Oral Mucositis Evaluation of Epstein et al in a Patient Receiving Radiation Therapy for a Cancer of the Head and Neck

 

Evaluation:

(1) physical findings involving 14 sites

(2) physical findings from those sites within the radiation field

(3) pain assessment using a 7-point categoric self-rating (Likert) scale

 

Sites examined for physical evidence of mucositis:

(1) right buccal mucosa

(2) left buccal mucosa

(3) upper labial mucosa

(4) lower labial mucosa

(5) ventral tongue

(6) dorsal tongue

(7) upper gingiva

(8) lower gingiva

(9) hard palate

(10) soft palate

(11) upper lip

(12) lower lip

(13) floor of mouth

(14) oropharynx

Findings	Points
normal	0
healed	0
erythema	1
single ulcer or pseudomembrane < 1 cm	2
single ulcer or pseudomembrane >= 1 cm	3
multiple ulcers	3

 

total mucositis score =

= SUM(points for all 14 sites)

 

mucositis score for sites within the radiation field =

= SUM(points for the sites within the radiation field)

 

mean score for sites within the radiation field =

= (mucositis score for sites within radiation field) / (number of fields within radiation field)

 

where:

• The use of a separate score for sites within the radiation field was used to prevent dilution of the score by those sites outside of the radiation exposure and thus unlikely to show significant changes.

 

Pain assessment:

(1) mouth pain

(2) throat pain

(3) pain during meals

 

Level of Pain	Points
none	0
slight	1
mild	2
moderate	3
considerable	4
severe	5
intolerable	6

 

pain score =

= SUM(points for all 3 pain measures)

 

Interpretation:

• minimum mucositis score: 0

• maximum mucositis score: 42

• minimum pain score: 0

• maximum pain score: 18

• The mean score for sites within the radiation field ranges from 0 to 3.

• The higher the scores, the greater the severity of oral mucositis.