THE USE OF IMMUNOGLOBULIN TO PREVENT RADI ATION-INDUCED MUCOSITIS

Among various therapies administered during radiation-induced mucositi s, treatment with immunoglobulin has proven clinically successful. In this study the efficacy of prophylactic applications of immunoglobulin was investigated from January 1992 through August 1993. Forty-two pat ients with histologically-proven head and neck cancer were given posto perative radiation treatment. In cases with macroscopic tumor residues or inoperability, combined radio-chemotherapy was given. This include d 51.3 Gy at 1.9 Gy 5X/week, boosted to 10-26 Gy at 2 Gy 5X/week and c arboplatin 60 mg/m(2) at days 1-5 and 29-33. Panthenol (4x10 ml/day) a nd nystatin (4x1 ml/day) were given to 20 patients as prophylactic tre atment for mucositis. Twenty-two subsequent patients also received int ramuscular 800 mg (5 ml) human immunoglobulin (1X/week). According to the Seegenschmiedt/Sauer classification the extent of mucositis was de termined 3X/week. Comparison of the distribution of maximal mucositis revealed a slightly more severe mucosal reaction in the controlgroup ( n.s.). Analysis of the mean degree of mucositis in both groups demonst rated statistically significant differences (p=0.031) related to the w hole collective and patients receiving concomitant chemotherapy while no effect of immunoglobulin was found in patients treated by radiation alone. In the immunoglobulin-treated-group, the time from the beginni ng of therapy to the first interruption was prolonged 5 days (37.5+/-1 3.1 vs. 42.7+/-13.3 days), but this difference was not significant. Al though prophylactic application of immunoglobulin seemed to lower the degree of radiation-induced mucositis, this effect was less significan t when compared to the immunoglobulin given in a therapeutic manner.