[Radiation-induced mucositis and neutrophil granulocytes in oral mucosa].
BACKGROUND
Chemotherapy-induced mucositis can be related to a decrease in oral neutrophils. We tested the relationship between radiation-induced mucositis and oral neutrophil counts.


METHODS
Oral neutrophil counts were obtained for ten patients with head and neck cancer who received radiotherapy of the pharynx and oral cavity. Four patients received additional chemotherapy (5-FU, Mitomycin). Counts were obtained before and during treatment; four healthy volunteers were included in the study as well. For evaluation, a quantitative mouth rinse assay, including neutrophil-staining with acridin-orange, was applied.


RESULTS
We observed large inter-individual variations with respect to neutrophil counts for patients and control persons (Table 1). During treatment (irradiation or chemoirradiation), large intra-individual variations were seen additionally (Figure 1). We found a correlation between neutrophil counts and clinical reaction grade. Neutrophil counts increased with increasing mucositis (Figure 2). This increase was more pronounced for patients treated with chemoirradiation compared to radiation alone. Treatment breaks at weekends had no clear influence on neutrophil counts.


CONCLUSIONS
We observed a weak correlation between neutrophil counts and clinical reaction grade. However, the variations in neutrophil counts are too large to utilize this parameter as a surrogate for clinical mucositis grading. The assumption that a decrease in oral neutrophils is associated with radiation-induced mucositis was clearly negated.
Schmidberger
Heinz
H
Klinik für Strahlentherapie und Radioonkologie, Universität Göttingen, Göttingen, Germany. hschmbg@med.uni-goettingen.de
Rave-Fränk
Margret
M
Kim
Solan
S
Hille
Andrea
A
Pradier
Olivier
O
Hess
Clemens F
CF
D000328:Adult; D000368:Aged; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D000964:Antimetabolites, Antineoplastic; D003131:Combined Modality Therapy; D003627:Data Interpretation, Statistical; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000532:radiotherapy*; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D007822:Laryngeal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D007958:Leukocyte Count; D008048:Lip Neoplasms / Q000532:radiotherapy; D008297:Male; D008875:Middle Aged; D016685:Mitomycin / Q000627:therapeutic use; D009061:Mouth Mucosa / Q000166:cytology* / Q000528:radiation effects; D009062:Mouth Neoplasms / Q000532:radiotherapy; D009067:Mouthwashes; D009504:Neutrophils / Q000528:radiation effects; D009959:Oropharyngeal Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D011832:Radiation Injuries / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D013280:Stomatitis / Q000209:etiology*; D014062:Tongue Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D014067:Tonsillar Neoplasms / Q000532:radiotherapy
D000903:Antibiotics, Antineoplastic; D000964:Antimetabolites, Antineoplastic; D009067:Mouthwashes; D016685:Mitomycin; D005472:Fluorouracil