Supportive dental therapy for cancer patients: management approach for preparation, treatment, and rehabilitation

Relevance. Malignant neoplasms of the oropharyngeal region are diagnosed at late stages (III–IV) in 66% of cases, which partially explains the high mortality from these diseases (26.7% of patients die within the first year after diagnosis). Supportive therapy (including dental support) is used to increase the effectiveness of combined antitumor treatment. Its key tasks are: to ensure continuity of therapy (reducing time due to the absence of breaks), preserve patients’ quality of life, increase indicators of average 5-year relapse-free survival, and improve the overall treatment prognosis. Dental support for oncology patients is a new direction, both in dentistry and oncology, including patient preparation for therapy, monitoring the oral cavity condition throughout treatment, and rehabilitation after its completion. The presented clinical example demonstrates all stages of dental support. Description of the Clinical Observation. A clinical case of a 74-year-old female patient diagnosed with squamous cell carcinoma of the hard palate mucosa pT4N0M0 G2 is described. She received postoperative radiation therapy (Total target dose 60 Gy) with carboplatin chemosensitization. Within the framework of dental support, the following was performed: training the patient on oral care rules before, during, and after the antitumor treatment, selection of individual hygiene products and medications for the prevention and treatment of chemoradiation reactions, fabrication of individual radioprotective mouthguards, local anti-inflammatory and regenerative therapy for oral complications, microbiological monitoring. Despite the development of grade II mucositis, systematic dental support allowed minimization of complications, prevention of secondary infection, and preservation of the dentoalveolar system’s functionality. Conclusion. Dental support for an oncology patient, including pre-radiation preparation, treatment, dynamic monitoring, and rehabilitation, contributes to reducing the toxicity of antitumor therapy, improves clinical outcomes and the quality of life of oncology patients. Interdisciplinary interaction between dentists, oncologists, and radiation therapists is a necessary condition for the effective management of this category of patients.
Keywords: oropharyngeal neoplasms, carcinoma squamous cell, mucositis, head and neck tumors, radiation therapy, combined chemotherapy protocols
Conflict of interest. The authors have no conflicts of interest.
Funding. Absent.