Risk factors for severe radiation-induced oral mucositis in patients with oral cancer

Sakiko Soutome, Souichi Yanamoto, Mika Nishii, Yuka Kojima, Takumi Hasegawa, Madoka Funahara, Masaya Akashi, Toshiyuki Saito, Masahiro Umeda, Sakiko Soutome, Souichi Yanamoto, Mika Nishii, Yuka Kojima, Takumi Hasegawa, Madoka Funahara, Masaya Akashi, Toshiyuki Saito, Masahiro Umeda

Abstract

Background/purpose: Radiotherapy for head and neck cancer often causes severe oral mucositis. The purpose of this retrospective study was to further examine the risk factors for developing severe oral mucositis in patients with oral cancer undergoing radiotherapy as a compliment to a previous study performed by our group.

Materials and methods: A total of 181 patients with oral cancer undergoing radiotherapy were enrolled in the study. The association between a number of potential risk factors and grade 3 oral mucositis were analyzed using the cox proportional hazard model and a logistic regression analysis.

Results: Grade 3 oral mucositis occurred in 56 patients. The cox proportional hazard model analysis revealed that those with lower hemoglobin levels, concurrent cisplatin and cetuximab administration, and a larger number of teeth showed a significantly higher incidence of severe oral mucositis. Logistic regression analysis revealed that patients who had lower hemoglobin levels, received concurrent cisplatin or cetuximab treatment, and were not administered pilocarpine showed a significantly higher incidence of severe oral mucositis. The presence of teeth may stimulate the oral mucosa and become a risk factor for mucositis, and the administration of pilocarpine might reduce the risk.

Conclusion: This study describes the risk factors of severe radiation-induced oral mucositis in oral cancer patients and shows the possibility of risk reduction by pilocarpine. This information could help patients avoid painful mucositis.

Keywords: Oral cancer; Oral mucositis; Pilocarpine; Radiotherapy; Risk factors.

© 2021 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V.

Figures

Figure 1
Figure 1
Development of grade 3 oral mucositis in patients with and without pilocarpine administration.
Figure 2
Figure 2
Grade 3 oral mucositis during radiotherapy. A: Patients with oral cancer. Mucositis occurred in the buccal mucosa stimulated by teeth. B: Patients with oropharyngeal cancer. Mucositis occurred mainly within the soft palate and buccal mucosa, areas in which teeth could not play a causal role in the development of mucositis.

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