Clinical effects of flurbiprofen tooth patch on radiation-induced oral mucositis. A pilot study.
BACKGROUND
Mucositis is an oral sequela of radiotherapy. In the development of mucositis several mechanisms play a role, such as inflammation and the effect of radiation on the high proliferation rate of oral basal epithelial cells. Therefore, administration of a drug with antiinflammatory and antiproliferative properties might delay the disorder and/or alleviate the severity of oral mucositis. The aim of this pilot study was to evaluate the effect of flurbiprofen in a tooth patch on the development, severity and duration of pseudomembranous mucositis in patients treated with curative head and neck radiotherapy.


METHODS
The study group comprised 12 patients with a malignant tumor in the head and neck region to be treated with primary curative or postoperative radiotherapy. Patients applied once a day before sleep a flurbiprofen tooth patch to a natural tooth or upper denture during the full course of radiotherapy, starting 1 week before the onset of radiotherapy. Oral mucositis, pain, feeding, body weight and viability and maturation of epithelial cells were assessed. The results were compared with the findings in a historical control group.


RESULTS
No differences were found for severity and duration of pseudomembranous mucositis between the two groups. The onset of pseudomembranous/ulcerative mucositis occurred later in the flurbiprofen group (14.6+/-3.8 days, mean+/-SD) than in the historical control group (11+/-3.5 days; P<0.05).


CONCLUSIONS
This study shows that the flurbiprofen 15 mg tooth patch cannot prevent the development of pseudomembranous mucositis and has no influence on the duration of oral mucositis.
Stokman
M A
MA
Department of Oral and Maxillofacial Surgery, University Hospital Groningen, PO Box 30.001, 9700, RB Groningen, The Netherland., m.a.stokman@kchir.azg.nl
Spijkervet
F K L
FK
Burlage
F R
FR
Roodenburg
J L N
JL
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy; D005260:Female; D005480:Flurbiprofen / Q000008:administration & dosage*; D006258:Head and Neck Neoplasms / Q000532:radiotherapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000473:pathology*; D010865:Pilot Projects; D011878:Radiotherapy / Q000009:adverse effects*; D013280:Stomatitis / Q000209:etiology* / Q000517:prevention & control*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D005480:Flurbiprofen