Mucositis reduction by selective elimination of oral flora in irradiated cancers of the head and neck: A placebo-controlled double-blind randomized study
Ob. Wijers et al., Mucositis reduction by selective elimination of oral flora in irradiated cancers of the head and neck: A placebo-controlled double-blind randomized study, INT J RAD O, 50(2), 2001, pp. 343-352
Citations number
89
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Onconogenesis & Cancer Research
Journal title
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
Purpose: The aim of the study was to test the hypothesis that aerobic Gram-
negative bacteria (AGNB) play a crucial role in the pathogenesis of radiati
on-induced mucositis; consequently, selective elimination of these bacteria
from the oral flora should result in a reduction of the mucositis,
Methods and Materials: Head-and-neck cancer patients, when scheduled for tr
eatment by external beam radiation therapy(EBRT), were randomized for proph
ylactic treatment with an oral paste containing either a placebo or a combi
nation of the antibiotics polymyxin E, tobramycin, and amphotericin B (PTA
group). Weekly, the objective and subjective mucositis scores and microbiol
ogic counts of the oral flora were noted. The primary study endpoint was th
e mucositis grade after 3 weeks of EBRT.
Results: Seventy-seven patients were evaluable. No statistically significan
t difference for the objective and subjective mucositis scores was observed
between the two study arms (p = 0.33). The percentage of patients with pos
itive cultures of AGNB was significantly reduced in the PTA group (p = 0.01
). However, complete eradication of AGNB was not achieved.
Conclusions: Selective elimination of AGNB of the oral flora did not result
in a reduction of radiation-induced mucositis and therefore does not suppo
rt the hypothesis that these bacteria play a crucial role in the pathogenes
is of mucositis. (C) 2001 Elsevier Science Inc.