Relevance. According to the WHO scale, mucositis of 3-4 degrees is a severe injury among patients receiving high-dose radiation and chemotherapy for the head and neck region, the frequency of which reaches 85%. Dental treatment of such patients is extremely important, more often it is symptomatic and is aimed at improving their well-being and limiting the spread of the process, particularly oral mucositis. The aim of this study was to increase the effectiveness of the prevention of oral mucositis in patients with COR cancer against the background of systemic chemoradiation treatment. Material and methods. We examined 89 patients with a diagnosis of oral mucosa cancer (C00-C06, C10, C13, C14) according to ICD-10) II and III stages (T2-3, N0-1, M0), aged from 55 to 67 years, who received chemo-radiation therapy for the head and neck area. To rate immune status, in particular the mechanisms of regulation of protective reactions at the local level, patients with mucositis in the oral fluid were examined and it was determined by the content of pro-inflammatory and anti-inflammatory interleukins (IL), the concentration of cytokines in saliva was determined by ELISA. Depending on the method of treatment, patients were divided into two groups: comparison (traditional treatment) and main (developed method). Results. The concentration of proinflammatory IL-1b in the saliva of patients before starting treatment averaged 126.14 ± 45.01 pg/ml and anti-inflammatory IL-10 at 94.96 ± 44.20 pg/ml. Laetrile has a short-term local effect, which slightly affects the cytokine profile of saliva, the concentration of IL-1 increases by the 5th day, and IL-10 decreases 2.2 times. The concentration of cytokines before treatment was 64.55 ± 22.85 pg/ml and tended to gradually increase by the 7th day. For IL-10, the values were also low. Thus, a significant individual difference in the content of these cytokines was revealed, reflecting the sensitivity to both radiation and local therapy.

Background — Radiation and chemotherapy of cancer cause complications that drastically reduce the quality of life. This requires the search for effective therapeutic agents for the mucositis treatment. We investigated the effects of amygdalin as a trophic external agent for post-radiation and post-chemotherapeutic oral mucositides. The study objectives were to conduct an immunomorphological analysis using an experimental model of iatrogenic mucositis, and to evaluate the effectiveness of amygdalin as cyanide with probable protective chemical properties in mucositis correction. Material and Methods — Our studies were performed on 40 male white rats. Radiation therapy was simulated by irradiating animals with a cranial dose of 6 Gy. Then an intraperitoneal injection of cisplatin was performed. On day 7, a biopsy was taken (model control), and animals were treated for 14 days with a mixture of 0.02% nitrofurazone, Desensitin® gel, Suprasorb® and amygdalin, after which a biopsy was taken again (therapy control). Results — Immunomorphological studies revealed dystrophic structural changes due to the progress of tissue hypoxia and the launch of Fas-dependent apoptosis in tissues. Using treatment with amygdalin by activating hypoxia-inducible factor (HIF) stimulates the macrophage population to remodel the stroma of the submucosal layer. In addition to activating the cellular components of local immunity, a therapeutic anti-apoptotic effect has been established. Conclusion — The method of mucositis correction by amygdalin is effective, which is confirmed by increased proliferation and decreased apoptosis due to revascularization and hypoxia reduction.

Oral mucosal cancer is diagnosed worldwide. There are approximately 350,000 patients annually and it accounts for 5% of all malignant neoplasms detected in Europe and the USA. More than 60% of patients with initial treatment in medical institutions are assigned III–IV stage, which requires combined or complex treatment. Under the influence of chemo-radiation therapy, the salivary glands are affected and the physico-chemical properties of saliva change: viscosity, pH, salivation rate, etc. The study involved 89 people from the V.M. Efetov Crimean Republican Oncological Clinical Dispensary with a diagnosis of cancer of the oral mucosa, who, depending on the type of treatment (developed or traditional), were divided into two groups: the main one – using Laetrile in the form of rinses or oral baths for 8–14 days and the control – antitumor treatment according to the protocol (0.06% chlorhexidine solution, ointments for the elements of the lesion – levomycol, vaseline, pharmacy lotion and decoctions of chamomile and sage herbs). A clinical and laboratory evaluation of the salivation function was performed: the volume, salivation rate and relative viscosity of the oral fluid were studied. Oral fluid after irritation of the tongue with a food irritant (0.5% citric acid) was collected in a graduated tube for 5–10 minutes and the volume was determined. The salivation rate and saliva viscosity were determined using an Oswald’s viscometer using the technique of T.L. Redinova (1986). The features of salivation dysfunction in oncopatients receiving chemo-radiation therapy of the oral cavity are a decrease in volume (0.14 ± 0.01 ml) and velocity (0.42 ± 0.018 ml/min), as well as an increase in viscosity (7.42 ± 0.25 p.u.) saliva. The use of Laetrile for 10–14 days from the beginning of the course of chemo-radiation therapy can significantly prevent a decrease in the volume and increase in the viscosity of saliva and minimize the associated decrease in quality of life.