Patient-reported oral adverse events during cancer chemotherapy: longitudinal evaluation using patient-reported outcomes version of the common terminology criteria for adverse events (PRO-CTCAE) and concordance with clinician assessments

TL;DR

This study tracks how cancer patients report oral side effects during chemotherapy and finds that mild symptoms often persist, affecting quality of life, with patient reports differing from clinician assessments.

Contribution

The study provides new insights into longitudinal patient-reported oral adverse events and highlights discrepancies between patient and clinician assessments during chemotherapy.

Findings

Over 85% of patients experienced at least one oral adverse event, with dry mouth being the most common.

Persistent mild symptoms, like dry mouth, were reported by more than half of patients throughout treatment.

Only 31.1% concordance was found between patient-reported and clinician-assessed dry mouth severity.

Abstract

This study aimed to (1) describe longitudinal trends in patient-reported oral adverse events using the patient-reported outcomes version of the common terminology criteria for adverse events (PRO-CTCAE) in patients receiving multidisciplinary oral care during outpatient cancer drug therapy, and (2) evaluate concordance between PRO-CTCAE and clinician-reported CTCAE scores.

Conducted at the Outpatient Cancer Chemotherapy Center, Niigata University Medical and Dental Hospital (June–December 2023), oral adverse events were assessed using PRO-CTCAE and CTCAE at baseline and every 3 weeks up to 24 weeks. Concordance for dry mouth and oral mucositis was evaluated using paired same-day scores.

Among patients receiving multidisciplinary oral care, 85.2% experienced at least one oral adverse event, most commonly dry mouth. Based on PRO-CTCAE, symptoms rated as moderate or higher were reported in fewer than 10% of cases for most items. Notably, over half of patients reported persistent dry mouth of at least mild severity, and 20–30% of other symptoms also remained. These findings suggest that even lower-grade symptoms may persist and affect quality of life. Concordance between PRO-CTCAE and CTCAE was limited, with 31.1% of patients reporting greater dry mouth severity than clinicians documented.

Patient-reported oral adverse events, as assessed by PRO-CTCAE, were frequently mild but persistent throughout outpatient chemotherapy, suggesting a cumulative impact on quality of life. Concordance between PRO-CTCAE and clinician-reported CTCAE was limited, indicating that clinician assessments may underestimate symptoms such as dry mouth. These findings underscore the need to integrate patient-reported outcomes into routine oral care.

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