Factors influencing radiation induced oral mucositis in head and neck cancer.

Introduction: Radiotherapy alone or in combination with chemotherapy is an effective and standard treatment of head and neck carcinoma. Oral mucositis is an unavoidable consequence of chemoradiation which is seen in almost all the patients. This painful condition leads to deterioration of the quality of life and thus interferes with the overall outcome of cancer therapy. As no study has been conducted in an Indian context, we conducted this study for better identification of factors influencing the occurrence and severity of oral mucositis in this patient population.

Objectives: Evaluation of the factors influencing the occurrence, severity, and resolution of radiation induced oral mucositis (RIOM) in patients with head and neck cancer. The relationship between RIOM and treatment volume (TV) and mean dose to oral mucosa were also explored.

Methods: This prospective study was conducted in patients with a histopathological diagnosis of head and neck carcinoma treated with radiation and chemoradiation. The patient, tumor, and treatment-related factors influencing RIOM were evaluated.

Results: Univariate logistic regression analysis of correlated factors with acute radiation oral mucositis revealed TV in phase one (up to 40 Gy) having P value of 0.029 with odds ratio of 1.008. Spearman rank correlation coefficient demonstrated significant positive correlation between oral mucosa dose and TV in all three phases of radiation.

Conclusion: Our study concluded that the most important factor influencing RIOM is TV during phase one of radiation. We found positive correlation between TV and oral mucosa dose through all the phases of radiation treatment.