e-Poster Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2020

Health Professionals’ Perceptions Regarding Chemotherapy and/or Radiation Therapy Related Mucositis (Mucosal Barrier Injury). (#338)

Michelle Kang 1 2 , Aaron Pritchard 3 , Cheryl Bedford 1 , Melissa Burns 3 , Mark Schifter 1 2 , Terry Whittle 2 , Michael Veness 3 4 , Jennifer Curnow 4 5 , Purnima Sundaresan 3 4
  1. Department of Oral Medicine, Oral Pathology and Special Needs Dentistry, Westmead Centre for Oral Health, Sydney, NSW, Australia
  2. Sydney Dental School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
  3. Radiation Oncology Network, Western Sydney Local Health District, NSW, Australia
  4. Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
  5. Department of Haematology, Westmead Hospital, Sydney, NSW, Australia

Background: Oral/oropharyngeal mucositis (OM) may be caused by certain chemotherapy (CT) agents and radiation therapy (RT) to mucosal structures. CT-induced OM is usually a manifestation of widespread mucosal inflammation, whereas RT-induced OM only affects irradiated mucosa. Health professionals (HPs) may have a varied understanding of OM.

Aims: Determine HPs’ perceptions of OM, including clinical presentation of CT-induced vs RT-induced OM, its assessment and management.

Methods: HPs involved in the care of head and cancer (HNC) patients receiving RT to the oral cavity/oropharynx and bone marrow transplant (BMT) patients receiving mucositis-inducing CT regimens were invited to participate in a custom 20-question online survey. Themes included OM presentation, assessment tools and management.

Results: The study had an 81.4% response rate. Most were nurses (33%) and specialist doctors/dentists (25%). Majority (45%) identified as part of the Haematology service, followed by Radiation Oncology (32%). Most Haematology and Radiation Oncology HPs (89% and 70% respectively) agreed/strongly agreed that OM impacted patients’ ability to complete treatment. There was a strong association (p<0.01) between HPs’ specialty and their perceptions of OM manifestations. Most Radiation Oncology (85%) and all Oral Medicine HPs agreed/strongly agreed that clinical manifestations of CT-induced OM and RT-induced OM were different, whereas Haematology HPs varied in their perceptions (11% disagreed, 41% were neutral and 48% agreed/strongly agreed). There was uncertainty regarding differences in management of CT vs RT-induced OM: 30% of Haematology HPs and 45% Radiation Oncology HPs agreed/strongly agreed but most (52% and 45% respectively in each group) responded “neutral”.

Conclusions: OM was recognised to adversely impact BMT and HNC RT patients’ ability to complete treatment. There were differences in HPs’ perceived understanding of OM manifestations and management. Interventions to address these may reduce unwanted variations in patient care and outcomes, such as when HPs rotate between services or provide cross-disciplinary care.