Prevalence of late oral effects after radiotherapy and correlation between oral dryness scores and salivary flow in head and neck cancer patients at UCI

Abstract

ABSTRACT Background: Head and neck cancers contribute significantly to the global cancer burden, with many patients receiving radiotherapy as part of their treatment. While radiotherapy improves disease control, it is associated with long-term oral complications such as dry mouth (xerostomia), reduced saliva production (salivary gland hypofunction), radiation-related dental caries, and difficulty in mouth opening (trismus), which negatively impact quality of life. In Uganda, the burden of these complications is not well documented. Objective: This study aimed to determine the prevalence of late oral complications following radiotherapy and to assess the relationship between the Clinical Oral Dryness Score (CODS) and unstimulated salivary flow rate among patients treated for head and neck cancer at the Uganda Cancer Institute. Methods: A cross-sectional study was conducted among seventy-four patients who had completed radiotherapy for head and neck cancer at least ninety days prior to the study. Data were collected through patient interviews, clinical examinations, and measurement of unstimulated salivary flow rate. Results: The study found a high prevalence of late oral complications, affecting ninety-four percent of participants. Dental caries affected eighty-eight percent of patients, fifty percent reported experiencing dry mouth (xerostomia), and sixty percent had reduced mouth opening of less than thirty millimeters (trismus). The average unstimulated salivary flow rate was 0.42 milliliters per minute, and the average Clinical Oral Dryness Score (CODS) was 4.5. A statistically significant moderate negative correlation (r = -0.4412, p = 0.001) was observed between CODS and unstimulated salivary flow rate. Conclusion: Late oral complications following radiotherapy are highly prevalent among patients with head and neck cancer. The Clinical Oral Dryness Score, used alone or together with measurement of unstimulated salivary flow rate, may be valuable in the clinical assessment of dry mouth (xerostomia) in this patient population