Kemoterapi ve Radyoterapi Uygulanan Baş-Boyun Kanserli Hastalarda Mukozit Yönetimine Yönelik Kullanılan Oral Ajanların Retrospektif Olarak İncelenmesi

Yıl 2017, Cilt: 4 Sayı: 1, 15 - 27, 18.05.2017

Kübra Çıtlak Sevgisun Kapucu

Öz

Amaç: Bu araştırma kemoterapi ve radyoterapi uygulanan baş-boyun kanserli hastalarda mukozit yönetimine yönelik kullanılan oral ajanların incelenmesi amacıyla retrospektif tanımlayıcı olarak yapılmıştır. Gereç ve Yöntem: Çalışma Dr. Abdurrahman Yurtaslan Onkoloji Eğitim ve Araştırma Hastanesi Radyasyon Onkolojisi Kliniğinde yürütülmüştür. Araştırmanın örneklemini tanı konduktan sonra tedavi amaçlı planlanmış kemoterapi ve radyoterapi kürü almak için Mayıs 2012-Mayıs 2015 tarihleri arasında klinikte yatışı olan 46 hastanın hastane kayıtları oluşturmuştur. Veriler araştırmacı tarafından geliştirilen dosya inceleme formu kullanılarak toplanmış olup, hasta dosyalarında var olan DSÖ Oral Toksisite Skalasına göre değerlendirilmiş oral mukozit dereceleri bu forma eklenmiştir. Grup farklılıklarının belirlenmesinde Mann Whitney U ve Kruskal Wallis Testi, iki sayısal değişken arasındaki ilişkiye bakmak için Spearman korelasyon testi kullanılmıştır. Bulgular: Araştırmaya alınan baş-boyun kanserli hastaların %39.1’inin 61 yaş ve üzeri, %84.8’inin erkek, %45.7’sinin ise larenks kanseri olduğu belirlenmiştir. Tedavi sürecinde hastaların %13’ünde mukozit görülmez iken, %30.4’ünde Grade 2, %26’sında Grade 3 ve %17.3’ünde Grade 4 seviyesinde oral mukozit görülmüştür. Hastaların %4.4’ünde grade 2 oral mukozitte sukralfat-lidokain karışımı, %6.6’sında grade 3 oral mukozitte nistatin+klorheksidin+L-Glutamin kombinasyonu, %10.9’unda grade 4 oral mukozitte sadece oral L-Glutamin kullanıldığı saptanmıştır.
Sonuç: Araştırmadan elde edilen sonuçlar doğrultusunda; baş-boyun radyoterapisi alanlarda oral mukozit yönetiminde kullanılan ağız bakım ajanlarının etkinliğine ilişkin randomize kontrollü çalışmaların yapılması ve rehberlere göre etkinliği kanıtlanmış ağız bakım ajanlarınının etkin kullanımı önerilmiştir.

Anahtar Kelimeler

Ağız bakım ajanları, baş-boyun kanserleri, hemşirelik, oral mukozit, radyoterapi

Retrospective Investigation of Oral Agents Used for Management of Mucositis in Patients With Head and Neck Cancer Receiving Radiotherapy and Chemotherapy

Öz

Aim: This study was conducted as a retrospective descriptive study with the aim of investigating the oral agents used for management of mucositis in patients with head and neck cancer receiving radiotherapy and chemotherapy. Material and Methods: The study was conducted in Dr. Abdurrahman Yurtaslan Oncology Education and Research Hospital Radiation Oncology Clinic. The sample of the study composed hospital records of 46 patients who were staying at the clinic to get radiotherapy and chemotherapy cures plannned for treatment after diagnosis between May 2012 and May 2015. Data was collected by using a file review form developed by the researcher, degrees of oral mucositis which had already been evaluated according to the WHO oral toxicity scale and was present in patient files were added into the review form. Non-parametric statistics including Mann-Whitney U Test and Kruskal Wallis Test for group comparisons and Spearman’s correlation analysis for relations among quantitative variables were used. Results: Of the patients with head and neck cancer, 39.1% were 61 years old and older, 84.8% were men, 45.7% had laryngeal cancer. During the treatment period while mucositis was not observed in 13% of the patients, Grade 2 oral mucositis was observed in 30.4% of the patients, Grade 3 in 26% of the patients and Grade 4 in 17.3% of the patients. In 4.4% of patients having grade 2 oral mucositis mixture of sucralfat-lidocain was used, in 6.6% of patients having grade 3 oral mucositis nystatin+chlorhexidin+L-Glutamin was used and in 10.9% of patients with grade 4 oral mucositis oral L-Glutamin was used. Conclusion: In the direction of results obtained in this study, it was recommended that randomized controlled studies on the effectiveness of the oral care agents used in the management of oral mucositis in the patients receiving head and neck radiotherapy should be conducted and effective use of the oral care agents, effectiveness of which are proven according to the guides, should be provided.

Anahtar Kelimeler

: Oral care agents, head-neck cancers, nursing, oral mucositis, radiotherapy

Kaynakça

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