Journal articles on the topic 'Oral mucositis; radiotherapy; head and neck cancer'
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Bajracharya, Barsha, Subrata Bhattacharyya, and Pratibha Poudel. "Evaluation of oral mucositis in oral cancer patients undergoing radiotherapy." Journal of Chitwan Medical College 8, no. 2 (June 30, 2018): 6–9. http://dx.doi.org/10.3126/jcmc.v8i2.23730.
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Introduction: The present study was conducted to evaluate oral mucositis in oral cancer patients receiving head and neck radiotherapy.
Methods: Sixty oral cancer patients who had received at least 40 grays of radiation were included in the study. Mucositis was scored by oroscopy using WHO scale. Grades of mucositis were then compared with total dose of radiation received by the patients.
Results: The cases were receiving the mean cumulative dose of standard radiation therapy of 2Gy per fraction, 5 fractions per week. All the patients developed oral mucositis. The majority had grade I mucositis, followed by grade III, II and IV. The grade of mucositis was directly proportional to the dose of radiation exposure.
Conclusion: Oral mucositis occurs among all the patients undergoing head and neck radiotherapy and grade of mucositis is proportional to the dose of radiation exposure.
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Dewi, Tenny Setiani, Yannie Febby Lefaan, Sri Susilawati, Adji Kusumadjati, and Erry Mochamad Arief. "<strong>Correlation analysis between risk factors and mucositis oral in head and neck cancer patients undergoing radiotherapy</strong>." Padjadjaran Journal of Dentistry 34, no. 2 (July 31, 2022): 95. http://dx.doi.org/10.24198/pjd.vol34no2.39165.
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ABSTRACTIntroduction: Radiotherapy is a cancer therapy that uses ionizing radiation to damage cancer cells. Ionizing radiation in the head and neck area can disrupt the function and integrity of the oral mucosa and cause oral mucositis. In Bandung, the prevalence and risk factors of oral mucositis in head and neck cancer (HNC) patients undergoing radiotherapy have not been studied. Some textbooks claim that the prevalence of radiotherapy-induced oral mucositis in HNC patients occurs at almost 100%. Various risk factors associated with oral mucositis have been studied, giving significantly different results. This research analyzes the correlation between risk factors and mucositis oral in head and neck cancer patients undergoing radiotherapy. Methods: This research is a cross-sectional retrospective study with secondary data from medical records of HNC patients at RSHS from January 2015 until December 2019. A consecutive sampling method was used to collect the data that match the Inclusion criteria, including diagnosis of HNC(ICD-10), receiving radiotherapy from the first cycle until the last cycle; having a complete medical record following variables (location of HNC coding by ICD-10, gender, age, education level, smoking habit, the cycle of radiotherapy, oral treatment, body mass index, and comorbid disease). All data were then analyzed using Spearman correlation. Result: 171 medical records showed 59 patients had oral mucositis after radiotherapy. 26.9% male and 7.6% female, with susceptible age 40-60 years. Analysis of the Spearman correlation, there is a significant relationship between body mass index (BMI) (ρ = 0,001), smoking habits (ρ = 0,001), and radiotherapy cycles (ρ = 0.001). Conclusion: There is a correlation between risk factors of oral mucositis in HNC patients undergoing radiotherapy in RSHS, including body mass index (BMI), smoking habits, and radiotherapy cycles.Keywords: Head and neck cancer; oral mucositis; prevalence; risk factor; retrospective study
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Verma, Anjali, Rashmi P. John, and Kirti Srivastava. "EFFECTIVENESS OF TOPICAL APPLICATION OF MIXTURE OF HONEY AND COFFEE IN RADIATION INDUCED ORAL MUCOSITIS AMONG PATIENTS WITH HEAD & NECK CANCER UNDERGOING RADIOTHERAPY AT RADIOTHERAPY DEPARTMENT OF KGMU, LUCKNOW, U.P." International Journal of Advanced Research 8, no. 10 (October 31, 2020): 55–62. http://dx.doi.org/10.21474/ijar01/11823.
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Background: Cancers commonly known as head and neck cancers typically begin in the squamous cells that line the moist, mucosal surfaces within the head and neck. Oral mucositis is erythematous and ulcerative lesion of the oral mucosa in patients with cancer being treated with chemotherapy/ radiation therapy in the areas of oral cavity. Objectives: To assess the grade of the oral mucositis among head & neck cancer patients receiving radiotherapy. 2. To evaluate the effectiveness of mixture of honey and coffee application on radiation induced oral mucositis among the study group. 3. To find the association between the radiation induced oral mucositis with selected demographic variables. Method: quasi experimental non randomized control group design was applied and 60 samples (30 in each group) were selected by convenience sampling technique. The mixture of honey and coffee was applied to the study group before and after 15 minutes of radiotherapy till the continuation of radiotherapy and no intervention was given in the control group. Result: The result revealed that the application of honey and coffee mixture was significantly effective on oral mucositis (p<0.001) in the study group. Conclusion: The study concluded that, application of mixture of honey and coffee is an effective method of reducing the onset and severity of oral mucositis in comparison with no intervention.
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Traktama, Dewi Oktafia, and Irna Sufiawati. "Oral mucositis severity in patient with head and neck cancer undergoing chemotherapy and/or radiotherapy." Majalah Kedokteran Gigi Indonesia 4, no. 1 (December 19, 2018): 52. http://dx.doi.org/10.22146/majkedgiind.33709.
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Oral mucositis is an inflammatory process and ulcerative of the oral mucosa due to chemotherapy and/or radiotherapy. The incidence and severity of oral mucositis might be influenced by a variety of risk factors, related to the host and treatment of the cancer. This aim of the case report is to evaluate risk factors that affect the severity of oral mucositis in two patients with nasopharyngeal cancer undergoing chemotherapy and/or radiotherapy. The first case, oral mucositis grade III and oral candidiasis to a 54-year old woman undergoing 16 times radiotherapy for nasopharyngeal cancer stage IV. The second case, oral mucositis grade I and oral candidiasis were found in a 55-year old man suffering from nasopharyngeal cancer stage IV who has been treated 10 times with chemotherapy and radiotherapy. Both patients had a similar age range and cancer stage. The differences of severity oral mucositis in both cases were suspected due to the host factors-related that are gender and nutritional status. In addition, intra-oral condition (poor oral hygiene, xerostomia), smoking habits and patient compliance may also affect the severity of oral mucositis in the second case. Treatment factors such as the type, dose and duration of chemotherapy t, might also affect the severity in both cases. Both patients were given chlorhexidine gluconate 0.2%, nystatin oral suspension, vitamin B12, and folic acid for treating oral mucositis. In conclusion, the understanding of risk factors oral mucositis is deemed necessary to control the severity and to provide an appropriate management to improve the quality of patients’ life.
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Arumsadu, Annisa Gustiasti, Niluh Ringga Woroprobosari, Rina Kartika Sari, and Rochman Mujayanto. "POTENTIAL OF OZONE WATER TO REDUCE THE SEVERITY OF ORAL MUCOSITIS IN PATIENTS POST HEAD AND NECK RADIOTHERAPY." Jurnal Medali 3, no. 1 (September 28, 2021): 12. http://dx.doi.org/10.30659/medali.v3i1.16965.
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Background: Cancer is the second leading cause of death in the world after heart disease. One type of cancer, namely head and neck cancer, can be treated with head and neck radiotherapy. Continuous radiotherapy will cause an increase in oxidative stress and free radicals and damage to the oral mucosa, one of which is oral mucositis. Giving ozone water can help reduce the degree of oral mucositis in patients. Ozone water itself has several beneficial effects such as antioxidant, anti-inflammatory, and antimicrobial. The purpose of this study was to determine the potential of ozone water in reducing the severity of oral mucositis in patients after head and neck radiotherapy.Method: Gargling treatment using ozone water in a ratio of 2:3 for 1 minute with 4 repetitions for 2 weeks showed a significant reduction in pain. Ozone used in gas or liquid form for more than 5 minutes has the potential to cause side effects on the duration of inflammation and for gas can cause infection in the respiratory tract.Conclusion: The conclusion of this review is that the administration of ozone water with a concentration of 2-4 ppm for approximately 5 minutes has the potential to cure oral mucositis due to head and neck radiotherapy
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Saher, Fizza, Mervyn Hosein, Abne Hasan, Jabbar Ahmed Qureshi, Tazein Amber, and Nisa Fatima Sunderjee. "Effects of Oil Pulling On Chemo-radiotherapy Induced Oral Mucositis in Head and Neck Cancer Patients." Journal of the Pakistan Dental Association 28, no. 01 (February 2019): 03–12. http://dx.doi.org/10.25301/jpda.281.3.
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Kamian, S. "Benzydamine for prophylaxis of radiation induced oral mucositis in head and neck cancers: Double-blind clinical trial." Journal of Clinical Oncology 25, no. 18_suppl (June 20, 2007): 9042. http://dx.doi.org/10.1200/jco.2007.25.18_suppl.9042.
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9042 Background: Oral mucositis is one of the most common adverse effects of radiotherapy in head and neck tumors. We determined the efficacy of oral rinse benzydamine in prevention of radiation induced mucositis. Methods: Patients with head and neck cancers were enrolled in a randomize, placebo-controlled clinical trail to receive either benzydamine or placebo. All the cases received at least 50 Gy radiation to the oral cavity and oropharyngeal areas. The end points were comparison of highest grade of mucositis at the end of radiotherapy, frequency of grade 2 or more, the interval days to establishing grade 2 in the groups. Results: 100 patients with head and neck cancers were randomized in this trail. At the end of the study, 19 patients were excluded of the analysis due to minor side effects of drug, or stopping the radiotherapy. In 39 cases in the treated group, the frequency of mucositis grade 3 or more was 43.6% (17 cases) in contrast to 78.6% (33 cases) in 42 cases in the placebo group, which was significant (p=0.001). Mucositis grade 3 or more was 2.6 times frequent in placebo group (CI=95%, relative risk=1.38–5). At the end of RT, at least 42% of the treated group had mucositis grade 3 or more in contrast to at least 76% in the control group which was statistically significant. Intensity of mucositis was increased up to forth week of treatment in both groups to grade 2. In the treated group the grade of mucositis was approximately constant to the end of therapy; but in the control group it raised to grade 3 (p<0.001). The highest grade of mucositis during the treatment time was significantly different between two groups (p=0.049). The median interval days of establishing grade 2 mucositis was 3.6 days sooner in the placebo group (p=0.12). Conclusions: According to these results it seems that oral rinse benzydamine was effective, safe, and well tolerated for prophylactic treatment of radiation-induced oral mucositis in head and neck tumors. [Table: see text]
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Chattopadhyay, Subrata, Aramita Saha, Mohammad Azam, Anindya Mukherjee, and Prabir Kumar Sur. "Role of oral glutamine in alleviation and prevention of radiation-induced oral mucositis: A prospective randomized study." South Asian Journal of Cancer 03, no. 01 (January 2014): 008–12. http://dx.doi.org/10.4103/2278-330x.126501.
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Abstract Background: Oral mucositis is the most frequently occurring painful and dose-limiting side-effect of radiation of the head and neck region. Few studies demonstrated that oral glutamine suspension may significantly reduce the duration and severity of objective oral mucositis during radiotherapy. Materials and Methods: A randomized, prospective single institutional case control study was performed between April 2012 and November 2012 comparing the influence of oral glutamine on radiation induced mucositis in head and neck malignancy patients. Seventy biopsy proven patients with head and neck cancer receiving primary or adjuvant radiation therapy were randomized to receive either oral glutamine suspension daily 2h before radiation in the study arm (10 g in 1000 ml of water) (n = 35) or nothing before radiation; control arm (n = 35). Results and Analysis: Total 32 patients (91.43%) in the glutamine arm and total 34 patients (97.15%) developed mucositis. Grade 3 mucositis (14.29%) and grade 4 mucositis (2.86%) in the study arm (who received oral glutamine) were significantly less (P = 0.02 and P = 0.04, respectively) in the glutamine arm. The mean duration of grade 3 or worse mucositis (grade 3 and grade 4) was significantly less (6.6 days vs. 9.2 days) in study arm with P < 0.001. Mean time of onset of mucositis was significantly delayed in patients who took glutamine in comparison to control arm with P < 0.001. Conclusion: Glutamine delays oral mucositis in the head neck cancer patients. Moreover, it reduces the frequency and duration of grade 3 and grade 4 mucositis.
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Maurya, Reeta, Manodeep Sen, Madhup Rastogi, and Somali Sanyal. "Alteration in Oral Flora and Effect of Mucositis in Head and Neck Cancer Patients Undergoing Chemo-radiotherapy." Journal of Pure and Applied Microbiology 14, no. 3 (September 29, 2020): 2129–35. http://dx.doi.org/10.22207/jpam.14.3.53.
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The main aim of this study is to determine the various types of oral bacteria and yeast. Present in oral flora of head and neck cancer patients at different stages of chemo-radiotherapy, and compare it with the control group (patients with contralateral healthy mucosa). Seventy seven patients with proven history of squamous cell carcinoma were included in the study. The oral mucosa profile was assessed for bacterial manifestations in swab samples from both the sites of the patients. The grade of mucositis was charted out for all patients during the second and third week of radiotherapy. The study revealed that all isolated oral flora showed a non-significant increase during radiotherapy, while there was a decrease in oral flora in post RT. However, E. faecalis showed a non- significant decrease during RT, while Citrobacter showed an increase. Candida albicans showed 83% non- significant decrease post- radiotherapy. When these floras were correlated with grade of mucositis, an insignificant increase in flora was found in G2 and G3 stage of mucositis. In this study, the effect of radiation was evaluated on oral flora of head and neck cancer patients and compared with contralateral healthy mucosa of the patients. Various changes were observed during and after radiation therapy. In patients with head and neck cancer the normal oral flora are replaced by pathogenic flora during radiotherapy, and the latter is responsible for infections in post- radiation phase.
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Rashad, U. M., S. M. Al-Gezawy, E. El-Gezawy, and A. N. Azzaz. "Honey as topical prophylaxis against radiochemotherapy-induced mucositis in head and neck cancer." Journal of Laryngology & Otology 123, no. 2 (May 19, 2008): 223–28. http://dx.doi.org/10.1017/s0022215108002478.
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AbstractAim:To evaluate the efficacy of pure natural honey as prophylaxis against radiochemotherapy-induced mucositis, through clinical scoring of oral and oropharyngeal mucositis, and culturing of pathogenic oral and oropharyngeal microbes.Patients and methods:The study was done in Assiut University Hospital, Egypt, between January 2005 and July 2006. Forty patients diagnosed with head and neck cancer were entered into the trial. Enrolled patients were randomised to either the treatment group, receiving concomitant chemotherapy and radiotherapy (with a significant area of directly visible oral and/or oropharyngeal mucosa included in the radiation fields) plus prior topical application of pure natural honey, or the control group, receiving concomitant chemotherapy and radiotherapy without honey. Patients were evaluated clinically every week to assess development of radiation mucositis. Aerobic cultures and candida colonisation assessment were undertaken, via oral and oropharyngeal swabs, prior to and at the completion of irradiation, and when infection was evident.Results:In the treatment group, no patients developed grade four mucositis and only three patients (15 per cent) developed grade three mucositis. In the control group, 13 patients (65 per cent) developed grade three or four mucositis (p < 0.05). Candida colonisation was found in 15 per cent of the treatment group and 60 per cent of the control group, either during or after radiotherapy (p = 0.003). Positive cultures for aerobic pathogenic bacteria were observed in 15 per cent of the treatment group and 65 per cent of the control group, during or after radiotherapy (p = 0.007).Conclusion:This study shows that prophylactic use of pure natural honey was effective in reducing mucositis resulting from radiochemotherapy in patients with head and neck cancer.
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Das, Bishnu Prasad, and Jitendra Patra. "Effect of glutamine supplement on chemo-radiation induced mucositis in head and neck cancer patients: a prospective study." International Journal of Basic & Clinical Pharmacology 9, no. 3 (February 25, 2020): 417. http://dx.doi.org/10.18203/2319-2003.ijbcp20200580.
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Background: Radiotherapy is one of the primary modalities of cancer treatment but may associated with short and long-term toxicities. Oral mucositis is frequently encountered in head and neck cancer resulting in unplanned treatment breaks. Few studies emphasized that use of oral glutamine may significantly reduce oral mucositis and other acute toxicities. This study aims to assess the effects of glutamine on oral mucositis in head and neck cancer patients receiving chemo-radiation.Methods: It is a prospective study carried out in sixty-four head and neck cancer patients attending radiotherapy department for chemo-radiation from January 2018 to May 2019. Patients were randomly assigned into two arms containing 32 subjects in each. All the patients in arm-A were taking oral glutamine supplement of 15 mg once daily, two hours prior to radiation and arm-B serve as the control group. Dose of radiation fixed at 66 Gy in 33 fractions over a period of 7 weeks along with an infusion of weekly cisplatin (40 mg/m2). Patients were evaluated regarding onset, severity and the recovery period of mucositis.Results: Oral mucositis appeared at around 5th week in arm-A and 3rd week in arm-B (p<0.0001). Number of patients with mucositis is significantly less in arm-A (75%, 24 out of 32) as compared to arm-B (96.8%) (p=0.0310). The time required for healing of mucositis is significantly less than 1 week in arm-A compared to ~2 weeks in the arm-B (p<0.0001).Conclusions: Oral glutamine when given prior to radiation results in delayed onset of oral mucositis with decreased severity and an early healing period.
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Dong, Ying-Li, Wei-Feng Hou, Chong Zhang, Xiao-Zhong Cao, and Zhen-Yu Li. "Effectiveness of Honey on Radiation-Induced Oral Mucositis Among Patients with Head and Neck Malignancies: A Systematic Review and Meta-Analysis." Current Topics in Nutraceutical Research 21, no. 1 (August 23, 2022): 53–59. http://dx.doi.org/10.37290/ctnr2641-452x.21:53-59.
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While radiotherapy remains the cornerstone of head and neck cancer treatment, oral mucositis is a very serious side effect, especially grade III/IV oral mucositis. Oral mucositis not only seriously reduces the quality of life of patients, but also affects the ongoing treatment of patients. Use of honey for the remediation of oral mucositis promising, but clinically controversial. Therefore, to further ascertain its role in oral mucositis, an extensive literature search was performed in the Pubmed, Embase and Cochrane databases. Thirteen randomized controlled trials with 899 patients were included in the analysis. Pooled Odds ratio with 95% confidence intervals was analyzed. The results show that a significantly fewer number of patients treated with honey experienced grade III/IV oral mucositis after radiotherapy (OR 0.24, 95% CI 0.13–0.44, p < 0.001). The administration of honey concurrently with radiotherapy decreased the rate of graded III/IV oral mucositis. Thus, the use of honey during radiotherapy may represent a feasible strategy for preserving tolerance.
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Demiroz, C., L. Ozkan, and O. Karadag. "Prophylactic fluconazole treatment of mucositis in radiotherapy of head and neck cancer patients." Journal of Clinical Oncology 27, no. 15_suppl (May 20, 2009): 6062. http://dx.doi.org/10.1200/jco.2009.27.15_suppl.6062.
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6062 Background: The aim of the study is to evaluate the preventive role of antifungal fluconazole prophylaxis on mucositis in head and neck cancer patients treated with radiotherapy. Methods: We evaluated 43 head and neck cancer patients treated with radiotherapy with/without chemotherapy. The patients were randomized to two groups: twenty patients (group A) received fluconazole when micotic infections appeared; 23 patients (group B) received fluconazole 200 mg once a week starting from the sixth irradiation session throughout the treatment.The two groups were similar in terms of patients and radiotherapy characteristics. Oral mucositis was recorded according to EORTC/RTOG criteria. Results: The usage of fluconazole 200 mg once a week was well tolerated and no early and late toxicity was observed. Mucositis was appeared in both groups on the third week of radiotherapy. Grade 3 mucositis developed at eight of the patients in group A (40%), three of the patients in group B (13%) and the result was statistically significant (p = 0.044). While grade 3 mucositis was observed the second/third week in group A, it was also observed in group B on third/fourth week in group B (p = 0.043). Conclusions: Weekly fluconazole prophylaxis showed a significant effect on the grade 3 mucositis and improved radiotherapy results. No significant financial relationships to disclose.
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Brzozowska, Anna, and Paweł Gołębiowski. "Acute radiation-induced oral mucositis in patients subjected to radiotherapy due to head and neck cancer." Polish Journal of Public Health 129, no. 1 (March 1, 2019): 27–30. http://dx.doi.org/10.2478/pjph-2019-0006.
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Abstract Oral mucositis is a common side effect of radiation therapy for head and neck cancer. Severe mucositis is followed by symptoms, such as extreme pain, mucosal ulceration and consequent limitations in swallowing and achieving adequate nutritional intake. Mucositis may also increase the risk of local and systemic infection and significantly affect quality of life and cost of care. Severe oral mucositis can lead to the need to interrupt or discontinue cancer therapy and thus may have an impact on cure of the primary disease. In spite of all the advances made in understanding the pathophysiology of oral mucositis, there is still no prophylactic therapy with proven efficacy and known risk factors. This review will discuss oral mucositis epidemiology, impact and side effects, pathogenesis, scoring scales and prevention.
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Raman Ponna, Dulasi, Yumkhaibam Sobita Devi, Kishalay Baidya, Laishram Jaichand Singh, Ningthoujam Dinita Devi, and Silchang K. Marak. "A COMPARATIVE STUDY ASSESSING THE DIFFERENT PATTERNS OF RADIATION REACTIONS IN HEAD AND NECKCANCER PATIENTS UNDERGOING RADIATION THERAPY AT DIFFERENT TIMES OF THE DAY-IN THE MORNING VERSUS EVENING." International Journal of Advanced Research 9, no. 07 (July 31, 2021): 284–91. http://dx.doi.org/10.21474/ijar01/13127.
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Background: Human oral mucosa, is a prime target for radiation induced toxicity in patients undergoing radiotherapy for head and neck cancer. The oral cavity is highly susceptible to direct and indirect toxic effects of cancer chemotherapy and ionizing radiation. In our study we investigated the role of chronotherapy with respect to radiation induced mucositis occurring in the normal oral mucosa and treatment response in tumor tissue in cancer patients undergoing radiation therapy to head and neck region. Materials and Methods: This non-randomized clinical study was done to compare the two different timing schedules in the management of head and neck cancer by external beam radiation therapy by cobalt-60 (Theratron780C). In morning arm (arm A), Patients received external beam radiotherapy (EBRT) by cobalt-60 with SSD of 80cm with daily fractions, five days a week, between 8AM–10 AM whereas in evening arm (arm B), patients received EBRT by cobalt-60 with daily fractions, five days a week, between 3PM–5 PM. Both the arms received same radiation regimen. Results: The study concluded that in the morning arm the onset of oral mucositis was observed to be significantly delayed and the duration of mucositis was also significantly shorter as compared to the evening arm. Statistically significant difference in severity of mucositis was found between the two arms. Conclusion: Since there is no active measure to minimize normal tissue toxicity, chronomodulated radiotherapy would be a feasible and cost effective treatment strategy that can be put into clinical practice.
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Abraham, Z. S., B. Ngunyale, E. R. Massawe, D. Ntunaguzi, and B. Mpondo. "Oral and Otolaryngological Complications of Radiotherapy for Head and Neck Cancers among Patients attending Ocean Road Cancer Institute, Tanzania." Medical Journal of Zambia 45, no. 1 (July 10, 2018): 32–43. http://dx.doi.org/10.55320/mjz.45.1.113.
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Background: The prevalence of head and neck cancers is on the increase worldwide. Treatment modalities include surgery, radiotherapy and chemotherapy. Radiotherapy with or without chemotherapy affects different parts of the body upon their exposure including the ear, nose, throat and the oral cavity. Data on these complications is scarce. The aim of this study was to determine the proportion of acute oral and otolaryngological complications of radiotherapy with or without chemotherapy for head and neck cancers.
Methods: A retrospective cross-sectional, hospital based study was done to 80 patients with head and neck cancers who have just completed radiotherapy with or without chemotherapy at Ocean Road Cancer Institute (ORCI). Data was collected using a structured questionnaire within one week after completion of radiotherapy. Patients who reported hearing loss underwent otoscopy and audiological assessment including tympanometry and pure tone audiometry. Data was analyzed using SPSS program.
Results: The proportion of males was higher than that of females in the ratio of 2:1 and majority of the patients involved were in the 6 decade of life,
(27.5%). Out of the 80 study participants, 80% were found to have oropharyngeal mucositis, 90% were found to have xerostomia and 50% were found to have dysphagia. In addition, 76.2% of patients reported to have developed taste disorders after radiotherapy and 43.1% reported to have developed voice disorders. The proportion of hearing loss following radiotherapy was 21.9% though this should be taken with caution since there was no before and after intervention taken.
Patients with sinonasal cancers had the least proportion of oral and oropharyngeal mucositis (50%), xerostomia (64.3%) and voice disorders (14.3%). Most of patients who developed hearing loss had nasopharyngeal cancer (85.6%) and salivary gland cancer (66.7%) while patients with oropharyngeal cancer, hypopharyngeal cancer and laryngeal cancer did not develop hearing loss at all.
Conclusion: Oral and otolaryngological complications of radiotherapy with or without chemotherapy for head and neck cancers at ORCI are quite prevalent. Prevention of complications should be highly regarded especially by using shield protectors on uninvolved areas and advanced radiotherapy machines should be considered to minimize such complications.
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Arun, P., A. Sagayaraj, S. M. Azeem Mohiyuddin, and D. Santosh. "Role of turmeric extract in minimising mucositis in patients receiving radiotherapy for head and neck squamous cell cancer: a randomised, placebo-controlled trial." Journal of Laryngology & Otology 134, no. 2 (February 2020): 159–64. http://dx.doi.org/10.1017/s0022215120000316.
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AbstractObjectiveTo determine the role of turmeric extract in reducing mucositis in patients undergoing radiotherapy for head and neck cancer.MethodsSixty-one patients who underwent radiotherapy were included in the study and randomised into groups A and B. Patients in group A received 500 mg of turmeric extract (BCM-95) thrice daily, while patients in group B received placebo until radiotherapy completion. All patients were assessed for oral mucositis on a weekly basis during treatment and two months post-treatment using the National Cancer Institute Common Terminology Criteria for Adverse Events and World Health Organization criteria.ResultsBoth groups had a similar grade of mucositis in first two weeks of treatment. The severity of mucositis was progressive in the control group, with four patients developing grade 3 mucositis by week four. In group A, however, the majority of patients (73.3 per cent) had grade 1 mucositis after four weeks of treatment. The difference was statistically significant from the third week onwards (p < 0.001).ConclusionTurmeric extract reduces the incidence and severity of radiation-induced mucositis, which can benefit patients undergoing radiation for head and neck cancer.
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Park, SongWon, MinJee Kim, and Seong-Woo Lim. "Clinical Efficacy of Coptidis Rhizoma for Non-alcoholic Fatty Liver Disease: A Systematic Review." Journal of Korean Medicine 43, no. 4 (December 1, 2022): 89–100. http://dx.doi.org/10.13048/jkm.22048.
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Objectives: The purpose of this systematic review was to evaluate the effects of herbal medicine on Chemo -Radiotherapy-induced oral mucositis.Methods: Electronic databases were used to search for studies published through 10 years until October 2022, and a randomized controlled study was conducted to evaluate efficacy of herbal medicine on chemo-radiotherapy-induced oral mucositis. Study quality was assessed using the Cochran’s risk bias tool.Results: Two-hundred and three articles were initially searched, and 11 studies (head and neck cancer, breast cancer, colorectal cancer, esophageal cancer etc. undergoing radio-chemotherapy were included in analysis. The effect of herbal medicine on chemo-radiotherapy-induced oral mucositis, 9 studies reported that herbal medicine was more effective than the placebo group or conventional treatment. One study reported that the effect of the herbal compound treatment group was similar to that of the conventional herbal medicine, and one study reported that there was no difference in effect between the two herbal medicines and the group without treatment.Conclusion: This study suggests that herbal medicine effectively relieves the symptoms of chemo-radiotherapy -induced oral mucositis. However, there is limited evidence that herbal medicine may relief chemo-radiotherapy -induced oral mucositis, so further investigation is needed.
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Pattanayak, Lucy, Niharika Panda, Manoj Kumar Dash, Sumita Mohanty, and Sagarika Samantaray. "Management of Chemoradiation-Induced Mucositis in Head and Neck Cancers With Oral Glutamine." Journal of Global Oncology 2, no. 4 (August 2016): 200–206. http://dx.doi.org/10.1200/jgo.2015.000786.
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Purpose Head and neck cancers are the third most common cancers worldwide. Oral mucositis is the most common toxicity seen in patients who receive chemoradiation to treat head and neck cancer. The aim of this study was to evaluate the efficacy and safety of oral glutamine supplementation in these patients. Materials and Methods From December 2013 to December 2014, we randomly assigned to two arms 162 patients who had squamous cell carcinoma of the head and neck. Patients in arm A were given oral glutamine once per day, whereas those in arm B served as negative control subjects. All patients received radiotherapy given as 70 Gy in 35 fractions over 7 weeks with an injection of cisplatin once per week. Patients were assessed once per week to evaluate for the onset and severity of mucositis, pain, use of analgesics, and for Ryle tube feeding. Results We observed that 53.1% of patients developed mucositis toward the fifth week in the glutamine arm compared with 55.5% of patients in the control arm at the third week. None in the glutamine arm compared with 92.35% of patients in the control arm developed G3 mucositis. Rates of adverse events like pain, dysphagia, nausea, edema, and cough, as well as use of analgesics and Ryle tube feeding, were significantly lower in the glutamine arm than in the control arm. Conclusion This study highlights that the onset as well as the severity of mucositis in patients receiving glutamine was significantly delayed. None of the patients receiving glutamine developed G3 mucositis. Hence, the findings emphasize the use of oral glutamine supplementation as a feasible and affordable treatment option for mucositis in patients with head and neck cancers who are receiving chemoradiation.
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Huang, Chih-Jen, Ming-Yii Huang, Pen-Tzu Fang, Frank Chen, Yu-Tsang Wang, Chung-Ho Chen, Shyng-Shiou Yuan, et al. "Randomized double-blind, placebo-controlled trial evaluating oral glutamine on radiation-induced oral mucositis and dermatitis in head and neck cancer patients." American Journal of Clinical Nutrition 109, no. 3 (February 9, 2019): 606–14. http://dx.doi.org/10.1093/ajcn/nqy329.
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ABSTRACT Background Glutamine is the primary fuel for the gastrointestinal epithelium and maintains the mucosal structure. Oncologists frequently encounter oral mucositis, which can cause unplanned breaks in radiotherapy (RT). Objectives The aim of this study was to explore the association between oral glutamine and acute toxicities in patients with head and neck cancer undergoing RT. Methods This was a parallel, double-blind, randomized, placebo-controlled Phase III trial conducted in a university hospital. A central randomization center used computer-generated tables to allocate interventions to 71 patients with stages I–IV head and neck cancers. The patients, care providers, and investigators were blinded to the group assignment. Eligible patients received either oral glutamine (5 g glutamine and 10 g maltodextrin) or placebo (15 g maltodextrin) 3 times daily from 7 d before RT to 14 d after RT. The primary and secondary endpoints were radiation-induced oral mucositis and neck dermatitis, respectively. These were documented in agreement with the National Cancer Institute Common Terminology Criteria for Adverse Events version 3. Results The study included 64 patients (placebo n = 33; glutamine n = 31) who completed RT for the completers’ analysis. Based on multivariate analysis, glutamine had no significant effect on the severity of oral mucositis (OR: 0.3; 95% CI: 0.05, 1.67; P = 0.169). Only the change in body mass index (BMI) was significant in both multivariate completers (OR: 0.41; 95% CI: 0.20, 0.84; P = 0.015) and per-protocol analysis (OR: 0.40; 95% CI: 0.20, 0.83; P = 0.014). No difference was found in the incidence and severity of neck dermatitis between the two arms. Conclusions The decrease in BMI was strongly related to the severity of oral mucositis in the head and neck cancer patients under RT, but not to the use of glutamine. This trial was registered at clinicaltrials.gov as NCT03015077.
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Stokman, M. A., F. K. L. Spijkervet, H. M. Boezen, J. P. Schouten, J. L. N. Roodenburg, and E. G. E. de Vries. "Preventive Intervention Possibilities in Radiotherapy- and Chemotherapy-induced Oral Mucositis: Results of Meta-analyses." Journal of Dental Research 85, no. 8 (August 2006): 690–700. http://dx.doi.org/10.1177/154405910608500802.
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The aim of these meta-analyses was to evaluate the effectiveness of interventions for the prevention of oral mucositis in cancer patients treated with head and neck radiotherapy and/or chemotherapy, with a focus on randomized clinical trials. A literature search was performed for reports of randomized controlled clinical studies, published between 1966 and 2004, the aim of which was the prevention of mucositis in cancer patients undergoing head and neck radiation, chemotherapy, or chemoradiation. The control group consisted of a placebo, no intervention, or another intervention group. Mucositis was scored by either the WHO, the National Cancer Institute-Common Toxicity Criteria (NCI-CTC) score, or the absence or presence of ulcerations, or the presence or absence of grades 3 and 4 mucositis. The meta-analyses included 45 studies fulfilling the inclusion criteria, in which 8 different interventions were evaluated: i.e., local application of chlorhexidine; iseganan; PTA (polymyxin E, tobramycine, and amphotericin B); granulocyte macrophage-colony-stimulating factor/granulocyte colony-stimulating factor (GM-CSF/G-CSF); oral cooling; sucralfate and glutamine; and systemic administration of amifostine and GM-CSF/G-CSF. Four interventions showed a significant preventive effect on the development or severity of oral mucositis: PTA with an odds ratio (OR) = 0.61 (95% confidence interval [CI], 0.39–0.96); GM-CSF, OR = 0.53 (CI: 0.33–0.87); oral cooling, OR = 0.3 (CI: 0.16–0.56); and amifostine, OR = 0.37 (CI: 0.15–0.89). To date, no single intervention completely prevents oral mucositis, so combined preventive therapy strategies seem to be required to ensure more successful outcomes.
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S, Vijayakumar. "To study the radiation induced oral mucositis in head and neck cancer - A prospective study." Panacea Journal of Medical Sciences 12, no. 1 (April 15, 2022): 187–90. http://dx.doi.org/10.18231/j.pjms.2022.035.
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Patients suffering from Head and Neck Cancers (HNC), when treated with radiotherapy (RT), often experience Oral mucositis (OMS) side effects. OMS can complicate the treatment and worsen the management of HNC. The Radio-oncologist should find a way to minimize the incidence of OMS during the treatment of HNC. To study the Radiation-induced OMS in HNC patients and its associated factors. This prospective study was performed from October 2018 to September 2019. Total 80 patients of with HNC, who were treated with RT, were enrolled for the study with informed consent. In the study, 40 patients received RT and 40 received concurrent chemo-Radiotherapy (CCRT). Amongst 80 patients included in the study, 72.5% were found to be male. Poor oral hygiene was observed in 77.5% of patients in the study. The tongue cancer (35%) and Cancer of Stage IVa (47.5%) were more prevalent in the patients under study. OMS was observed maximum (60%) in 1 to 4 weeks of treatment. Inflammation response of epithelial mucosa to chemo- radiotherapy cytotoxic effects leads to mucositis, a painful side effect. This study gives proper understanding of Radiation-induced OMS and identifies the predisposing factors for OMS.
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Pacheco, Raquel, Maria Cavacas, Paulo Mascarenhas, Pedro Oliveira, and Carlos Zagalo. "Incidence of Oral Mucositis in Patients Undergoing Head and Neck Cancer Treatment: Systematic Review and Meta-Analysis." Medical Sciences Forum 5, no. 1 (July 21, 2021): 23. http://dx.doi.org/10.3390/msf2021005023.
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This systematic review and meta-analysis aimed to assess the literature about the incidence of oral mucositis and its degrees (mild, moderate, and severe), in patients undergoing head and neck cancer treatment (radiotherapy, chemotherapy, and surgery). Addressing this issue is important since oral mucositis has a negative impact on oral health and significantly deteriorates the quality of life. Therefore, a multidisciplinary team, including dentists, should be involved in the treatment. The overall oral mucositis incidence was 89.4%. The global incidence for mild, moderate, and severe degrees were 16.8%, 34.5%, and 26.4%, respectively. The high incidence rates reported in this review point out the need for greater care in terms of the oral health of these patients.
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Bolton, Laura. "Managing Oral Mucositis in Patients With Cancer." Wounds : a compendium of clinical research and practice 33, no. 5 (May 10, 2021): 136–38. http://dx.doi.org/10.25270/wnds/2021.136138.
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Patients with oral mucositis (OM) have inflamed epithelial lesions of the mouth that progress to form painful ulcerations with submucosal hemorrhaging and infection. Oral mucositis makes it painful to eat, drink, and speak, resulting in distress, weight loss, and declining health. These symptoms occur in up to 40% of patients within 5 to 10 days after beginning chemotherapy (CT), and in nearly all patients within 1 to 2 weeks of starting radiotherapy (RT) for head and neck cancer. Oral mucositis can be severe enough to interrupt treatment and reduce survival rates. In 2014, the Mucositis Guidelines Leadership Group of the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology released OM treatment guidelines aiming to provide nutritional support, while reducing pain, inflammation, hemorrhaging, and oral microbial contamination. This installment of Evidence Corner explores 2 recent systematic reviews of randomized controlled trial (RCT) evidence informing clinical decisions in ways that may change thoughts about effective topical OM treatment.
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El-Sayed, S., A. Nabid, W. Shelley, J. Hay, J. Balogh, M. Gelinas, R. MacKenzie, et al. "Prophylaxis of Radiation-Associated Mucositis in Conventionally Treated Patients With Head and Neck Cancer: A Double-Blind, Phase III, Randomized, Controlled Trial Evaluating the Clinical Efficacy of an Antimicrobial Lozenge Using a Validated Mucositis Scoring System." Journal of Clinical Oncology 20, no. 19 (October 1, 2002): 3956–63. http://dx.doi.org/10.1200/jco.2002.05.046.
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PURPOSE: Mucositis occurs in almost all patients treated with radiotherapy for head and neck cancer. The aim of this multicenter, double-blind, prospective, randomized trial was to evaluate the clinical efficacy of an economically viable antimicrobial lozenge (bacitracin, clotrimazole, and gentamicin [BcoG]) in the alleviation of radiation-induced mucositis in patients with head and neck cancer. PATIENTS AND METHODS: One hundred thirty-seven eligible patients were randomized to treatment with either antimicrobial lozenge (69 patients) or placebo lozenge (68 patients). The primary end point of the study was the time to development of severe mucositis from the start of radiotherapy. Secondary end points included severity and duration of mucositis, pain measurement, radiation therapy interruption, and quality of life. Mucositis was scored using a validated mucositis scoring system. RESULTS: Toxicity profiles were similar between the two arms of the study. The median time to development of severe mucositis from the start of radiotherapy was 3.61 weeks on BCoG and 3.96 weeks on placebo (P = .61). There were no statistically significant differences between the arms in the extent of severe mucositis as measured by physician, in oral toxicities as recorded by patients, or in radiotherapy delays. CONCLUSION: This study was conducted on the basis of a pilot study that demonstrated the BCoG lozenge to be tolerable and microbiologically efficacious. A validated mucositis scoring system was used. However, in this group of patients treated with conventional radiotherapy, the lozenge did not impact significantly on the severity of mucositis. Whether such a lozenge would be beneficial in treatment situations where rate of severe mucositis is higher (ie, in patients treated with unconventional fractionation or with concomitant chemotherapy) is unknown.
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Vesty, Anna, Kim Gear, Kristi Biswas, Brett Wagner Mackenzie, Michael W. Taylor, and Richard G. Douglas. "Oral microbial influences on oral mucositis during radiotherapy treatment of head and neck cancer." Supportive Care in Cancer 28, no. 6 (October 25, 2019): 2683–91. http://dx.doi.org/10.1007/s00520-019-05084-6.
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Da Conceição, Taís Correia, Ana Carla Barletta Sanches, Tila Fortuna Costa Freire, Gabriela Botelho Martins, Marcelo Victor Coelho Marques, and Juliana Borges de Lima Dantas. "Acute Oral Manifestations in Patients Submitted to Radiotherapy in the Head and Neck Region: Literature Narrative Review." Journal of Health Sciences 23, no. 2 (June 21, 2021): 92–98. http://dx.doi.org/10.17921/2447-8938.2021v23n2p92-98.
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AbstractThe use of ionizing radiation, affects not only malignant cells but also healthy tissues, and promotes several side acute or late effects in the oral cavity. Among the acute effects, oral mucositis, xerostomia, hyposalivation, dysgeusia and dysphagia present a prominent role. The present study aims to conduct a narrative literature review on radiotherapy in the head and neck region as a therapeutic modality for cancer in this region and the main acute oral manifestations and their respective treatments. This was an exploratory literature review, through the database of Scielo, Pubmed, Medline and institutional websites using the crossing of the descriptors in English and Portuguese “head and neck neoplasms”, “radiotherapy”, “xerostomia”, “dysgeusia” and “dysphagia”. According to the established criteria, a total of 46 articles and 2 institutional websites were selected from the databases, and one book was added for presenting relevance on this theme. The results demonstrate that oral mucositis is the most prevalent acute effect and has a direct impact on patient’s quality of life, but there is no gold standard treatment. Dysphagia, xerostomia, hyposalivation and dysgeusia are common manifestations in irradiated patients, and present several therapeutic modalities. Given the importance of side effects of radiotherapy in head and neck region, further studies are needed to widely disseminate acute oral manifestations in irradiated patients. Keywords: Oral Mucositis. Head and Neck Neoplasms. Radiotherapy. Xerostomia. ResumoA utilização de radiação ionizante, no câncer de cabeça e pescoço, afeta não somente células malignas, mas também tecidos sadios, o que promove diversos efeitos colaterais em cavidade oral, classificados em agudos ou tardios. Dentre os efeitos agudos, a mucosite oral, xerostomia, hipossalivação, disgeusia e disfagia apresentam papel de destaque. O presente trabalho visou realizar uma revisão narrativa de literatura sobre a radioterapia em região de cabeça e pescoço como modalidade terapêutica para o câncer nesta região e as principais manifestações orais agudas decorrentes da radiação ionizante e seus respectivos tratamentos. Tratou-se de revisão de literatura do tipo exploratória, através das bases de dados da Scielo, Pubmed, Medline e sites institucionais utilizando o cruzamento dos descritores em inglês e português “neoplasias de cabeça e pescoço”, “radioterapia”, “mucosite oral”, “xerostomia”, “disgeusia” e “disfagia”. De acordo com os critérios estabelecidos, um total de 46 artigos e 2 sites institucionais foram selecionados nas bases de dados, e 1 livro foi acrescentado por apresentar relevância sobre a temática em questão. Os resultados demonstram que a mucosite oral é o efeito agudo mais prevalente e apesar de ter impacto direto na qualidade de vida, não há tratamento considerado padrão ouro para esta condição. A disfagia, xerostomia, hipossalivação e disgeusia são manifestações comuns em pacientes irradiados, e apresentam diversas modalidades terapêuticas que podem ser empregadas. Dada à importância dos efeitos colaterais da radioterapia de cabeça e pescoço, torna-se necessária a realização de mais estudos afim de divulgar amplamente as manifestações orais agudas em pacientes irradiados. Palavras-chave: Mucosite Oral. Neoplasias de Cabeça e Pescoço. Radioterapia. Xerostomia
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Wanjarkhedkar, Pankaj, Sonali Pingley, Shaileshkumar Shende, Dhananjay Kelkar, Amit Parasnis, Mahesh Sambhus, Girish Phadake, Sachin Hingmire, Padmaj Kulkarni, and Chetan Deshmukh. "An Ayurveda Gargle Regimen in Management of Radiotherapy-induced Oral Mucositis." South Asian Journal of Cancer 09, no. 04 (October 2020): 250–52. http://dx.doi.org/10.1055/s-0041-1726138.
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Abstract Background Radiotherapy-induced oral mucositis (RIOM) in patients with head and neck cancer may lead to significant morbidity. OM may result in erythema, ulceration, and pseudomembrane formation. The usual time of onset is second or third week of radiotherapy (RT), after the doses of 16 to 18 Gy. OM may cause severe pain, significant weight loss, increased resource use, interruption or discontinuation of the treatment, and added cost of supportive care. Materials and Methods Patients who underwent RT and chemoradiation (CTRT) for head and neck squamous cell carcinoma (HNSCC) from 2015 to 2016 were included. The patients who were treated with the add-on Ayurveda gargle regimen (AGR) of sapthachhadadi gandoosham were evaluated against patients treated with standard symptomatic care (SSC). Statistical Analysis Chi-square test was used to compare the difference between the two groups in the present study with SPSS (SPSS version 20 for Windows package SPSS Science, Chicago, IL, USA). software. Result Grade III to IV OM was lower in the AGR group when compared with the SSC group (p < 0.001). Onset of OM was significantly delayed in patients from the AGR group (p < 0.001). Conclusion The AGR with sapthachhadadi gandoosham is effective in delaying the onset and reducing severity of OM in HNSCC, without compromising the rate of locoregional recurrence.
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Zambrano, Thaináh Bruna dos Santos, Solange De Paula Ramos, Nora Gavilanes, and Ricardo Sergio Almeida. "Oropharyngeal Candidiasis in Patients Undergoing Radiotherapy for Head and Neck Cancer: Literature Review." Journal of Health Sciences 20, no. 2 (July 27, 2018): 119. http://dx.doi.org/10.17921/2447-8938.2018v20n2p119-121.
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AbstractCandidiasis is closely related to patients undergoing head and neck radiotherapy due to the immunosuppressive state, induced xerostomia, mucositis and difficulties in establishing adequate oral hygiene. Therefore, the aim of this study was to discuss the relationship between candidal infections and the radiotherapy of the head and neck region, based on available scientific literature. In order to identify the studies included or considered in this study, a search strategy was carried out for the following databases: SCOPUS, Web of Science and PubMed. Inclusion criteria were publications that addressed key words: Candida spp. of the oral cavity and head and neck cancer. Therefore, this work exposes the necessity for studies relating candidal infections with radiotherapy treatment of the head and neck region. However, it is possible suggest that colonization and infection by Candida spp. can be increased by radiotherapy. Additionally, it can be suggested that patients irradiated at the head and neck region should be periodically investigated for the presence of pathogenic yeasts in the oral cavity, followed by greater care with oral hygiene and nutrition.Keywords: Candida Spp. Xerostomia. Oral Health. Publications.ResumoA candidíase está intimamente relacionada com pacientes submetidos a radioterapia de cabeça e pescoço devido ao estado imunossupressor, xerostomia induzida, mucosite e dificuldades no estabelecimento de higiene bucal adequada. Portanto, o objetivo deste estudo foi discutir a relação entre infecções por Candida spp. e a radioterapia da região da cabeça e pescoço, com base na literatura científica disponível. Para identificar os estudos incluídos ou considerados neste estudo, foi realizada uma estratégia de busca para os seguintes bancos de dados: SCOPUS, Web of Science e PubMed. Os critérios de inclusão foram publicações que abordavam as palavras-chave: Candida spp. da cavidade oral e câncer de cabeça e pescoço. Desta forma, este trabalho expõe a necessidade de estudos relacionados às infecções por Candida spp. com tratamento de radioterapia da região da cabeça e pescoço. No entanto, podemos sugerir que a colonização e a infecção por Candida spp. pode ser aumentada por radioterapia. Além disso, pode-se sugerir que os pacientes irradiados na região da cabeça e pescoço devem ser investigados periodicamente quanto à presença de leveduras patogênicas na cavidade bucal, seguido de maiores cuidados com higiene bucal e nutrição.Palavras-chave: Candida Spp. Xerostomia. Saúde Bucal. Publicações.
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Kawashita, Yumiko, Sakiko Soutome, Masahiro Umeda, and Toshiyuki Saito. "Predictive Risk Factors Associated with Severe Radiation-Induced Mucositis in Nasopharyngeal or Oropharyngeal Cancer Patients: A Retrospective Study." Biomedicines 10, no. 10 (October 21, 2022): 2661. http://dx.doi.org/10.3390/biomedicines10102661.
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Radiation-induced mucositis in head and neck cancer patients generates difficulties in eating and swallowing, and may influence treatment tolerance, compliance, and quality of life. However, predictive factors have not been studied in detail. Thus, the aim of this study was to describe the association between pre-radiotherapy clinical factors and the incidence of severe radiation-induced mucositis in nasopharyngeal or oropharyngeal cancer patients. This retrospective study included all patients with definitive radiotherapy or chemoradiotherapy for nasopharyngeal or oropharyngeal cancer between July 2011 and June 2021 in a single center. The eligibility criteria included patients who received oral management during radiotherapy. Exclusion criteria was patients who received postoperative radiotherapy. The data were acquired from the medical records of patients. One hundred patients were included in this retrospective study. Grade 3 radiation-induced mucositis occurred in 47 patients (47%). Lymphocyte count was significantly associated with grade 3 mucositis (OR = 0.40; 95% CI = 0.19–0.86; p = 0.018). It is suggested that pre-radiation lower lymphocyte counts are a predictive risk factor for severe mucositis in patients who undergo definitive radiotherapy or chemoradiotherapy for nasopharyngeal or oropharyngeal cancer
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Suresh, Rao, Hegde Sanath, Rao Pratima, D’silva Prajna, Katherin D’souza Rhea, Ponadka Rai Manoj, and Shrinath Baliga Manjeshwar. "Appraisal of Beneficial Effects of Oral Supplementation with Folic Acid during Curative Chemo-Radiation for Head and Neck Cancer: An Observational Study." Cancer Medicine Journal 2, no. 2 (December 31, 2019): 54–62. http://dx.doi.org/10.46619/cmj.2019.2-1014.
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Background: In people undergoing curative radiation treatment to the head and neck region the local effects like mucositis, dysphasia, dermatitis, salivary dysfunction and systemic effects like anaemia and leucopoenia are major issues. Folic acid is always provided when a patient has anaemia and is also regularly used in the care of cancer patients. However, literature study indicates that the quantum of beneficial effects of folic acid supplementing to patients undergoing curative radiotherapy are lacking. In lieu of these observations the present study was conducted to ascertain the beneficial effect of folic acid supplementation to head and neck cancer (HNC) patients undergoing curative radiotherapy. Methods: This was an observational study and was carried out in HNC patients planned for curative radiotherapy. The folic acid levels were estimated at the start of the study. Patients who had folic acid less than 20 ng/ml were prescribed folic acid (5 mg TID) for the first two weeks. The incidence of mucositis, dysphasia, dermatitis, salivary dysfunction, anaemia and leucopoenia were analysed at the end of the study. For analysis we studied what is the effect in people who had folic acid less than and, above 5 ng/ml and analysed the results using the X2 analysis. Results: The results indicated that there was a significant difference (p = 0.03) was seen in the incidence of leukopenia in the volunteers who had less than 5 ng/ml of folic acid. A significant difference in the incidence of severe dermatitis (P = 0.04) and in weight loss (P = 0.02) was also observed. Conclusions: The study findings suggest that when compared to the patients who had folic acid less than 5 ng/ml, administering folic acid was beneficial in mitigating dermatitis, weight loss and leucopenia in people with folic acid above 5 ng/ml. More studies are required to ascertain the benefit of folic acid.
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Wei, J., J. Wu, L. Meng, B. Zhu, H. Wang, Y. Xin, Y. Chen, et al. "Effects of early nutritional intervention on oral mucositis in patients with radiotherapy for head and neck cancer." QJM: An International Journal of Medicine 113, no. 1 (August 20, 2019): 37–42. http://dx.doi.org/10.1093/qjmed/hcz222.
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Summary Background To observe the effect of early nutritional intervention on radiation-induced oral mucositis and nutritional status in patients with head and neck cancer (HNC). Methods A total of 54 HNC patients were divided into early (28 cases) and late (26 cases) nutritional intervention groups. The early group received enteral nutrition at the beginning of radiotherapy (RT), while the late group received enteral nutrition after restricted feeding. Operators reported and assessed the timing and extent of oral mucositis and nutritional status during treatment. The nutritional status assessment indicators included body weight; body mass index (BMI); Patient-Generated–Subjective Global Assessment (PG-SGA) score; levels of albumin, hemoglobin and pre-albumin and total lymphocyte count. Results The incidence of high-grade oral mucositis was significantly lower in the early group than that in the late group (P < 0.05). Nutritional status assessments showed more significant weight and BMI losses in the late group than in the early group at weeks 4 and 7 after RT (P < 0.01). The albumin decreased in the late group at week 7 after RT was more significant than that in the early group (P < 0.05). Albumin, hemoglobin and pre-albumin levels and total lymphocyte count decreased significantly in both groups (P > 0.05). During therapy, more patients in the early group were well-nourished and fewer were malnourished according to PG-SGA scores (P < 0.05). Conclusion Early nutritional intervention can reduce the incidence of high-grade oral mucositis during RT in patients with HNC and improve the nutritional status during treatment, which has important clinical significance.
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Guedes, Cizelene do Carmo Faleiros Veloso, Silas Antonio Juvencio de Freitas Filho, Paulo Rogério de Faria, Adriano Mota Loyola, Robinson Sabino-Silva, and Sérgio Vitorino Cardoso. "Variation of Energy in Photobiomodulation for the Control of Radiotherapy-Induced Oral Mucositis: A Clinical Study in Head and Neck Cancer Patients." International Journal of Dentistry 2018 (February 22, 2018): 1–6. http://dx.doi.org/10.1155/2018/4579279.
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Oral mucositis (OM) is a frequent and severe adverse effect of therapy against head and neck cancer. Photobiomodulation with the low-power laser is known to be effective against OM, but the diversity of protocols and the possibility of stimulating residual tumor cells are still obstacles. The present study aimed to compare two doses of laser energy delivered to the oral mucosa of patients under oncologic treatment for head and neck cancer, looking for differences in the control of mucositis, as well as in the frequency of tumoral recurrences. Fifty-eight patients undergoing radiotherapy were randomized into two groups, distinguished according to the energy delivered by laser irradiation, namely, 0.25 J and 1.0 J. The groups were compared according to frequency, severity, or duration of OM, as well as the frequency of tumoral recurrences. OM was significantly less frequent in patients receiving 1.0 J of energy, but the groups did not differ regarding severity or duration of OM. Tumoral recurrence also did not vary significantly between the groups. Photobiomodulation with a higher dose of energy (1.0 J versus 0.25 J) is associated with better control of radiotherapy-induced OM and does not significantly increase the risk of neoplastic recurrence.
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Chambers, M. S., D. V. Welsh, R. A. Scrimger, W. Zehn, J. B. Epstein, J. Troha, and S. T. Sonis. "RK-0202 for radiation-induced oral mucositis." Journal of Clinical Oncology 24, no. 18_suppl (June 20, 2006): 5523. http://dx.doi.org/10.1200/jco.2006.24.18_suppl.5523.
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5523 Background: This study evaluated the effect of RK-0202, administered as an oral rinse, on the incidence of severe oral mucositis in patients being treated with of radiation therapy (RT) for tumors of the head and neck. Methods: This was a prospective, randomized, placebo-controlled, double-blind study that compared the effect of 2 concentrations of RK-0202 with placebo on the incidence of severe oral mucositis at a cumulative RT dose of 60 Gy in 110 subjects. Twenty-seven subjects received RK-0202 5%, 38 received RK-0202 10%, 29 received placebo and 16 received standard of care. Subjects began dosing just prior to RT and continued dosing six times daily throughout RT. Oral mucositis was assessed twice weekly throughout RT by trained oral evaluators. Results: The higher dose of RK-0202 (10%) successfully attenuated severe oral mucositis as measured by WHO or NCI-CTC v.3 criteria. The incidence of WHO grade 3 or 4 oral mucositis by a cumulative RT dose of 60 Gy was 35% in the RK-0202 group vs. 54% in the placebo group (p = NS). By 50 Gy the incidences in the RK-0202 and placebo groups were 25% and 54%, respectively (p = 0.053). Similarly, the incidence of NCI grade 3 or 4 oral mucositis by 60 Gy was 64% in the RK-0202 cohort vs. 92% for subjects being treated with placebo (p = 0.005). Subjects treated with RK-0202 required less feeding tube placement compared to placebo recipients (3% vs. 22%, p = 0.037) and less opiate analgesia. The median percent of time on opiates was 6% on RK-0202 vs. 21% on placebo. The overall incidence of serious adverse events was significantly lower in subjects treated with RK-0202 (8% vs. 31%, p = 0.024). In general, there was no benefit noted among subjects who received RK-0202 as a 5% solution. Conclusions: RK-0202 significantly reduced the incidence of severe mucositis in subjects treated with radiotherapy for head and neck cancer and was not associated with significant adverse events. [Table: see text]
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Wang, Cong, Peiguo Wang, Huaqiang Ouyang, Jing Wang, Lining Sun, Yanwei Li, Dongying Liu, Zhansheng Jiang, Bin Wang, and Zhanyu Pan. "Efficacy of Traditional Chinese Medicine in Treatment and Prophylaxis of Radiation-Induced Oral Mucositis in Patients Receiving Radiotherapy: A Randomized Controlled Trial." Integrative Cancer Therapies 17, no. 2 (September 4, 2017): 444–50. http://dx.doi.org/10.1177/1534735417725578.
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Objective: To estimate the efficacy of traditional Chinese medicine (Chining decoction, CHIN) for radiation-induced oral mucositis in patients with head and neck cancer. Methods: From May 2014 to December 2015, 70 consecutive patients were randomly assigned to receive CHIN (treatment group) or recombinant human epidermal growth factor (rhEGF) spray (control group) at a 1:1 ratio. CHIN was administered to treatment group from the first day of radiotherapy until the completion of radiotherapy. Simultaneously, the rhEGF spray was administered to control group on the oral mucosa of irradiated area. The clinical benefit was determined by gradation of mucositis (Common Terminology Criteria for Adverse Events v4.0), oral pain, and xerostomia (visual analysis scale) for each week during radiotherapy. Body mass index was evaluated before and after radiotherapy. Results: Patients in the treatment group had prominent remission of oral pain and grade of mucositis on each observing point compared with those in control group ( P < .01). Xerostomia was decreased notably in treatment group compared with control group ( P < .01). Body mass index in the treatment group exhibited advantage over control group after radiotherapy, but there was no statistical significance (19.8 ± 3.26 vs 18.8 ± 2.5 kg/m2, P = .153, >.05). Conclusions: CHIN presented an obvious advantage in preventing radiation-induced oral mucositis compared with rhEGF spray.
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Yatsuoka, Wakako, Takao Ueno, Kanako Miyano, Ayame Enomoto, Sana Ota, Masahiro Sugimoto, and Yasuhito Uezono. "Time-Course of Salivary Metabolomic Profiles during Radiation Therapy for Head and Neck Cancer." Journal of Clinical Medicine 10, no. 12 (June 15, 2021): 2631. http://dx.doi.org/10.3390/jcm10122631.
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Oral mucositis (OM) is one of the most frequently observed adverse oral events in radiation therapy for patients with head and neck cancer. Thus, objective evaluation of OM severity is needed for early and timely intervention. Here, we analyzed the time-course of salivary metabolomic profiles during the radiation therapy. The severity of OM (National Cancer Institute (NCI) Common Terminology Criteria for Adverse Events v3.0) of nine patients with head and neck cancer was evaluated. Partial least squares regression-discriminant analysis, using samples collected before radiation therapy, showed that histidine and tyrosine highly discriminated high-grade OM from low-grade OM before the start of radiation therapy (significant difference, p = 0.048 for both metabolites). Further, the pretreatment concentrations of gamma-aminobutyric acid and 2-aminobutyric acids were higher in the high-grade OM group. Although further validations are still necessary, this study showed potentially associated metabolites with worse radiotherapy-related OM among patients with head and neck cancer.
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Zhu, J., H. Zhang, J. Li, X. Zheng, X. Jia, Q. Xie, L. Zheng, X. Zhou, Y. Wang, and X. Xu. "LiCl Promotes Recovery of Radiation-Induced Oral Mucositis and Dysgeusia." Journal of Dental Research 100, no. 7 (March 11, 2021): 754–63. http://dx.doi.org/10.1177/0022034521994756.
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Oral mucositis and taste dysfunction are frequently complained by patients with head and neck cancer receiving radiotherapy, challenging the clinical outcome of cancer treatment. Recent studies have indicated the protective role of Wnt/β-catenin signaling in radiation-induced oral mucositis (RIOM) and its pivotal role in the development and self-renewal of taste buds. The current study hypothesizes that lithium chloride (LiCl), a potent activator of the Wnt/β-catenin signaling pathway, can promote the postirradiation restoration of oral mucosa integrity and taste function. To validate this hypothesis, we established a RIOM mouse model and evaluated the treatment efficacy of LiCl on oral mucositis and taste dysfunction in comparison with keratinocyte growth factor (KGF), an agent approved by the US Food and Drug Administration for oral mucositis. The results showed that LiCl alleviated the weight loss and tongue ulceration of RIOM mice, promoted proliferation of basal epithelial cells, and inhibited epithelial-mesenchymal transition in tongue mucosa. More important, elevated taste bud renewal and dysgeusia recovery toward sweetness were observed in RIOM mice treated with LiCl as compared to those treated by KGF. Collectively, our data demonstrate that LiCl can mitigate oral mucositis and rescue taste alteration induced by irradiation, and activation of Wnt/β-catenin signaling may represent a promising therapy to improve the quality of life of patients receiving radiotherapy.
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Wang, Yujie, Lichuan Zhang, Shuai Jin, Hongmei Li, Liqing Gong, Yanli Wang, Sanli Jin, Yiwei Cao, Yian Shih, and Qian Lu. "Swallowing functional outcomes and nutritional status in head and neck cancer radiotherapy: longitudinal study." BMJ Supportive & Palliative Care 10, no. 4 (May 13, 2020): 452–61. http://dx.doi.org/10.1136/bmjspcare-2020-002216.
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ObjectiveTo explore the relationships between swallowing functional outcomes and nutritional status in patients with head and neck cancer undergoing radiotherapy (RT).MethodsThis longitudinal study included 122 patients. Data were collected at three time points: baseline (T1), the third week of RT (T2) and the completion of RT (T3). The Common Terminology Criteria for Adverse Events was used to assess the symptom of dysphagia and other toxicities; the MD Anderson Dysphagia Inventory (MDADI) was used to assess the patient-perceived swallowing functional outcomes; the nutritional status was evaluated by the weight ratio and the Patient-Generated Subjective Global Assessment (PG-SGA). The generalised estimating equation (GEE) was used to measure the correlation of MDADI with the weight ratio or PG-SGA and also to analyse the influential factors of swallowing functional outcomes.ResultsThe participants’ acute dysphagia rates were 5.7% at T1, 69.7% at T2 and 77.9% at T3. The swallowing functional outcomes worsen over RT (p<0.001) and were associated with weight ratio (β=0.032, p=0.008) and PG-SGA (β=−0.115, p<0.001). GEE models showed that patients with cancer of the pharynx region, advanced stage, chemoradiotherapy and high RT dose perceived worse swallowing functional outcomes. Oral mucositis, pharynx mucositis and salivary gland inflammation were positively correlated with swallowing functional outcomes, and the pharynx mucositis presented the highest absolute value of β.ConclusionThe swallowing functional outcomes were negatively correlated with nutritional status. Healthcare professionals should identify early on the population at higher risk and focus on multiple toxicities, especially the management of pharynx mucositis, to improve nutritional status.
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Vissink, A., F. R. Burlage, F. K. L. Spijkervet, J. Jansma, and R. P. Coppes. "Prevention and Treatment of the Consequences of Head and Neck Radiotherapy." Critical Reviews in Oral Biology & Medicine 14, no. 3 (May 2003): 213–25. http://dx.doi.org/10.1177/154411130301400306.
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The location of the primary tumor or lymph node metastases dictates the inclusion of the oral cavity, salivary glands, and jaws in the radiation treatment portals for patients who have head and neck cancer. The clinical sequelae of the radiation treatment include mucositis, hyposalivation, loss of taste, osteoradionecrosis, radiation caries, and trismus. These sequelae may be dose-limiting and have a tremendous effect on the patient’s quality of life. Most treatment protocols to prevent these sequelae are still based on clinical experience, but alternatives based on fundamental basic and clinical research are becoming more and more available. Many of these alternatives either need further study before they can be incorporated into the protocols commonly used to prevent and treat the radiation-related oral sequelae or await implementation of these protocols. In this review, the various possibilities for prevention and/or treatment of radiation-induced changes in healthy oral tissues and their consequences are discussed.
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Galitis, Evangelos, Vyron Droukas, Michail Tzakis, Vassileios Psarras, Dimitra Galiti, Eythymios Kyrodimos, Miltiadis Trichas, et al. "Trismus and reduced quality of life in patients with oral squamous cell carcinoma, who received post-operative radiotherapy alone or combined with chemotherapy." Forum of Clinical Oncology 8, no. 1 (June 30, 2017): 29–36. http://dx.doi.org/10.1515/fco-2015-0023.
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Abstract Background Patients, who receive radiotherapy (RT) for head and neck cancer, develop chronic functional abnormalities and survive with reduced quality of life. Purpose We aimed to study patients with oral cancer, who received post-operative radiotherapy or chemoradiotherapy. Patients Ten patients (mean age 63.8 years) were included. Methods Oral mucositis, pain and xerostomia, maximum mouth opening (MMO) and functional abnormalities before and after RT were recorded. The 35 mm MMO or less was accepted as trismus. Patients completed the EORTC QLQ C-30 and Head/Neck35 questionnaires. Results Mean RT dose was 64.3 Gray. Six patients received chemoradiotherapy. Severe mucositis, pain and xerostomia were recorded in 6 and 5 patients respectively. MMO was reduced in all patients. The mean MMO (34 mm) reached the level of trismus. The total number of symptoms increased from 3.1 to 6.3 in C-30 and from 3.1 to 8.8 per patient in the H/N35. Severe fatigue, pain, limitations at work, weakness, sad feelings, family problems, sleeping problems, anorexia, financial difficulties, tense/irritable, constipation, nausea, vomiting and depression were most often reported with C-30. Most patients reported low to moderate quality of life. Severe oral, jaw and neck pain, swallowing problems, taste alterations, sticky saliva, dry mouth, coarseness, dental problems, feeling sick and reduced interest in life/sex were the most common symptoms reported with N/H35. Conclusions The observed trismus, 2- to 3-fold increase of symptoms and poorer quality of life highlighted the need for support of oral cancer patients, who receive postoperative radiotherapy or chemoradiotherapy.
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Madiyal, Mridula, Krishna Sharan, Indira Bairy, Prakash Peralam Yegneswaran, and Mamidipudi Srinivasa Vidyasagar. "CLINICAL AND MICROBIOLOGICAL PROFILE OF CANDIDA ISOLATES FROM ORAL CANDIDIASIS IN PATIENTS UNDERGOING RADIOTHERAPY FOR HEAD AND NECK MALIGNANCY." Asian Journal of Pharmaceutical and Clinical Research 9, no. 9 (December 1, 2016): 197. http://dx.doi.org/10.22159/ajpcr.2016.v9s3.14870.
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ABSTRACTObjective: To study the clinico-microbiological profile of oral candidiasis in head and neck squamous cell cancer (HNSCC) patients undergoingcurative radiotherapy (cRT).Methods: Patients undergoing cRT and developing oral candidiasis were enrolled. Clinical features such as pain and xerostomia were recorded.Candida isolates from lesions were speciated using CHROMagar (Himedia Inc.), and antifungal susceptibility was determined using microbrothdilution (MBD). Patients were followed up to study the clinical course of infection.Results: Of the 100 patients undergoing cRT, 79 developed oral candidiasis. Median duration to development of infection was 4 weeks (range:1-6.5 weeks). Mucositis was observed in 76 (96.2%) and xerostomia in 53 (67.1%) patients; 61 patients (77.2%) had symptoms attributable tocandidiasis. However, there was no correlation between severity of infection and mucositis (p=0.84) or xerostomia (p=0.51). Candida albicans was themost frequent (47 patients, 59.4%) isolate, followed by Candida tropicalis (23 patients; 29.1%). All isolates were sensitive to nystatin, but fluconazoleresistance/dose-dependent susceptibility was noted in 26 (32.9%) isolates. Both Candida krusei and two of four Candida glabrata isolate exhibitedfluconazole resistance. All patients received treatment for Candidiasis. On follow-up, 1 month after cRT, oral candidiasis resolved with gradualrecovery of mucositis in all patients.Conclusion: Candida albicans was the most common cause of oral Candidiasis in HNSCC cRT, and all isolates were susceptible to nystatin in-vitro.All lesions resolved with recovery from mucositis. In addition, as no patient developed systemic candidiasis, it appears that oral candidiasis thoughtroublesome is curable with treatment.Keywords: Radiation mucositis, CHROMagar, Microbroth dilution, Antifungal susceptibility.
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Fasanaro, Elena, Paola Del Bianco, Elena Groff, Antonella Riva, Giovanna Petrangolini, Fabio Busato, Paola Stritoni, Giovanni Scarzello, Lucio Loreggian, and Gian Luca De Salvo. "Role of SAMITAL in the Prevention and Treatment of Chemo-Radiotherapy-Induced Oral Mucositis in Head and Neck Carcinoma: A Phase 2, Randomized, Double-Blind, Placebo-Controlled Clinical Trial (ROSAM)." Cancers 14, no. 24 (December 15, 2022): 6192. http://dx.doi.org/10.3390/cancers14246192.
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Background: In patients affected by head and neck squamous cell carcinoma, the onset of severe oral mucositis is a decisive factor in completing concurrent chemo-radiotherapy, and few interventions have demonstrated a modest benefit. The primary aim of this clinical study was to evaluate the role of SAMITAL in reducing the incidence of severe mucositis induced by concurrent chemo-radiotherapy; the secondary aims were the tolerability and patient-reported quality of life measures. Methods: Patients were randomized to receive SAMITAL granules for oral suspension of 20 mL, four-time daily or matching placebo in a 1:1 fashion using a stratified-block randomization scheme by disease site and type of chemotherapy. The SAMITAL/placebo was dispensed at the baseline visit and at each weekly visit following radiotherapy initiation. Patients were subjected to weekly endoscopic evaluations to assess the presence of mucositis. In addition, patient-reported outcomes were measured. Results: Among the 116 patients treated with a median total dose of 66 Gy, 59 were randomized to SAMITAL and 57 to placebo. Overall, the incidence of severe mucositis was 51.7%, with 45.8% in the SAMITAL and 57.9% in the placebo arm (OR = 0.6; 95% CI: 0.3–1.3). After chemo-radiotherapy, patients randomized to SAMITAL reported significantly lower xerostomia, coughing and swallowing scores and a better quality of life. Conclusion: SAMITAL did not significantly reduce the incidence of severe mucositis in all studied populations. However, the lower rate of mucositis, together with a significantly better quality of life, suggested that a clinical benefit existed. This trial is registered with the EU Clinical Trials Register database, number 2012-002046-20, and with ClinicalTrials.gov, NCT01941992.
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El Mobadder, Marwan, Fadi Farhat, Wassim El Mobadder, and Samir Nammour. "Photobiomodulation Therapy in the Treatment of Oral Mucositis, Dysgeusia and Oral Dryness as Side-Effects of Head and Neck Radiotherapy in a Cancer Patient: A Case Report." Dentistry Journal 6, no. 4 (November 10, 2018): 64. http://dx.doi.org/10.3390/dj6040064.
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Successful management of oral mucositis, dysgeusia and oral dryness was made with five sessions of photobiomodulation. The severity of oral mucositis was measured according to the World Health Organization scale for the assessment of oral mucositis. Dysgeusia testing was performed according to the International Standards Organization (ISO). For the assessment of oral dryness or hyposalivation, quantity of the total resting and stimulated saliva (Q-sal, mL/min) was measured. Photobiomodulation parameters, applications, and treatment protocol used were suggested by an international multidisciplinary panel of clinicians and researchers with expertise in the area of supportive care in cancer and/or PBM clinical application and dosimetry. This case report confirms the effectiveness of photobiomodulation therapy in the management of oral mucositis, dysgeusia, and oral dryness.
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Daugėlaitė, Goda, Kristė Užkuraitytė, Eglė Jagelavičienė, and Aleksas Filipauskas. "Prevention and Treatment of Chemotherapy and Radiotherapy Induced Oral Mucositis." Medicina 55, no. 2 (January 22, 2019): 25. http://dx.doi.org/10.3390/medicina55020025.
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Background and objectives: Oral mucositis is one of the main adverse events of cancer treatment with chemotherapy or radiation therapy. It presents as erythema, atrophy or/and ulceration of oral mucosa. It occurs in almost all patients, who receive radiation therapy of the head and neck area and from 20% to 80% of patients who receive chemotherapy. There are few clinical trials in the literature proving any kind of treatment or prevention methods to be effective. Therefore, the aim of this study is to perform systematic review of literature and examine the most effective treatment and prevention methods for chemotherapy or/and radiotherapy induced oral mucositis. Materials and methods: Clinical human trials, published from 1 January 2007 to 31 December 2017 in English, were included in this systematic review of literature. Preferred reporting items for systematic reviews and meta-analysis (PRISMA) protocol was followed while planning, providing objectives, selecting studies and analyzing data for this systematic review. “MEDLINE” and “PubMed Central” databases were used to search eligible clinical trials. Clinical trials researching medication, oral hygiene, cryotherapy or laser therapy efficiency in treatment or/and prevention of oral mucositis were included in this systematic review. Results: Results of the studies used in this systematic review of literature showed that laser therapy, cryotherapy, professional oral hygiene, antimicrobial agents, Royal jelly, L. brevis lozenges, Zync supplementation and Benzydamine are the best treatment or/and prevention methods for oral mucositis. Conclusions: Palifermin, Chlorhexidine, Smecta, Actovegin, Kangfuxin, L. brevis lozenges, Royal jelly, Zync supplement, Benzydamine, cryotherapy, laser therapy and professional oral hygiene may be used in oral mucositis treatment and prevention.
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Taheri, M., K. Sohrabi, M. H. Salehi, and M. H. Najafi. "Clinical evaluation of the effects of radiotherapy on oral mucosa and gingiva." Journal of Radiotherapy in Practice 7, no. 4 (December 2008): 195–204. http://dx.doi.org/10.1017/s1460396908006390.
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AbstractIntroduction:The use of radiotherapy, alone or in conjunction with surgical resection, is common in treating head and neck tumours. However, ionising radiation induces unavoidable changes in the surrounding normal tissues, causing severe complications. Therefore, we decided to study different effects of radiotherapy on gingiva and oral mucosa.Methods and Materials:This prospective analytical study was performed on 30 patients with head and neck cancers referred to the radiotherapy department of Ghaem Hospital from March to October 2006. Data were collected by means of interviews, clinical examinations and patients’ medical file investigation. The impact of different dosages of radiation on gingiva and oral mucosa was investigated. Data analysis was performed using general linear model (GLM), Cochran and multivariate analysis of variance (MANOVA) tests via SPSS V. 11.5 software.Results:A direct relationship between increase in radiation dosage, irritation of oral mucosa, ulcer development and mucositis was observed. But there was no significant relationship between NUG (necrotising ulcerative gingivitis) and perlèche and radiation dosage. Periodontal index (PI), gingival index (GI) and papillary bleeding index (PBI) were increased, but due to limited time of study (6–7 weeks), no change in gingival recession was observed. Plaque index (PLI) decreased during treatment process because of oral hygiene instructions.Conclusion:The oral and periodontal health status of head and neck cancer patients before and during radiotherapy has been described in this article. The authors believe that prevention or reduction of side-effects of radiation should be an integral part of treatment as they may have tremendous effect on the patient's quality of life. This study supports the need for dental assessment and treatment planning before radiation therapy.
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Winter, Christina, Roman Keimel, Markus Gugatschka, Dagmar Kolb, Gerd Leitinger, and Eva Roblegg. "Investigation of Changes in Saliva in Radiotherapy-Induced Head Neck Cancer Patients." International Journal of Environmental Research and Public Health 18, no. 4 (February 9, 2021): 1629. http://dx.doi.org/10.3390/ijerph18041629.
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The intact function of the salivary glands is of utmost importance for oral health. During radiotherapy in patients with head and neck tumors, the salivary glands can be damaged, causing the composition of saliva to change. This leads to xerostomia, which is a primary contributor to oral mucositis. Medications used for protective or palliative treatment often show poor efficacy as radiation-induced changes in the physico-chemical properties of saliva are not well understood. To improve treatment options, this study aimed to carefully examine unstimulated whole saliva of patients receiving radiation therapy and compare it with healthy unstimulated whole saliva. To this end, the pH, osmolality, electrical conductivity, buffer capacity, the whole protein and mucin concentrations, and the viscoelastic and adhesive properties were investigated. Moreover, hyaluronic acid was examined as a potential candidate for a saliva replacement fluid. The results showed that the pH of radiation-induced saliva shifted from neutral to acidic, the osmolality increased and the viscoelastic properties changed due to a disruption of the mucin network and a change in water secretion from the salivary glands. By adopting an aqueous 0.25% hyaluronic acid formulation regarding the lost properties, similar adhesion characteristics as in healthy, unstimulated saliva could be achieved.
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Vidović Juras, Danica, Monika Burja, Ivana Škrinjar, Ana Andabak Rogulj, Božana Lončar Brzak, and Vlaho Brailo. "Suvremeni pristup liječenju oralnog mukozitisa." Medicina Fluminensis 58, no. 3 (September 1, 2022): 204–13. http://dx.doi.org/10.21860/medflum2022_280995.
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Oral mucositis (OM) is a serious inflammation of the mucosa and occurs in patients with head and neck cancer (HNC) who are being treated with radiotherapy (RT) and/or chemotherapy (CT), and in patients undergoing hematopoietic stem cell transplantation (HSCT). The inflammation accompanied with painful ulcerations inside the oral cavity impairs its function making the basic functions like eating and speech hard or even impossible. It usually occurs at the end of the first week of RT and lasts for several weeks after cessation. The intensity of OM can sometimes lead to discontinuation of RT. The degree of mucositis regarding chemotherapy depends on the type of antineoplastic drug, therapeutic procedure, duration of the therapy and dose, as well as previous exposure of the oral cavity to toxic agents.Prolonged or repeated administration of lower doses of chemotherapy is associated with a higher chance of developing oral mucositis comparing to a bolus, while chronomodulation of chemotherapy reduces the possibility of mucositis without affecting antineoplastic activity. The treatment of OM is symptomatic, as there is still no effective treatment. In this review paper, several contemporary options for alleviating the symptoms of oral mucositis are listed.
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Nigro, Olga. "Evaluation of the effectiveness of a new medical device containing verbascoside, polyvinylpyrrolidone, and hyaluronic acid in prevention and treatment of mucositis in patients with cancer." Journal of Clinical Oncology 36, no. 34_suppl (December 1, 2018): 206. http://dx.doi.org/10.1200/jco.2018.36.34_suppl.206.
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206 Background: Mucosal injury is the consequence of biologic events coupled with the influence of the oral environment and microbiome. Oral mucositis is one of the most common toxicities of chemoradiation therapies. Incidence and severity varies by chemoradiation regimens, radiation fıelds, and tumor site. The influence of mucositis on quality of life is greater among patients than the medical literature would suggest. Lack of experience in evaluating treatment toxicities is a daily problem in cancer patients. The aim of this study was to assess the efficacy of verbascoside’s (mucosyte) oral solution on mucositis in cancer patients. Methods: Fourty-five patients with different grade mucositis treated with mucosyte (ranging from 1-2 to 6-7 rinses/day, according to the guidelines) were evaluated from October 2017 to June 2018. Patients were monitored every week until complete remission. Results: Of 45 patients enrolled, 5 had G1 oral mucositis at baseline, 21 had G2, 13 had G3 and 3 had G4. Three patients had G0 oral mucositis at baseline. Median age was 66.8 years. Six patients were treated with carboplatin/paclitaxel, and six with cisplatin/pemetrexed for non-small cell lung cancer; nine patients were treated with paclitaxel, six with adriamycin/cyclophosphamide, and two with eribulin for breast cancer; four patients were treated with FOLFOX for intestinal adenocarcinoma; three patients were treated with nab-paclitaxel/gemcitabine for pancreatic cancer; five patients were treated with cisplatin/cetuximab, and four with cisplatin/cetuximab plus radiotherapy for squamous-cell head and neck cancer. All patients reached complete remission in a median time of 14.9 days (10-24 days). Conclusions: Mucosyte treatment was able to rapidly shorten G3/4 oral mucositis to G1/2, and to never happen mucositis in G0 at baseline. Thus, we suggest that mucosyte can be effective both in prevention and treatment of mucositis.
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Takase, H., T. Sueta, T. Nakagawa, and K. Futagami. "Irsogladine Maleate Prevents Oral Mucositis Associated with Radiotherapy in Patients with Head and Neck Cancer." Annals of Oncology 23 (October 2012): xi91. http://dx.doi.org/10.1016/s0923-7534(20)32222-5.
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Tang, Xiuyu, Jiahui Sun, Jie Deng, and Bin Shi. "Treatment of Yunnan Baiyao plus Kangfuxin Solution Reduces Inflammatory Response and Prevents Patients with Nasopharyngeal Carcinoma against Radiation-Induced Oral Mucositis." Journal of Nanomaterials 2021 (May 14, 2021): 1–8. http://dx.doi.org/10.1155/2021/9973539.
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Oral mucositis refers to secondary mucosal damage, which usually occurs during cancer treatment. Generally, patients with head and neck cancers receiving radiotherapy will develop mucositis. Oral mucositis usually begins with mucosal inflammation and is characterized by erythema and confluent ulcers. The purpose of the study is to explore the therapeutic effects of Yunnan Baiyao combined with Kangfuxin solution on radiation-induced oral mucositis and the influence on production of inflammatory factors in patients with nasopharyngeal carcinoma (NPC) after radiotherapy. Clinical variables of 90 NPC patients were retrospectively analyzed. All patients underwent combined treatment (normal saline and inhalation of dexamethasone, gentamicin, and vitamin B12) 1st after radiotherapy, among which 45 patients received additional treatment of Yunnan Baiyao plus Kangfuxin solution and assigned as the study group. We found that additional treatment of Yunnan Baiyao plus Kangfuxin solution remarkably attenuated pain and dry mouth and reduced the degree of mucosal hyperaemia, edema, and ulceration in NPC patients undergoing radiotherapy ( P < 0.05 ). It was also found that additional treatment of Yunnan Baiyao plus Kangfuxin solution notably inhibited the release of inflammatory factors and cancer-related markers, as evidenced by lower serum levels of C-reactive protein (CRP), tumor necrosis factor-α (TNF-α), interleukin-1 (IL-1), matrix metalloproteinase-9 (MMP-9), serum hypoxia-inducible factor-1 α (HIF-1α), and vascular endothelial growth factor (VEGF) detected in the study group than the control group ( P < 0.05 ). Additionally, the numbers of CD+3 and CD+4 subpopulations of T lymphocytes and the ratio of CD+4/CD+8 in the study group were significantly higher than those in the control group ( P < 0.05 ), and the number of CD+8 subpopulations in the study group was significantly lower than those in the control group ( P < 0.05 ). In conclusion, these results indicated that additional treatment of Yunnan Baiyao plus Kangfuxin solution reduces inflammatory response and prevents patients with NPC against radiation-induced oral mucositis.