DECREASED ACUTE TOXICITY BY USING MIDLINE MUCOSA-SPARING BLOCKS DURING RADIATION-THERAPY FOR CARCINOMA OF THE ORAL CAVITY, OROPHARYNX, AND NASOPHARYNX

PURPOSE: To determine whether midline mucosa-sparing blocks (MSBs) pro tecting the aerodigestive tract can statistically significantly reduce acute toxicity during radiation therapy for carcinoma of the head and neck, without compromising tumor control. MATERIALS AND METHODS: Radi ation records and simulation films were reviewed in 125 patients with carcinoma of the oral cavity, oropharynx, or nasopharynx. Patients wit h and without MSBs were compared. Measures of acute toxicity during ra diation therapy were weight loss (greater than or equal to 5%), hospit alization for nutritional support, and unplanned treatment interruptio ns (greater than or equal to 5 days). Actuarial local-regional tumor c ontrol was compared. RESULTS: Patients with MSBs had significantly les s weight loss (26 of 50 vs 37 of 47 patients, P = .006), fewer hospita lizations for nutritional support (one of 61 vs seven of 64 patients, P = .04), and a trend toward fewer treatment interruptions (10 of 61 v s 19 of 64 patients, P = .07) than patients without MSBs. The 3-year a ctuarial tumor control rates in the neck were similar. CONCLUSION: Mid line MSBs decrease acute toxicity during radiation therapy for carcino ma of the oral cavity, oropharynx, and nasopharynx without compromisin g tumor control.