Impact of oral submucous fibrosis on chemotherapy-induced mucositis for head and neck cancer in a geographic area in which betel quid chewing is prevalent

In Southeast Asia and Taiwan, betel quid chewing is prevalent. Patients wit h head and neck cancer who chewed betel quid habitually seem to experience more severe chemotherapy-induced mucositis in our clinical practice. To val idate this issue, patients with untreated head and neck cancer who received cisplatin (cDDP) plus a 5-fluorouracil (5-FU)-based neoadjuvant chemothera py were included in this analysis. Information on the consumption of betel quid, tobacco, and alcohol were recorded before chemotherapy. Oral submucou s fibrosis (OSF) was diagnosed clinically according to the fibrotic appeara nce of the mucosa and trismus. Mucositis was scored according to the World Health Organization criteria, and the mucositis score of the first course o f chemotherapy was used for analysis. From December 1993 to April 1996, 120 patients were enrolled in this trial. Neither the betel quid chewing nor t he cancer of the oral cavity was to be a significant factor for mucositis. However, clinically diagnosed OSF was found to display a significant correl ation with more severe mucositis (p = 0.02). We concluded that in betel qui d chewing-prevalent areas, OSF was a risk factor of more severe mucositis i n head and neck cancer patients treated by CDDP and 5-FU-based regimens.