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Chemo-radiotherapy induced oral mucositis during IMRT for head and neck cancer - An assessment.

Nagarajan K - Med Oral Patol Oral Cir Bucal (2015)

Bottom Line: They were compared with a group of age- and sex-matched healthy individuals.The procedure involved WHO clinical scoring, collection of oral washings and preparation of buccal smears from both study group and control group.There was a significant increase in percentage of viable buccal epithelial cells in study group when compared to normal controls (P<0.005) during and at the end of chemo-radiotherapy. quantification of oral mucositis can be done at cellular level by determining the oral mucosal cell viability and their maturation during IMRT.

View Article: PubMed Central - PubMed

Affiliation: Unit 40/71, Cherwood Lodge, Olsen Avenue, Labrador, Gold Coast, QLD, 4215, Australia, karthika.shanmuganathan66@gmail.com.

ABSTRACT

Background: This study is conducted mainly to evaluate the changes in quality and quantity of oral epithelial cells during the course of IMRT.

Material and methods: 30 Patients undergoing chemo-radiotherapy were followed through course of treatment. They were compared with a group of age- and sex-matched healthy individuals. The procedure involved WHO clinical scoring, collection of oral washings and preparation of buccal smears from both study group and control group. The changes occurred were recorded as a way of assessing the severity of oral mucositis.

Results: revealed a significant occurrence of oral mucositis in almost all patients during weekly follow up. There was a significant increase in percentage of viable buccal epithelial cells in study group when compared to normal controls (P<0.005) during and at the end of chemo-radiotherapy.

Conclusions: quantification of oral mucositis can be done at cellular level by determining the oral mucosal cell viability and their maturation during IMRT.

No MeSH data available.


Related in: MedlinePlus

Comparison of mature, intermediate and immature buccal cells between week 1, week 2, week 3 and week 4 of study group.
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Figure 2: Comparison of mature, intermediate and immature buccal cells between week 1, week 2, week 3 and week 4 of study group.

Mentions: The chemo-radiotherapy induced oral mucositis has been extensively evaluated in patients receiving Hematopoietic Stem Cell transplantation (HSCT) and a study by Archibald et al. state that the addition of chemotherapy to the treatment regimen did not increase the incidence of complications when compared with historical controls receiving radiotherapy alone (19,20). Our study using IMRT also showed a similar pattern of behavior of upper epithelial cell layer (Fig. 2). Our study showed a shift from mature to immature cells (10) and this proves the profound effect of chemotherapy on cells when compared to radiotherapy. There was statistically no difference in this trend between the patients who underwent chemo-radiotherapy and radiotherapy alone (18). The findings also correlated well with the increased percentage of viable epithelial cells as the chemo-radiotherapy progressed. There was a significant increase in viable cells as compared to the WHO score in second week which is also well evidenced by increase in number of mature cells by the end of week 4 (Fig. 2). The change in viability preceded the change in WHO score (Fig. 3). This means that this assay is more sensitive for the detection of mucositis in adjunct to the clinical WHO toxicity grading system.


Chemo-radiotherapy induced oral mucositis during IMRT for head and neck cancer - An assessment.

Nagarajan K - Med Oral Patol Oral Cir Bucal (2015)

Comparison of mature, intermediate and immature buccal cells between week 1, week 2, week 3 and week 4 of study group.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4464913&req=5

Figure 2: Comparison of mature, intermediate and immature buccal cells between week 1, week 2, week 3 and week 4 of study group.
Mentions: The chemo-radiotherapy induced oral mucositis has been extensively evaluated in patients receiving Hematopoietic Stem Cell transplantation (HSCT) and a study by Archibald et al. state that the addition of chemotherapy to the treatment regimen did not increase the incidence of complications when compared with historical controls receiving radiotherapy alone (19,20). Our study using IMRT also showed a similar pattern of behavior of upper epithelial cell layer (Fig. 2). Our study showed a shift from mature to immature cells (10) and this proves the profound effect of chemotherapy on cells when compared to radiotherapy. There was statistically no difference in this trend between the patients who underwent chemo-radiotherapy and radiotherapy alone (18). The findings also correlated well with the increased percentage of viable epithelial cells as the chemo-radiotherapy progressed. There was a significant increase in viable cells as compared to the WHO score in second week which is also well evidenced by increase in number of mature cells by the end of week 4 (Fig. 2). The change in viability preceded the change in WHO score (Fig. 3). This means that this assay is more sensitive for the detection of mucositis in adjunct to the clinical WHO toxicity grading system.

Bottom Line: They were compared with a group of age- and sex-matched healthy individuals.The procedure involved WHO clinical scoring, collection of oral washings and preparation of buccal smears from both study group and control group.There was a significant increase in percentage of viable buccal epithelial cells in study group when compared to normal controls (P<0.005) during and at the end of chemo-radiotherapy. quantification of oral mucositis can be done at cellular level by determining the oral mucosal cell viability and their maturation during IMRT.

View Article: PubMed Central - PubMed

Affiliation: Unit 40/71, Cherwood Lodge, Olsen Avenue, Labrador, Gold Coast, QLD, 4215, Australia, karthika.shanmuganathan66@gmail.com.

ABSTRACT

Background: This study is conducted mainly to evaluate the changes in quality and quantity of oral epithelial cells during the course of IMRT.

Material and methods: 30 Patients undergoing chemo-radiotherapy were followed through course of treatment. They were compared with a group of age- and sex-matched healthy individuals. The procedure involved WHO clinical scoring, collection of oral washings and preparation of buccal smears from both study group and control group. The changes occurred were recorded as a way of assessing the severity of oral mucositis.

Results: revealed a significant occurrence of oral mucositis in almost all patients during weekly follow up. There was a significant increase in percentage of viable buccal epithelial cells in study group when compared to normal controls (P<0.005) during and at the end of chemo-radiotherapy.

Conclusions: quantification of oral mucositis can be done at cellular level by determining the oral mucosal cell viability and their maturation during IMRT.

No MeSH data available.


Related in: MedlinePlus