Background Few studies have examined health related Quality of Life (HR-QoL) during the treatment of head and neck cancer (HNC) with even fewer focusing on the impact of oral mucositis (OM) on HR-QoL. Studies performed during treatment of HNC makes it possible to follow fluctuations in HR-QoL, OM and other treatment related side effects. The aim was to prospectively analyze HR-QoL, changes in clinical variables and the impact of OM on HR-QoL during HNC treatment.Materials and methods Patients were recruited before commencing curative cancer treatment and were given professional oral care weekly during oncologic treatment. HR-QoL was reported before, during (week 2, 4 and 6) and three months after treatment using the EORTC Quality of Life questionnaires C30 and H&N35 and the stimulated whole salivary secretion rate was determined at the same time-points. OM (erythema and ulceration) was registered using the Oral Mucositis Assessment Scale (OMAS), at baseline, weekly during treatment and post treatment. Differences in HR-QoL between different timepoints were analyzed. To analyze the impact of OM on HR-QoL the patients were categorized into two groups: no/mild OM (OMAS ulceration score 0-1) or severe OM (OMAS ulceration score >= 2) and HR-QoL was compared between the two OM groups at three timepoints during treatment.Results Fifty-seven patients (43 men, 14 women), with a mean age of 58 years were included. Patients reported progressively impaired HR-QoL, with peak issues noted at weeks 4 and 6, particularly in social eating, senses, appetite loss, sticky saliva, and decreasing salivary secretion rates were determined. Patients with severe OM reported worse HR-QoL compared to those with no/mild OM. Persistent problems 3 months post treatment were appetite loss, dry mouth, senses (smell and taste) and problems with social eating.Conclusion Patients experienced exacerbated symptoms and problems weeks 4 and 6 of oncological treatment, especially among those with severe OM, stressing the importance of clinically monitoring the patients to reduce and alleviate their symptoms. Persistent problems three months post treatment are likely associated with the reduced salivary secretion rate indicating that patients should be monitored also after completed oncological treatment.

OBJECTIVE: To analyse sex differences in health-related quality of life (HRQL) before, during and up to 3 months posttreatment of head and neck cancer, and to examine the importance of salivary secretion rate for HRQL posttreatment.

METHODS: Patients were recruited before starting curative oncologic treatment. Clinical examinations were performed including determination of the stimulated salivary secretion rate. HRQL (EORTC C30 and HN35) was reported at baseline, weeks 2, 4 and 6 during treatment and 3 months after treatment.

RESULTS: A total of 56 men and 19 women were included. During treatment, men reported more problems with pain and sexuality, a higher use of painkillers and need for nutritional support during oncologic treatment, while women reported more problems with weight loss and dry mouth. At 3 months posttreatment, women reported more problems and symptoms than men with the highest scores noted for dry mouth, weight loss and sticky saliva. Patients with hyposalivation (≤ 0.7 mL/min) posttreatment reported more problems and symptoms compared with those with a secretion rate of > 0.7 mL/min, especially regarding dry mouth, sticky saliva and social eating (p < 0.001 for all three).

CONCLUSION: Problems and symptoms during and postoncologic treatment seem to differ between women and men, which must be taken into consideration by healthcare and dental professionals. Patients with hyposalivation posttreatment have more problems and symptoms and are therefore in greater need of supportive care.

Objective: To explore self-perceived oral health and general self-efficacy and relate this to dental plaque, gingival inflammation, and oral mucositis in head and neck cancer patients in Sweden, before, during, and three months after treatment.

Methods: Registration of clinical variables (dental plaque, gingival inflammation, and oral mucositis) was performed in 75 patients. The patients completed the self-perceived oral health (SPOH), and general self-efficacy (GSE) questionnaires at baseline, week 6 during treatment, and 3 months after treatment. Changes in clinical variables and answers to questionnaires between time-points were analyzed as well as differences between clinical variables and questionnaire data.

Results: The majority had low levels of plaque and gingival inflammation at all time-points, and oral mucositis occurred in 82%. Forty-three percent perceived their oral health as good at baseline, and the proportion decreased to 18% at week 6. At baseline, toothbrushing twice a day was reported by 95%, and daily interdental cleaning by 51%. The majority had high self-efficacy at all time-points. No statistically significant differences between self-perceived oral health and clinical variables were found.

Conclusion: Despite major challenges during cancer treatment, most patients had good oral hygiene, perceived their oral health as good, and had high self-efficacy.

Clinical relevance: This study contributes to increased knowledge about HNC patients' self-perceived oral health and ability to maintain good oral hygiene during cancer treatment. Such knowledge can be used in the development of customized oral care protocols, which in turn may have a positive impact on both oral health and quality of life.