Evaluation of radiotherapy-related oral complications and functional outcomes in patients with oral cavity carcinoma.

Authors

Mert Kutsal, Ozlem Ozkaya Akagunduz, Kaan Koca, Seray Koska, Mehmet Orman, Sema Becerik

Published in

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer. Volume 34. Issue 11. Oct 30, 2026. Epub Oct 30, 2026.

Abstract

Radiotherapy (RT), a major treatment modality for head and neck cancers, may cause oral complications such as mucositis, xerostomia, dysphagia, and taste dysfunction, negatively affecting patients' quality of life and treatment compliance. This study aimed to evaluate longitudinal changes in salivary flow and gingival crevicular fluid (GCF) volume and explore associations between RT-related oral complications and periodontal status, radiation dose, volumetric parameters, and tumor localization in patients with oral cavity cancer (OCC).
Fifty-two patients with OCC who underwent surgery and were scheduled for RT were enrolled in this prospective study. Of these, 28 completed the T1 assessment and were included in the longitudinal and oral complication analyses. Clinical periodontal examinations and saliva and GCF sampling were performed at baseline (T0) and eight weeks after RT initiation (T1). RT-related oral complications were monitored during the study period. Baseline demographic and clinical characteristics were compared between patients who completed and did not complete the T1 assessment to explore potential attrition-related differences. Statistical analyses included descriptive, comparative, and correlation analyses, with p < 0.05 considered statistically significant.
Among the 28 patients with paired measurements, GCF volumes (µL) were 50.80 ± 36.53 at T0 and 55.32 ± 36.31 at T1, while salivary flow rates (mL/min) were 0.34 ± 0.27 and 0.27 ± 0.26, respectively. Neither GCF volume (p = 0.655) nor salivary flow rate (p = 0.084) showed a statistically significant overall change. An exploratory analysis stratified by prescribed primary planning target volume (PTV) dose (62-64 Gy vs. 66-70 Gy) identified a significant time effect for salivary flow (p = 0.042), whereas no significant change was observed in GCF volume. Stratification by elective PTV dose (54-56 Gy vs. 58-60 Gy) revealed no significant longitudinal changes in GCF volume (p = 0.647) or salivary flow (p = 0.089). Among the 28 patients included in the oral complication analyses, mucositis was the most frequently observed complication (82.1%), predominantly Grade 1-2, followed by xerostomia (39.3%) and dysphagia (35.7%). No statistically significant differences were observed in the evaluated baseline characteristics between patients with and without T1 follow-up data (all p > 0.05).
Oral complications were frequently observed during RT in patients with OCC. Although an exploratory dose-stratified analysis identified a significant time effect for salivary flow, the findings should be interpreted cautiously because of the limited analytical sample, substantial loss to follow-up, incomplete complication data, and reliance on prescribed PTV doses rather than organ-at-risk dosimetry. Larger prospective studies with more complete follow-up and detailed dosimetric assessment are needed to clarify these associations.

PMID:
42961516
Bibliographic data and abstract were imported from PubMed on 31 Oct 2026.

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