ORAL MUCOSITIS IN PATIENTS OF HEAD AND NECK CANCERS TREATED WITH CHEMORADIOTHERAPY: ASSOCIATED FACTORS AND TREATMENT OUTCOME
Abstract
Introduction: Oral Mucositis develops in nearly all patients receiving radiation therapy for
head and neck cancers. Number of risk factors has been reported to influence the frequency and
severity of Mucositis. The goal of the present study is to evaluate some of the patient and
treatment related factors which make impact on oral mucositis and also to evaluate the impact
of oral Mucositis on treatment outcome.
Material and Methods: Fifty patients were included in this study from July 2014 to June
2016. All the patients were treated with concurrent radiotherapy (70 Gy in 35 fractions in 7
weeks) and chemotherapy (Cisplatin 35 mg/m2 weekly). Clinical Response Assessment was
done as per RTOG Grading and Radiation toxicity was assessed by RTOG Acute & Late
Morbidity Scoring criteria. Statistical analysis was done using Chi Square test and Fischer
Test.
Results: In a patient population of fifty, the intensity of oral Mucositis was correlated with
various patient and treatment related factors. Patient related factors- body mass index ≤18.5
and patients taking tobacco had a higher incidence of Grade III/IV Mucositis (p<0.00 &
p=0.04 respectively). Other factors like age, gender, stage, site of disease and co morbidities
did not show statistical difference in Grade III/IV oral Mucositis. None of the treatment related
factors- total dose of Cisplatin, number of chemotherapy cycles and radiation dose showed
statistical difference in the occurrence of oral Mucositis.
Conclusion: Severe oral Mucositis leads to additional supportive care & even hospitalization.
Targeted interventions need to be developed to reduce the incidence of oral Mucositis.
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