[Immunoglobulin for prevention of radiogenic mucositis].
Among various therapies administered during radiation-induced mucositis, 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 patients with histologically-proven head and neck cancer were given postoperative radiation treatment. In cases with macroscopic tumor residues or inoperability, combined radio-chemotherapy was given. This included 51.3 Gy at 1.9 Gy 5x/week, boosted to 10-26 Gy at 2 Gy 5x/week and carboplatin 60 mg/m2 at days 1-5 and 29-33. Panthenol (4x10 ml/day) and nystatin (4 x 1 ml/day) were given to 20 patients as prophylactic treatment for mucositis. Twenty-two subsequent patients also received intramuscular 800 mg (5 ml) human immunoglobulin (1x/week). According to the Seegenschmiedt/Sauer classification the extent of mucositis was determined 3x/week. Comparison of the distribution of maximal mucositis revealed a slightly more severe mucosal reaction in the control group (n.s.). Analysis of the mean degree of mucositis in both groups demonstrated statistically significant differences (p = 0.031) related to the whole 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 beginning of therapy to the first interruption was prolonged 5 days (37.5 +/- 13.1 vs. 42.7 +/- 13.3 days), but this difference was not significant. Although prophylactic application of immunoglobulin seemed to lower the degree of radiation-induced mucositis, this effect was less significant when compared to the immunoglobulin given in a therapeutic manner.
Mose
S
S
Abteilung für Strahlentherapie und Onkologie, Universität Frankfurt/M.
Adamietz
I A
IA
Thilmann
C
C
Saran
F
F
Heyd
R
R
Knecht
R
R
Böttcher
H D
HD
D000328:Adult; D000368:Aged; D016190:Carboplatin / Q000008:administration & dosage / Q000009:adverse effects; D003131:Combined Modality Therapy; D005260:Female; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy* / Q000601:surgery; D006801:Humans; D007116:Immunization, Passive; D007273:Injections, Intramuscular; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000528:radiation effects*; D018365:Neoplasm, Residual / Q000188:drug therapy / Q000532:radiotherapy / Q000601:surgery; D011832:Radiation Injuries / Q000517:prevention & control*; D011838:Radiation-Sensitizing Agents / Q000008:administration & dosage / Q000009:adverse effects; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D013280:Stomatitis / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
D011838:Radiation-Sensitizing Agents; D016190:Carboplatin
Immunglobulin zur Prophylaxe der radiogen induzierten Mukositis.