Departmental Papers (Dental)

Document Type

Journal Article

Date of this Version

1-2013

Publication Source

Lasers in Surgery and Medicine

Volume

45

Issue

1

Start Page

22

Last Page

27

DOI

10.1002/lsm.22111

Abstract

Background and Objective Oral mucositis (OM) is a common and severe complication of many cancer therapies. Currently, prediction and early detection are not possible and objective monitoring remains problematic. Goal of this prospective study is to assess non-invasive imaging using optical coherence tomography (OCT) for early detection and evaluation of chemotherapy-induced OM in 48 patients, 12 of whom developed clinical mucositis. Study Design/Materials and Methods In 48 patients receiving neoadjuvant chemotherapy for primary breast cancer, oral mucosal health was assessed clinically, and imaged using non-invasive OCT. Images were evaluated for mucositis using an imaging-based scoring system ranging from 0 to 6. Conventional clinical assessment using the OM assessment scale (OMAS) was used as the gold standard. Patients were evaluated on Days 0-11 after commencement of chemotherapy. OCT images were visually scored by three blinded investigators. Results The following events were identified from OCT images (1) change in epithelial thickness and subepithelial tissue integrity (beginning on Day 2), (2) loss of surface keratinized layer continuity (beginning on Day 4), (3) loss of epithelial integrity (beginning on Day 4). Imaging data gave higher scores compared to clinical scores early in treatment, suggesting that the imaging-based diagnostic scoring was more sensitive to early mucositic change than the clinical scoring system. Once mucositis was established, imaging and clinical scores converged. Conclusion Using OCT imaging and a novel scoring system, earlier, more sensitive detection of mucositis was possible than using OMAS. Specific imaging-based changes were a consistent predictor of clinical mucositis. Lasers Surg. Med. 45: 22-27, 2013. © 2013 Wiley Periodicals, Inc. Copyright © 2013 Wiley Periodicals, Inc.

Keywords

Author keywords: cancer therapy, imaging, monitoring, oral diagnosis, oral mucosa, prediction MeSH: Antineoplastic Agents, Breast Neoplasms, Early Diagnosis, Female, Humans, Neoadjuvant Therapy, Predictive Value of Tests, Prospective Studies, Reproducibility of Results, Stomatitis, Tomography, Optical Coherence EMTREE drug terms: antineoplastic agent EMTREE medical terms:article, breast cancer, cancer adjuvant therapy, chemotherapy induced oral mucositis, clinical article, controlled study, diagnostic imaging, female, human, in vivo study, non invasive procedure, optical coherence tomography, oral mucositis, priority journal, prospective study, scoring system

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Date Posted: 10 February 2023

This document has been peer reviewed.