CAN PROPHYLACTIC APPLICATION OF IMMUNOGLOBULIN DECREASE RADIOTHERAPY-INDUCED ORAL MUCOSITIS

Therapeutic application of immunoglobulin is reported to be successful in radiation-induced oral and oropharyngeal mucositis. In this study the efficacy of prophylactic application of immunoglobulin was investi gated. In 42 patients with head and neck cancer, postoperative radiati on treatment or radiation combined with chemotherapy was performed. In 20 consecutive patients, prophylactic mucositis treatment consisted o f panthenol (4 X 10 ml/day) and nystatin (4 X 1 ml/day). The 22 follow ing patients received, supplementary to panthenol and nystatin, 800 mg (5 ml) human immunoglobulin intramuscularly once weekly. During the t reatment time, the degree of mucositis was examined 3 times a week. Th e distribution of maximal mucositis degree revealed slightly more seve re mucous membrane reaction in the control group compared with the imm unoglobulin group (n.s.). The analysis of mean mucositis degrees in bo th groups demonstrated statistically significant differences (t test, p = 0.031) related to the entire group (n = 42) and to those 16 patien ts receiving radiation combined with chemotherapy. There was no signif icant immunoglobulin-induced effect on mucositis in patients treated b y radiation alone. The time from the beginning of therapy to the first interruption could be prolonged 5 days in the immunoglobulin group (n .s.). In conclusion, it is demonstrated that the prophylactic applicat ion of immunoglobulin seems to lower the degree of radiation-induced m ucositis. In comparison to the published data about therapeutically gi ven immunoglobulin, the clinical efficacy of the prophylactic applicat ion of immunoglobulin as it is performed in this study is less evident .