Postradiotherapy Evaluation of Patients Treated for Head and Neck Tumours

Objectives: To evaluate the oral health consequences of radiotherapy in patients treated between 1999 and 2003 for head and neck tumors. One-hundred patients (24 women, 76 men) ranging in age from 30 to 83 years (mean: 59 years) were examined. The mean time of evaluation since radiotherapy was 28 months (1 to 68 months). The total mean radiation dose was 5,955 cGy. Methods: Evaluation consisted of anamnesis, physical examination, measurement of stimulated salivary flow and salivary pH, and panoramic x-rays. Results: Symptoms reported by the patients included dry mouth in 68%, dysphagia in 38%, and dysgeusia in 30%. The mean stimulated salivary flow rate was less than 0.7 ml/min. The mean salivary pH was 6.971 (± 0.714). Stimulated salivary flow increased with increasing postradiotherapy time (p<0.05). The prevalence of mucositis was associated with higher radiation doses (p<0.05), and the prevalence of atrophic candidiasis was related to a longer post-treatment period (p<0.05). Two cases of second primary tumours were diagnosed 23 and 72 months after radiotherapy, respectively. No case of osteoradionecrosis was observed and the frequency of radiation caries was low. Conclusion: The most influence of the radiotheraphy in head and neck region was the decrease of salivary flow rate even though our study demonstrated that there was a modest late improvement of the salivary flow.