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Radiation Therapy and Oral Mucositis 放射線治療與口腔黏膜炎

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Radiation Therapy and Oral Mucositis 放射線治療與口腔黏膜炎

2024/4/23

Radiation therapy for the head and neck will cause oral mucositis, which emerges on the 3rd week after the start of radiation therapy. Smoking, drinking and betel nut chewing should be prohibited. 

Symptoms of Oral Mucositis

  • The oral submucosa is dry and swelling: including the lips, cheeks, jaw, and gingival mucosa.
  • Reduced and sticky saliva secretion. 

  • Excess and thick coating on the tongue with change in smell and texture.
  • Difficulty and pain with chewing and swallowing.

 

Treatment Method

  • Oral Hygiene Health: Clean the mouth about 6~8 times a day. Most importantly use soft toothbrush before and after eating, and before sleep. In case of no toothbrush, use Q-tip or oral cleaning stick to clean.
  • Denture may not fit well due to swollen gums. if it causes ulcers, stop wearing them to avoid infection.
  • Please follow dentist recommendation for use of fluoride gel.
  • Please cooperate with physician for use of prescribed mouthwash. Nystatin mouthwash: Can prevent and treat candidiasis. Use by medical advice and after cleaning the mouth, take 20-30c.c. to place in the mouth for 5 minutes before swallowing.
  • Use the straw to suck liquid food.
  • When feeling pain and could not eat, take the painkiller according to physician prescription.
  • Oral gel: Apply to the ulcer or wound after cleaning. Remember to clean the mouth and apply the medicine before the next application or spray.
  • The physician will prescribe mouthwash-type pain-relief liquid to rinse before eating or goggle in the mount for 10~15 minutes before cleaning the mouth in order to reduce pain and discomfort.
  • If the pain-relief liquid could not reduce pain and affects eating, the patients may consider using nasogastric tube or intravenous nutrient supplement if necessary.

Nutrition Instructions

  • Eat more food containing high protein such as milk, egg, fish, beans, and meat.  
  • Eat more food containing vitamin B such as rice with embryo, brown rice, grain rice, whole-wheat bread, deep-green vegetables, and low-fat milk.  
  • Eat more food containing vitamin C such as spinach, broccoli and other green vegetable and fruit (citrus, lemon, grapefruit, passion fruit, guava, strawberry, papaya, mango, kiwi, melon).  
  • Grind the food, cut into small pieces and wet the food to facilitate swallowing.  
  • Eat soft-texture food such as egg, vegetable oatmeal, milk, milk shake, pudding, sago with milk, ice cream; or cut food into smaller pieces and add more water in cooking.
  • Follow the medical advice to take glutamine in order to reduce oral mucosa ulcer and speed up mucosa repair. Take it for 2~3 times a day and add each packet of 10g (1 packet) to cold water or juice. Take it before or after the meal.
Reference
  • Liu, S., Zhao, Q., Zheng, Z., Liu, Z., Meng, L., Dong, L., & Jiang, X. (2021). Status of Treatment and Prophylaxis for Radiation-Induced Oral Mucositis in Patients With Head and Neck Cancer. Frontiers in oncology11, 642575. https://doi.org/10.3389/fonc.2021.642575
  • Zheng, Z., Zhao, X., Zhao, Q., Zhang, Y., Liu, S., Liu, Z., Meng, L., Xin, Y., & Jiang, X. (2021). The Effects of Early Nutritional Intervention on Oral Mucositis and Nutritional Status of Patients With Head and Neck Cancer Treated With Radiotherapy. Frontiers in oncology10, 595632. https://doi.org/10.3389/fonc.2020.595632
製作單位:放射腫瘤部 編碼:HE-RA002-E
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