of oral mucositis (OM) in patients receiving radiotherapy, describe the treatments used to manage pain in OM grades 3 and 4 and assess relief of pain and patient satisfaction. PATIENTS AND METHODS: All patients older than 18 years consecutively attending a Radiation Oncology Department over 5 working days were included in a cross-sectional study. The data recorded were RTOG scale of OM (1, 2, 3 or 4), age and sex. In a second stage, a clinical cohort was followed for 2 months. Pain management was assessed in patients with grades 3 and 4. RESULTS: Two thousand and forty-seven patients (98.5%) from 55 participating centres were eligible for the fi rst stage. The overall risk of OM was 16.4% (95% CI 14.8- 18.1); prevalence was 26.4%. In the second stage, 282 (91.6%) of the patients recruited were eligible. At the baseline visit, 95.7% of the population had OM grade 3 and 4.3% grade 4. At two months, OM was resolved in 62.3%, grade 1 in 20%, grade 2 in 10.3% and grade 3 in only 7.4% (p<0.05). 98.9% of the patients had head and neck cancer. From baseline to the two-months session, reported pain fell from 96.1% of affected patients to 39.8%(p<0.01), while chronic pain increased (19.5% vs. 38.2%, p<0.05). Verbal scale OM pain intensity indicated intense pain at baseline in 42.2% and a mean visual analogue scale (VAS) score of 5.6 (2.3). Mean VAS scores fell significantly according to pain intensity due to the OM and cancer (p<0.01). CONCLUSIONS: Pain due to OM, a common complication of chemotherapy and radiation, limits nutritional intake and oral function. Analgesia protocols need to be assessed to improve the quality of life of these patients.