Статті в журналах: "Periodontitis; oral mucositis; head and neck radiotherapy"

1

Khaw, Arlene, Sharon Liberali, Richard Logan, Dorothy Keefe, and P. Mark Bartold. "Influence of periodontitis on the experience of oral mucositis in cancer patients undergoing head and neck radiotherapy: a pilot study." Supportive Care in Cancer 22, no. 8 (March 20, 2014): 2119–25. http://dx.doi.org/10.1007/s00520-014-2186-3.

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Bodard, Anne-Gaëlle, Abdelbaste Hrifach, Samuel Salino, Matthieu Fabris, Aline Desoutter, Pascal Pommier, and Jérôme Fayette. "Incidence of mucositis in patients with head and neck squamous cell carcinoma treated with radiotherapy plus cetuximab: a pilot study." Médecine Buccale Chirurgie Buccale 18, no. 3 (July 5, 2012): 181–85. http://dx.doi.org/10.1051/mbcb/2012020.

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Labrosse, Géraldine, Nicolas Graillon, Eric Maladiere, Romain Lan, and Fabrice Campana. "Update of photobiomodulation in oral mucositis: a systematic review." Journal of Oral Medicine and Oral Surgery 28, no. 4 (2022): 40. http://dx.doi.org/10.1051/mbcb/2022016.

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Introduction: Oral mucositis (OM) is a common side effect of radiotherapy (RT) or radio-chemotherapy (RT/CT) for head and neck cancers. It causes lesions leading to impairment of the quality of life, dysphagia, pain, and in up to 20% of cases, a dosimetry concession, decreasing local tumor control, thereby impacting the survival rate. Positive results of photobiomodulation (PBM) to treat it have been reported in the literature. PBM has multiple parameters (type of laser, emission mode, number of sessions to be performed, wavelength, power, energy, fluence, exposure time, number of points) making it difficult to implement in clinical practice. Materials and methods: A literature search strategy was applied in Medline by selecting articles published between 2010 and 2020 to answer the following research question: “In patients treated with RT or RT/CT, what is the place of PBM in the management of OM?”, in accordance with PICO (patient, intervention, comparison and outcomes) criteria. The inclusion criteria were all original articles (clinical cases and clinical studies) which answered the research question. Meta-analyses, systematic reviews of the literature and journals, animal or in vitro studies, studies published in a language other than French or English, and full-text articles not accessible via inter-university credits were excluded. Results: Seventeen articles were included, representing 1576 patients. The PBM was intraoral in 16 papers and combined intra- and extra-oral emission in 1 paper. InGaAlP diode laser and HeNe laser significantly reduced OM compared with placebo in 62.5% and 75% of the studies, respectively. Pain reduction was poorly or not documented and when it was, it did not correlate with the reduction of analgesics. Temporary or permanent interruption of radiotherapy was also poorly documented. Discussion: The MASCC/ISOO (2019) report is an important step forward to establish a reproducible protocol for PBM, which as our results show, is heterogeneous in use. Our results showed that the studies started PBM on the first day of RT, using a wavelength of 660 nm for diode laser and 632.8 nm for HeNe laser. However, there is no scientific evidence vis-à-vis the values for power, energy, fluence, exposure time, or number of points. Although PBM appears to be effective in reducing OM scores, its effectiveness on improving patient quality of life, pain, painkiller consumption, compliance with treatment and the occurrence of complications remains to be defined. The relationship between PBM and survival rate was not an objective of this work. We found that of the 17 articles, 15 stated that they did not illuminate the tumor site during PBM sessions. Conclusion: The main objective of this work was to determine the place of PBM in the treatment of OM. Overall, the results on OM scores were favorable in almost ¾ of the studies. Despite its efficacy, the questions of the adjustment of the parameters of PBM, the harmonization on OM scale and its safety on carcinologic recurrence remain to be studied. In view of the lack of comparability of studies and the lack of reported data, studies that harmonize endpoints and follow-up criteria are needed to establish a standard protocol.

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Nicolatou-Galitis, Ourania, Konstantinos Dardoufas, Panagiotis Markoulatos, Anastasia Sotiropoulou-Lontou, Konstantinos Kyprianou, Georgia Kolitsi, George Pissakas, et al. "Oral pseudomembranous candidiasis, herpes simplex virus-1 infection, and oral mucositis in head and neck cancer patients receiving radiotherapy and granulocyte-macrophage colony-stimulating factor (GM-CSF) mouthwash." Journal of Oral Pathology & Medicine 30, no. 8 (September 2001): 471–80. http://dx.doi.org/10.1034/j.1600-0714.2001.030008471.x.

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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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Vissink, A., J. Jansma, F. K. L. Spijkervet, F. R. Burlage, and R. P. Coppes. "Oral Sequelae of Head and Neck Radiotherapy." Critical Reviews in Oral Biology & Medicine 14, no. 3 (May 2003): 199–212. http://dx.doi.org/10.1177/154411130301400305.

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In addition to anti-tumor effects, ionizing radiation causes damage in normal tissues located in the radiation portals. Oral complications of radiotherapy in the head and neck region are the result of the deleterious effects of radiation on, e.g., salivary glands, oral mucosa, bone, dentition, masticatory musculature, and temporomandibular joints. The clinical consequences of radiotherapy include mucositis, hyposalivation, taste loss, osteoradionecrosis, radiation caries, and trismus. Mucositis and taste loss are reversible consequences that usually subside early post-irradiation, while hyposalivation is normally irreversible. Furthermore, the risk of developing radiation caries and osteoradionecrosis is a life-long threat. All these consequences form a heavy burden for the patients and have a tremendous impact on their quality of life during and after radiotherapy. In this review, the radiation-induced changes in healthy oral tissues and the resulting clinical consequences are discussed.

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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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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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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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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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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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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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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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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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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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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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Cartaxo, André Costa, Liliane Cristina Nogueira Marinho, Davi Neto de Araújo Silva, Natália Teixeira da Silva, Maria de Lourdes Silva de Arruda Morais, André Luís Dorini, and Ana Rafaela Luz de Aquino Martins. "Impact of radiotherapy in head and neck regions on periodontal and oral hygiene conditions." Research, Society and Development 10, no. 2 (February 22, 2021): e44410212745. http://dx.doi.org/10.33448/rsd-v10i2.12745.

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Objective: Evaluate the influence of head and neck radiotherapy dose on periodontal tissue for to understanding of its adverse effects, and consequently to propose strategies to reduce its severity. Methodology: An observational, longitudinal and prospective study with intraoral clinical examinations performed before radiotherapy (T0) and immediately after the end of radiation therapy. The clinical data collected regarding oral and periodontal hygiene conditions were visible plaque index (VPI), gingival bleeding index (GBI), probing depth (PD), gingival recession area, clinical attachment level (CAL), degree of mobility and presence or absence of suppuration. In addition, data such as radiation dose, fractionation and duration of radiotherapy were reported. Results: Fourteen patients were evaluated, of which 11 had periodontitis after the radiotherapy, and 9 had poor oral hygiene conditions after the radiotherapy. Seven of the 11 subjects with periodontitis presented tumors in the oral cavity. There was a decrease in visible plaque index (VPI) and gingival bleeding index (GBI). The research was unable to establish a significant association between radiation therapy and oral hygiene condition and periodontitis. Conclusion: Poor oral hygiene conditions predominated in the sample, which can be associated with the presence of debilitating conditions. Direct radiation on the oral cavity may have an influence on the development of periodontitis. The development of gingivitis only and periodontitis was not influenced by dose, fraction or duration of radiotherapy in the study period.

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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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Lopes, Ana Cristina, Giovana Ferreira Gonçalves, Anna Cecília Dias Maciel Carneiro, André Luiz Pantoja dos Santos, Frederico Nobrega Tomas, Leonardo Rodrigues de Oliveira, Karina Ferrazzoli Devienne, and Virginia Oliveira Crema. "Comparison of the use of Solidago chilensis (Arnica) and low-level laser therapy for the prevention of oral mucositis in patients submitted of head and neck radiotherapy and/or high toxicity chemotherapy." Research, Society and Development 10, no. 14 (November 5, 2021): e369101422128. http://dx.doi.org/10.33448/rsd-v10i14.22128.

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The oral mucositis is an adverse event of radiotherapy and/or high toxicity chemotherapy. The Solidago chilensis (Arnica) has been used for its antiseptic, analgesic, healing and anti-inflammatory properties. Objective: The purpose of this study was to evaluate the uses of Arnica for oral mucositis prevention in patients submitted to radiotherapy for head and neck tumors treatment and/or high toxicity chemotherapy. Methodology: The determination of the cytotoxicity index of the aqueous extract was determined in vitro. The oral mucosa was evaluated in days 0, 10 and 14 of patients in the groups: treated with lasertherapy (L, n=18), treated with Arnica (A, n=24) and, treated with lasertherapy associated with Arnica (LA, n=4). It was considered significant p<0.05. Results: It was determined IC50=90,74 μg/mL of Arnica’s aqueous extract in SCC-4 cells. The development of oral mucositis was associated with the type of treatment for oral mucositis prevention: L, A, and LA (χ2 = 24,72, p<0.0001). The level of oral mucositis had significant interaction with the type of prevention treatment [F(2) = 9.545, p<0.0001] and, within 14 days [F(2) = 11.995, p<0.0001]. Conclusions: The results obtained suggest which the use of Solidago chilensis (Arnica) can be an important therapeutic option for treatment with low-level laser therapy for oral mucositis prevention in patients submitted of head and neck radiotherapy and/or high toxicity chemotherapy.

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Stempniewicz, Agnieszka, Piotr Ceranowicz, and Zygmunt Warzecha. "Potential Therapeutic Effects of Gut Hormones, Ghrelin and Obestatin in Oral Mucositis." International Journal of Molecular Sciences 20, no. 7 (March 27, 2019): 1534. http://dx.doi.org/10.3390/ijms20071534.

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Chemotherapy and/or head and neck radiotherapy are frequently associated with oral mucositis. Oral pain, odynophagia and dysphagia, opioid use, weight loss, dehydration, systemic infection, hospitalization and introduction of a feeding tube should be mentioned as the main determinated effect of oral mucositis. Oral mucositis leads to a decreased quality of life and an increase in treatment costs. Moreover, oral mucositis is a life-threatening disease. In addition to its own direct life-threatening consequences, it can also lead to a reduced survival due to the discontinuation or dose reduction of anti-neoplasm therapy. There are numerous strategies for the prevention or treatment of oral mucositis; however, their effectiveness is limited and does not correspond to expectations. This review is focused on the ghrelin and obestatin as potentially useful candidates for the prevention and treatment of chemo- or/and radiotherapy-induced oral mucositis.

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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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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 8AMÃƒÂƒÃ‚Â‚ÃƒÂ‚Ã‚Â–10 AM whereas in evening arm (arm B), patients received EBRT by cobalt-60 with daily fractions, five days a week, between 3PMÃƒÂƒÃ‚Â‚ÃƒÂ‚Ã‚Â–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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Dörr, E., and W. Dörr. "DOES SMOKING AFFECT ORAL MUCOSITIS DURING RADIOTHERAPY FOR HEAD-AND-NECK TUMOURS?" Radiotherapy and Oncology 98 (March 2011): S20. http://dx.doi.org/10.1016/s0167-8140(11)71748-0.

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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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Xiao, Huiwen, Yao Fan, Yuan Li, Jiali Dong, Shuqin Zhang, Bin Wang, Jia Liu, et al. "Oral microbiota transplantation fights against head and neck radiotherapy-induced oral mucositis in mice." Computational and Structural Biotechnology Journal 19 (2021): 5898–910. http://dx.doi.org/10.1016/j.csbj.2021.10.028.

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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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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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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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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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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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Elad, Sharon, and Yehuda Zadik. "Chronic oral mucositis after radiotherapy to the head and neck: a new insight." Supportive Care in Cancer 24, no. 11 (July 30, 2016): 4825–30. http://dx.doi.org/10.1007/s00520-016-3337-5.

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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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Zurnachyan, A. A. "Oral complications of radiotherapy: approaches to prevention and treatment." Kazan medical journal 96, no. 3 (June 15, 2015): 397–400. http://dx.doi.org/10.17750/kmj2015-397.

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The use of high-energy radiation sources covering large areas of head and neck, together with increased chances for clinical recovery leads to increased rates of radiation complications - a variety of changes in the surrounding healthy tissues and organs. One of the most common oral mucosa complications of radiation therapy is radiation mucositis. Its pathogenesis is based on developing erythematous lesions that turn into ulcer defects with a trend of merging to form an increasingly large focuses. After reaching its peak, inflammatory reaction regresses. The incidence of radiation mucositis is over 60% at standard mode radiotherapy and nearly 100% at hyperfractionated radiotherapy. In addition to the pecularities of radiotherapy, the incidence of mucositis also depends on the tumor type, patient’s age, the initial state of the oral cavity, the patient’s nutritional status. Cryotherapy using a helium-neon laser and drugs (pentoxifylline, thalidomide, simvastatin, analgesics, anesthetics) are recommended for treatment. Reducing the procedure time by improving medical technology, using pulsed fluoroscopy instead of constant, using additional protective filters and changing the X-ray beam focus site may significantly reduce the frequency of radiation complications.

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Dantas, Juliana Borges de Lima, Gabriela Botelho Martins, Hayana Ramos Lima, Manoela Pereira Carrera, Sílvia Regina De Almeida Reis, and Alena Peixoto Medrado. "IMMUNOPATHOGENESIS OF ORAL MUCOSITIS INDUCED BY CHEMOTHERAPY AND/OR RADIOTHERAPY: STATE OF ART." Brazilian Journal of Medicine and Human Health 5, no. 2 (June 22, 2017): 63–74. http://dx.doi.org/10.17267/2317-3386bjmhh.v5i2.1286.

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Introduction: Oral mucositis is a common and worrying clinical condition in patients undergoing radiotherapy of the head and neck regions and aggressive chemotherapy. Mucositis manifests as a continuous process, which begins with erythematous and atrophic lesions, which can progress to very painful ulcers. The immunopathogenesis of oral mucositis is considered a complex cascade of biological events, and advances in its understanding might result in promising and effective therapies. Objectives: The aim of this study is to highlight the recent findings of the immunopathogenesis of oral mucositis induced by chemotherapy and/or radiotherapy and their possible therapeutic agents. Methods and materials: scientific articles were selected in the PubMed and LILACS databases from December 2015 to May 2016, using the keywords in English "mucositis etiopathogenesis" and "mucositis". In PubMed 107 articles were found and, in LILACS, 61. The articles were selected after reading and those which reported detail on the immunopathology of oral mucositis were chosen. Results and conclusion: The literature indicates that histopathological changes related to oral mucositis, including apoptotic phenomenon, the action of certain chemical mediators and the influence of the oral cavity microbiota promote a better understanding of the immunopathogenesis of this type of injury and their biological development. Therefore, additional clinical studies based on scientific evidence are needed to get a better understanding of the immunopathology of oral mucositis and the determination of preventive agents and effective therapeutic for this deleterious effect arising from antineoplastic treatment.

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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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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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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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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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Dakovic, Dragana, Besir Ljuskovic, Nebojsa Jovic, and Dusan Mileusnic. "Dental treatment of oral complications during radiation therapy of head and neck cancer." Serbian Dental Journal 49, no. 3-4 (2002): 106–9. http://dx.doi.org/10.2298/sgs0204106d.

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Radiation therapy is often used as primary or adjuvant therapy for malignancy of the oropharyngeal region. Inflammatory changes of the oral mucosa resulting from the direct effect of radiation therapy, are defined as Radiation Mucositis (RM). As a consequence of irradiation, patients have xerostomia, pain, difficulty in chewing and swallowing, dental caries, oral microbial changes, chronic esophagitis, periodontitis, osteoradionecrosis. To eliminate or decrease discomfort in oral cavity, the use of various mouth rinses is recommended for compromised patients. These solutions should reduce pain, promote reepithelialization of soft tissue lesions, normalize the pH of oral fluids. They should be nontoxic, and to have acceptable taste. In the modern practice of head and neck oncology, dentists are essential members of the team. Their contribution is essential in improvement of the patients' quality of life.

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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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Lino, Maíra Dória Martinez da Costa, Fabíola Bastos de Carvalho, Lara Ramalho de Oliveira, Edval Barreto Magalhães, Antônio Luiz Barbosa Pinheiro, and Luciana Maria Pedreira Ramalho. "Laser phototherapy as a treatment for radiotherapy-induced oral mucositis." Brazilian Dental Journal 22, no. 2 (2011): 162–65. http://dx.doi.org/10.1590/s0103-64402011000200013.

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Oral mucositis is a harmful side effect of radiotherapy (RT) on the head and neck region. There are encouraging reports on the beneficial aspects of the use of laser light on the treatment of oral mucositis. This paper reports the efficacy of laser phototherapy (LPT) on the treatment of oral mucositis in a patient undergoing RT after surgical removal of a squamous cell carcinoma with osseous invasion of the maxilla. Palatal and commissural lesions were treated with λ660 nm, 40 mW, ∅=4 mm², in contact mode, 5 x 2.4 J/cm² per point, 14.4 J/cm² per session. For treating the lesion on the patient's nasal mucosa, LPT (∅=4 mm², λ780 nm, 70 mW, 3 x 2.1 J/cm² per point, 6.3 J/cm² per session, contact mode) was used on the external area of the nose. A single dose (2.4 J/cm²) with the λ660 nm laser, as described before, was applied on the entrance of each nostril. LPT was used 3 times/week during 4 weeks. Treatment results indicate that the use of LPT on oral mucositis was effective and allowed the patient to carry on the RT without interruption. However, long-term and controlled clinical trials are necessary to establish both preventive and curative protocols using LPT.

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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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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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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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Gr�tz, K. A., S. Genitsariotis, D. Vehling, and B. Al-Nawas. "Long-term oral Candida colonization, mucositis and salivary function after head and neck radiotherapy." Supportive Care in Cancer 11, no. 11 (November 1, 2003): 717–21. http://dx.doi.org/10.1007/s00520-003-0506-0.

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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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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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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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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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