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Oral rehabilitation and quality of life in head and neck cancer patients receiving dental clearance prior to radiotherapy: a retrospective observational study

M. H. I. Veld,Frank K J Leusink,Chayenne N Chhangur,Naichuan Su,F. Jansen,M. Vergeer,I. V. Leeuw,E. Schulten

Published 2025 in Supportive Care in Cancer

ABSTRACT

This retrospective observational study examined oral rehabilitation and the total oral rehabilitation time (TORT) in head and neck cancer patients (HNC) who underwent full dental clearance before intensity-modulated radiotherapy (IMRT). Additionally, it assessed changes in health-related quality of life (HRQoL) before and after IMRT and oral rehabilitation. HNC patients with HRQol data who underwent full dental clearance before IMRT in Amsterdam UMC between 2008 and 2021 were included. The EORTC QLQ-C30 and QLQ-H&N35 were used to assess HRQoL before dental clearance at baseline (T0), after dental clearance and IMRT (T1), after oral rehabilitation with conventional dentures (T2), and after oral rehabilitation with implant-retained overdentures (T3). HRQoL data were available for 28 patients at T0, T1, and T2; all received conventional dentures (TORT 13.5 months; range 4.8–64.0). Five also received implant-retained overdentures (TORT 29.8 months; range 25.8–31.5). Role and cognitive functioning declined at T1 vs. T0 (p < 0.01, p = 0.01), while emotional functioning improved (p < 0.01). HRQoL symptoms increased significantly at T1 vs. T0, including taste and smell, social contact troubles, and dry mouth. At T2, oral pain, supplement use, and weight gain decreased significantly (p = 0.05, p = 0.02, p < 0.01), while teeth and financial problems (p = 0.01, p = 0.04) increased compared to T1. All HNC patients in this study underwent dental clearance before IMRT and received oral rehabilitation with conventional dentures, with a mean TORT of over a year. Patients after oral rehabilitation had less oral pain but more problems with teeth and finances. Large prospective cohort studies are needed to confirm these findings.

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