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Oral mucositis and selective elimination of oral flora in head and neck cancer patients receiving radiotherapy: a double-blind randomised clinical trial.

Stokman MA, Spijkervet FK, Burlage FR, Dijkstra PU, Manson WL, de Vries EG, Roodenburg JL - Br. J. Cancer (2003)

Bottom Line: Mean weight loss after 5 weeks of radiation was less in the PTA group (1.3 kg) (s.d.: 3.0) than in the placebo group (2.8 kg) (s.d.: 2.9) (P=0.05).Colonisation index of Candida species and Gram-negative bacilli was reduced in the PTA group and not in the placebo group (P<0.05).In conclusion, selective oral flora elimination in head and neck irradiation patients does not prevent the development of severe mucositis.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, University Hospital Groningen, The Netherlands. m.a.stokman@kchir.azg.nl

ABSTRACT
Mucositis is an acute inflammation of the oral mucosa because of radiotherapy and/or chemotherapy. All patients receiving radiotherapy in the head and neck region develop oral mucositis. The aim of this study was to analyse the effects of selective oral flora elimination on radiotherapy-induced oral mucositis, in a double-blind, randomised, placebo-controlled trial. Sixty-five patients with a malignant tumour in the head and neck regions to be treated with primary curative or postoperative radiotherapy participated in this study. The patients received either the active lozenges of 1 g containing polymyxin E 2 mg, tobramycin 1.8 mg and amphotericin B 10 mg (PTA) (33 patients) or the placebo lozenges (32 patients), four times daily during the full course of radiotherapy. Mucositis, changes in the oral flora, quality of feeding and changes of total body weight were assessed. Mucositis score did not differ between the groups during the first 5 weeks of radiotherapy. Nasogastric tube feeding was needed in six patients (19%) of the placebo group and two patients (6%) of the PTA group (P=0.08). Mean weight loss after 5 weeks of radiation was less in the PTA group (1.3 kg) (s.d.: 3.0) than in the placebo group (2.8 kg) (s.d.: 2.9) (P=0.05). Colonisation index of Candida species and Gram-negative bacilli was reduced in the PTA group and not in the placebo group (P<0.05). No effect on other microorganisms was detected. In conclusion, selective oral flora elimination in head and neck irradiation patients does not prevent the development of severe mucositis.

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Related in: MedlinePlus

Percentage of patients colonised for Candida species for the PTA group (lines) and the placebo group (solid).
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fig2: Percentage of patients colonised for Candida species for the PTA group (lines) and the placebo group (solid).

Mentions: The colonisation and carriage of Candida species at baseline was equal in both groups (P>0.8). During the first two radiation weeks the colonisation for Candida species showed an increase in the placebo group and a decrease in the PTA group. After 2 weeks, an increase in both groups was found but the difference between the two groups remained significant during the total study period (P<0.05) (Figure 2Figure 2


Oral mucositis and selective elimination of oral flora in head and neck cancer patients receiving radiotherapy: a double-blind randomised clinical trial.

Stokman MA, Spijkervet FK, Burlage FR, Dijkstra PU, Manson WL, de Vries EG, Roodenburg JL - Br. J. Cancer (2003)

Percentage of patients colonised for Candida species for the PTA group (lines) and the placebo group (solid).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2376383&req=5

fig2: Percentage of patients colonised for Candida species for the PTA group (lines) and the placebo group (solid).
Mentions: The colonisation and carriage of Candida species at baseline was equal in both groups (P>0.8). During the first two radiation weeks the colonisation for Candida species showed an increase in the placebo group and a decrease in the PTA group. After 2 weeks, an increase in both groups was found but the difference between the two groups remained significant during the total study period (P<0.05) (Figure 2Figure 2

Bottom Line: Mean weight loss after 5 weeks of radiation was less in the PTA group (1.3 kg) (s.d.: 3.0) than in the placebo group (2.8 kg) (s.d.: 2.9) (P=0.05).Colonisation index of Candida species and Gram-negative bacilli was reduced in the PTA group and not in the placebo group (P<0.05).In conclusion, selective oral flora elimination in head and neck irradiation patients does not prevent the development of severe mucositis.

View Article: PubMed Central - PubMed

Affiliation: Department of Oral and Maxillofacial Surgery, University Hospital Groningen, The Netherlands. m.a.stokman@kchir.azg.nl

ABSTRACT
Mucositis is an acute inflammation of the oral mucosa because of radiotherapy and/or chemotherapy. All patients receiving radiotherapy in the head and neck region develop oral mucositis. The aim of this study was to analyse the effects of selective oral flora elimination on radiotherapy-induced oral mucositis, in a double-blind, randomised, placebo-controlled trial. Sixty-five patients with a malignant tumour in the head and neck regions to be treated with primary curative or postoperative radiotherapy participated in this study. The patients received either the active lozenges of 1 g containing polymyxin E 2 mg, tobramycin 1.8 mg and amphotericin B 10 mg (PTA) (33 patients) or the placebo lozenges (32 patients), four times daily during the full course of radiotherapy. Mucositis, changes in the oral flora, quality of feeding and changes of total body weight were assessed. Mucositis score did not differ between the groups during the first 5 weeks of radiotherapy. Nasogastric tube feeding was needed in six patients (19%) of the placebo group and two patients (6%) of the PTA group (P=0.08). Mean weight loss after 5 weeks of radiation was less in the PTA group (1.3 kg) (s.d.: 3.0) than in the placebo group (2.8 kg) (s.d.: 2.9) (P=0.05). Colonisation index of Candida species and Gram-negative bacilli was reduced in the PTA group and not in the placebo group (P<0.05). No effect on other microorganisms was detected. In conclusion, selective oral flora elimination in head and neck irradiation patients does not prevent the development of severe mucositis.

Show MeSH
Related in: MedlinePlus