Appraisal of Beneficial Effects of Oral Supplementation with Folic Acid during Curative Chemo-Radiation for Head and Neck Cancer: An Observational Study

Abstract

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.