Analysis of the Risk Factors for Severe Oral Mucositis in Head and Neck Cancer after Chemoradiotherapy with S-1

Abstract

Radiotherapy (RT) and chemoradiotherapy (CRT) is widely accepted as the standard treatment for head and neck cancer (HNC). Oral mucositis (OM) often develops as an adverse reaction in HNC patients that receive RT or CRT involving S-1. However, little is known about the risk factors for OM in HNC patients. We retrospectively evaluated patients' pre-treatment clinical data in order to identify the risk factors for severe OM in HNC patients that are treated with RT or CRT involving S-1. We analyzed the cases of 129 patients who received RT or CRT involving S-1 for HNC. The endpoint of the survey was the occurrence of severe OM (grade 2). Risk factors that were signiˆcantly related to severe OM were identiˆed using logistic regression analysis. The patients' mean age was 69.3±10.1 years, and 118 (92 ％) of the patients were male. The primary tumor was located in the oropharynx in 21.7％ of cases. Severe OM occurred in 85.0％ of cases. In the univariate analysis, the following variables were found to be associated with severe OM: age, the type of radiotherapy, disease stage, and chemotherapy. In the multivariate analysis, the location of the primary tumor and chemotherapy were identiˆed as signiˆcant risk factors that contributed independently to the risk of severe OM (p＜0.05). Our analysis suggests that cancer of the oropharynx and CRT are important risk factors for severe OM in HNC patients that undergo RT or CRT involving S-1.

The association between cumulative radiation dose and the incidence of severe oral mucositis in head and neck cancers during radiotherapy

“…We previously demonstrated that concurrent chemotherapy was identified as a significant, independent risk factor for the severity of OM 16 . Hata et al reported that 5‐FU was related to worse OM 5 .…”

“…We previously demonstrated that concurrent chemotherapy was identified as a significant, independent risk factor for the severity of OM. 16 Hata et al reported that 5‐FU was related to worse OM. 5 This study also revealed a relationship between cumulative radiation dose, even lower doses, and the development of OM in patients with HNC during RT.…”

Evaluating the Effect of Selenium in Preventing Oral Mucositis: A Randomized Clinical Trial

“…Regarding the P values of OM severity there was no significant difference between the two groups. Figures (3,4) show dry ulcerated borders of the mouth, mucosal erythema, ulcers and atrophic and coated tongue at day 42 for patients from the two groups. 2-Regarding VAS Table 3, figure 2 show comparison between the two groups using VAS.…”

“…Although both treatments have good cure rates during the early stages, these treatments can lead to functional impairments (3). Radiotherapy has irreversible side effects on the oral mucosa such as OM, xerostomia along with added risk of osteoradionecrosis (4,5). OM has impacts on the quality of life, morbidity and mortality (6).…”

Risk Factors for Oral Mucositis During Chemotherapy Treatment for Solid Tumors: A Retrospective STROBE-Guided Study

“…Severe oral mucositis requires immediate treatment, requiring dose reduction, or interruption of chemotherapy, affecting the patient's prognosis and quality of life and generating a strong economic impact associated with hospitalization support [6]. Some risk factors for oral mucositis have been described, such as age and gender [12], time of diagnosis, previous history of [13], and some speci c drugs are more strongly associated with oral mucositis than others [14]. Additionally, numerous ways to decrease the incidence of oral mucositis [15], such as lowintensity laser therapy [16], have been tested.…”