Multivariable model for predicting acute oral mucositis during combined IMRT and chemotherapy for locally advanced nasopharyngeal cancer patients

Orlandi, Ester; Iacovelli, Nicola Alessandro; Rancati, T.; Cicchetti, A.; Bossi, Paolo; Pignoli, E.; Bergamini, Cristiana; Licitra, Lisa; Fallai, C.; Valdagni, Riccardo; Cavallo, A.

doi:10.1016/j.oraloncology.2018.10.006

Cited by 35 publications

(37 citation statements)

References 46 publications

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“…In the recent years, several predictive multivariable models including inpatient-, tumour-and treatment-related factors have been developed in order to implement clinical support to the patients at higher probability of developing severe OM [7,8].…”

Section: Introduction/backgroundmentioning

confidence: 99%

The role of benzydamine in prevention and treatment of chemoradiotherapy-induced mucositis

Nicolatou‐Galitis

Bossi

Orlandi

et al. 2021

Support Care Cancer

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Purpose To discuss the role of benzydamine in the prevention and treatment of radiation-induced oral mucositis (OM) in head and neck (H&N) cancer patients. This document represents an expert opinion paper on indications and key-role aspects in OM pathogenesis, prevention and treatment. Oral mucositis OM represents a common side effect of chemotherapy (CHT) and radiotherapy (RT). It consists in a painful erythema involving the oral cavity mucosa, which may progress to ulceration. Five biologically dynamic phases are considered crucial in mucositis: “initiation, signalling, amplification, ulceration and healing”. Oral environment and microbiota are fundamental in mucositis development being involved in susceptibility to infections and in ulceration consequences. Different agents against mucositis have been studied and the use of benzydamine is strongly supported in literature. The Multinational Association of Supportive Care in Cancer and International Society for Oral Oncology (MASCC/ISOO) guidelines recommend its use for the prevention of OM in H&N patients undergoing RT and RT/CHT. Benzydamine Benzydamine is a local anti-inflammatory drug with analgesic properties. It can decrease TNF-α, IL-1β and prostaglandin synthesis, also inhibiting leukocyte-endothelial interactions, neutrophil degranulation, vasodilation and vascular permeability. Literature agrees on the beneficial effects of benzydamine in preventing and reducing oral mucositis severity in H&N cancer patients undergoing RT/CHT. Conclusions Mucositis represents a major concern in H&N cancer patients and a clinical and economical issue. A multimodal and multidisciplinary approach is needed for its management. International guidelines recommend benzydamine for OM prevention and treatment in H&N cancer patients, but further “real world” trials should be designed.

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Section: Introduction/backgroundmentioning

confidence: 99%

The role of benzydamine in prevention and treatment of chemoradiotherapy-induced mucositis

Nicolatou‐Galitis

Bossi

Orlandi

et al. 2021

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“…However, side effects from primary therapy can be debilitating. Radiation and chemotherapy can result in oral mucositis, which can significantly reduce tolerable doses [2]. Even with these aggressive therapy options, about 40% of HNSCC deaths will occur due to the development of therapy resistance [3].…”

Section: Introductionmentioning

confidence: 99%

Methylseleninic Acid Induces Lipid Peroxidation and Radiation Sensitivity in Head and Neck Cancer Cells

Lafin

Sarsour

Kalen

et al. 2019

IJMS

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Combination radiation and chemotherapy are commonly used to treat locoregionally advanced head and neck squamous cell carcinoma (HNSCC). Aggressive dosing of these therapies is significantly hampered by side effects due to normal tissue toxicity. Selenium represents an adjuvant that selectively sensitizes cancer cells to these treatments modalities, potentially by inducing lipid peroxidation (LPO). This study investigated whether one such selenium compound, methylseleninic acid (MSA), induces LPO and radiation sensitivity in HNSCC cells. Results from 4,4-difluoro-4-bora-3a,4a-diaza-S-indacene (BODIPY) C11 oxidation and ferric thiocyanate assays revealed that MSA induced LPO in cells rapidly and persistently. Propidium iodide (PI) exclusion assay found that MSA was more toxic to cancer cells than other related selenium compounds; this toxicity was abrogated by treatment with α-tocopherol, an LPO inhibitor. MSA exhibited no toxicity to normal fibroblasts at similar doses. MSA also sensitized HNSCC cells to radiation as determined by clonogenic assay. Intracellular glutathione in cancer cells was depleted following MSA treatment, and supplementation of the intracellular glutathione pool with N-acetylcysteine sensitized cells to MSA. The addition of MSA to a cell-free solution of glutathione resulted in an increase in oxygen consumption, which was abrogated by catalase, suggesting the formation of H2O2. Results from this study identify MSA as an inducer of LPO, and reveal its capability to sensitize HNSCC to radiation. MSA may represent a potent adjuvant to radiation therapy in HNSCC.

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“…The volume of irradiated tissue varied from different types of cancer, as well as different patients. Orlandi et al15 found that mean oral cavity irradiated dose was the most important factor affecting OM. Hence, we were trying to use the mean oral cavity irradiated dose instead of the volume of irradiated tissue.…”

Section: Discussionmentioning

confidence: 99%

<p>Prevention effect of low-temperature atomization inhalation for radiation induced oral mucositis in patients with head and neck cancer undergoing radiotherapy</p>

Bai¹,

Chen²,

Ma³

et al. 2019

CMAR

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Purpose: To investigate the prevention effect of low-temperature atomization inhalation for radiation induced oral mucositis (OM) in patients with head and neck cancer (HNC) undergoing radiotherapy. Patients and methods: A total of 68 patients with HNC (including nasopharyngeal cancer) undergoing radiotherapy were divided into an intervention group (33 cases) and a control group (35 cases). During radiotherapy, the intervention group received low-temperature (between 4°C and 8°C) atomization inhalation; while the control group received normal temperature (between 18°C and 24°C) atomization inhalation. Atomization inhalation was performed twice a day, 20 minutes per time, using distilled water. The incidence and severity of OM was evaluated every week during radiotherapy. The comparation was made between the two groups. Results: The two groups were comparable among age, sex, Eastern Cooperative Oncology group (ECOG) score, body mass index (BMI) before radiotherapy, BMI loss during radiotherapy, original tumor site, pathological type, TNM stage, and mean oral cavity irradiated dose. There was a significant difference in the incidence of OM between the two groups ( P <0.05). There were fewer patients with severe OM in the intervention group compared to the control group ( P <0.05). The onset time of OM in the intervention group was delayed by about 4 days compared to that in the control group ( P <0.05). Low-temperature atomization inhalation helped to avoid radiotherapy interruption in the intervention group. No patient in the intervention group suffered any adverse reaction for low-temperature atomization inhalation treatment. Conclusions: Low-temperature atomization inhalation can reduce the incidence and severity of OM, and slow down the progression process of it. It can be used as a new prevention method during radiotherapy, and should be promoted in clinical practice.

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Multivariable model for predicting acute oral mucositis during combined IMRT and chemotherapy for locally advanced nasopharyngeal cancer patients

Cited by 35 publications

References 46 publications

The role of benzydamine in prevention and treatment of chemoradiotherapy-induced mucositis

The role of benzydamine in prevention and treatment of chemoradiotherapy-induced mucositis

Methylseleninic Acid Induces Lipid Peroxidation and Radiation Sensitivity in Head and Neck Cancer Cells

<p>Prevention effect of low-temperature atomization inhalation for radiation induced oral mucositis in patients with head and neck cancer undergoing radiotherapy</p>

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