The presence and severity of oral mucositis and candidiasis were assessed in all participants at three-time points of the study: i) on the day of the first RT session (initial assessment); ii) halfway through RT treatment (intermediate assessment); and iii) on the day of the last RT session (final assessment). The intermediate evaluation occurred between the 14th and 20th RT sessions for the participants assigned to the GConv and between the 8th and 12th sessions for the GHipo.
Oral mucositis was evaluated according to the methodology proposed by the World Health Organization (WHO), which established the classification criteria to assess this oral mucosa condition [20 ]. It is a visual and noninvasive evaluation of the oral cavity, where the categorization follows the following parameters: grade 0, no changes; grade 1, pain/erythema; grade 2, erythema and ulcers; grade 3, ulcers (liquid diet only); grade 4, it is not possible to ingest food.
The presence of pseudomembranous candidiasis was clinically evaluated [21 (link)]. This evaluation was based on the observation of anatomic localization, features, and removal of the pseudomembrane by rubbing the lesion with gauze, with the adjacent mucosa appearing normal or erythematous, usually painless [21 (link)].
Both evaluations were performed on all participants by a single operator with extensive academic training in dentistry and clinical experience, properly trained in all stages proposed to minimize biases related to different perceptions of the oral condition of the participants. In addition to visual evaluation, the participant was also asked about the intensity of pain and difficulty swallowing food.
Oral mucositis was evaluated according to the methodology proposed by the World Health Organization (WHO), which established the classification criteria to assess this oral mucosa condition [20 ]. It is a visual and noninvasive evaluation of the oral cavity, where the categorization follows the following parameters: grade 0, no changes; grade 1, pain/erythema; grade 2, erythema and ulcers; grade 3, ulcers (liquid diet only); grade 4, it is not possible to ingest food.
The presence of pseudomembranous candidiasis was clinically evaluated [21 (link)]. This evaluation was based on the observation of anatomic localization, features, and removal of the pseudomembrane by rubbing the lesion with gauze, with the adjacent mucosa appearing normal or erythematous, usually painless [21 (link)].
Both evaluations were performed on all participants by a single operator with extensive academic training in dentistry and clinical experience, properly trained in all stages proposed to minimize biases related to different perceptions of the oral condition of the participants. In addition to visual evaluation, the participant was also asked about the intensity of pain and difficulty swallowing food.
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