THE PROBLEM OF RADIOTHERAPY OR CHEMOTHERA PY-INDUCED MUCOSITIS OF THEMOUTH AND PHARYNX - EFFECTS OF ACCELERATED RADIOCHEMOTHERAPY WITH CARBOPLATINUM ON PATIENTS WITH INOPERABLE SQUAMOUS-CELL CARCINOMA OF THE HEAD AND NECK - EXPERIENCES IN HEIDELBERG

Despite numerous treatment measures mucositis of the mouth and pharynx due to radiochemotherapy frequently remains refractory to therapy. In most cases high doses of pain medications are till required. However, mucositis as a strong early reaction may be controllable by limiting cancer therapy. Within the current framework of accelerated radiochemo therapy with carboplatin, 50 patients with inoperable squamous cell ca rcinomas of the head and neck were followed from 1992 to 1994. Acute t oxicity was documented from the first through eighth week after starti ng therapy. From the fifth week on, the degree of mucositis found was >3 (WHO scale) in 24 patients. The extent of mucositis in 5 patients r equired interrupting therapy for 10 days on average. In 14 cases the a verage stay in hospital had to be prolonged by 10.2 days because of se vere inflammation, In all, the average duration of mucositis after the end of the therapy amounted to 9.6 weeks. Twenty patients required by pass feedings with transnasal stomach tubes or percutaneous gastrostom y (PEG) tubes that were later removed, In addition, the incidences of dysphagia, xerostomia, hoarseness, skin reactions, nausea or vomitus a nd myelotoxicity were recorded, Descriptions of the supportive care co ncepts used at the University of Heidelberg are given and the supporti ve care concepts available scientific literature is updated.