Decreased acute toxicity by using midline mucosa-sparing blocks during radiation therapy for carcinoma of the oral cavity, oropharynx, and nasopharynx.
OBJECTIVE
To determine whether midline mucosa-sparing blocks (MSBs) protecting the aerodigestive tract can statistically significantly reduce acute toxicity during radiation therapy for carcinoma of the head and neck, without compromising tumor control.


METHODS
Radiation records and simulation films were reviewed in 125 patients with carcinoma of the oral cavity, oropharynx, or nasopharynx. Patients with and without MSBs were compared. Measures of acute toxicity during radiation therapy were weight loss (> or = 5%), hospitalization for nutritional support, and unplanned treatment interruptions (> or = 5 days). Actuarial local-regional tumor control was compared.


RESULTS
Patients with MSBs had significantly less weight loss (26 of 50 vs 37 of 47 patients, P = .006), fewer hospitalizations for nutritional support (one of 61 vs seven of 64 patients, P = .04), and a trend toward fewer treatment interruptions (10 of 61 vs 19 of 64 patients, P = .07) than patients without MSBs. The 3-year actuarial tumor control rates in the neck were similar.


CONCLUSIONS
Midline MSBs decrease acute toxicity during radiation therapy for carcinoma of the oral cavity, oropharynx, and nasopharynx without compromising tumor control.
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000532:radiotherapy*; D018572:Disease-Free Survival; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D009061:Mouth Mucosa / Q000528:radiation effects*; D009062:Mouth Neoplasms / Q000532:radiotherapy*; D009092:Mucous Membrane / Q000528:radiation effects; D009303:Nasopharyngeal Neoplasms / Q000532:radiotherapy*; D009305:Nasopharynx / Q000528:radiation effects*; D018529:Nutritional Support; D009959:Oropharyngeal Neoplasms / Q000532:radiotherapy*; D009960:Oropharynx / Q000528:radiation effects*; D010347:Patient Care Planning; D011835:Radiation Protection / Q000295:instrumentation*; D011878:Radiotherapy / Q000009:adverse effects; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D013280:Stomatitis / Q000209:etiology; D016896:Treatment Outcome; D015431:Weight Loss