• 11/16/2006
  • Philadelphia, PA
  • Ed Susman
  • DocGuide.com

Treatment of patients with head and neck cancer — whether with conventional radiation or with intensity-modulated radiation therapy — leave a majority of patients with severe oral mucositis, researchers reported here at the American Society for Therapeutic Radiology and Oncology (ASTRO) 48th annual meeting.

There appears to be no significant difference in the proportion of patients who require hospitalization, opioid analgesics or gastronomy tubes among patients treated with intensity-modulated radiation therapy or conventional radiology, said Linda Elting, DrPH, professor of epidemiology, University of Texas School of Public health, Houston, Texas.

Dr. Elting and colleagues undertook 2 studies; a retrospective record review of 160 consecutive, newly diagnosed patients with cancers of the oral cavity and oropharynx who were clinically scored for oral mucositis. Mucositis was scored on a scale of 0 to 4 –with 0 representing no oral mucositis and 4 representing “alimentation not possible.”

The second study was performed prospectively at 6 centers among 75 newly diagnosed patients with cancers of the oral cavity and oropharynx who were assessed for severity of oral mucositis 5 times over 6 weeks.

In the retrospective study, 69% of 29 patients who received intensity-modulated radiation therapy and chemotherapy and 84% of 50 patients who received with intensity-modulated radiotherapy and chemotherapy experienced grade 3 or grade 4 mucositis.

Mucositis occurred in 70% of 48 patients given intensity-modulated radiation therapy without chemotherapy and in 76% of 34 patients who received conventional radiation without chemotherapy.

In her poster presentation on November 8th, Dr. Elting said the differences failed to achieve statistical significance.

In the prospective study, 74% of 24 patients in the intensity-modulated radiation therapy plus chemotherapy group and 60% of 26 patients in the conventional radiation plus chemotherapy group experienced grade 3 or 4 oral mucositis. Grade 3 or 4 mucositis occurred in 60% of 10 patients receiving intensity-modulated radiation therapy without chemotherapy and in 87% of 15 patients getting convention radiation. Again, the differences were not statistically significant, she said.

“These findings indicate that the severity and debilitating consequences of oral mucositis and the downstream resource utilization is similar for patients treated with conventional radiation versus patients treated with intensity-modulated radiation therapy,” Dr. Elting said.

Presentation title: 2428 Retrospective and Prospective studies of the Severity of Oral Mucositis (OM) in Intensity-modulated radiation Therapy (IMRT) Compared to Conventional Radiation Therapy in Head and Neck Cancer (HNC) Patients.