title: Recombinant human epidermal growth factor treatment of radiation-induced severe oral mucositis in patients with head and neck malignancies.
abstract: Mucositis of the oral cavity and pharynx is a major dose-limiting factor in the application of radiotherapy (RT) to patients with head and neck cancer. Therefore, we evaluated the wound healing effect of human recombinant epidermal growth factor (rhEGF) in head and neck cancer and lymphoma patients with irradiation (with or without combined chemotherapy-induced oral mucositis). Patients at Asan Medical Center who had undergone definitive RT of the head and neck region with or without combined chemotherapy and who had developed severe oral mucositis (higher than the Radiation Therapy Oncology Group grade 3) were treated with topical rhEGF twice daily for 7 days. The evaluation of response with regard to oral mucositis was performed 1 week later. Of the 11 treated patients, three had nasopharyngeal carcinoma, three had carcinoma of the oropharynx, two had carcinoma of the oral cavity, one had carcinoma of the hypopharynx and two had lymphoma of the head and neck. Six patients received RT only, and five patients received concurrent chemoradiotherapy. All patients showed improvements in their oral mucositis after topical treatment with rhEGF in that the Radiation Therapy Oncology Group grade was significantly decreased (P = 0.0000). This finding suggests that rhEGF is effective and safe for the treatment of radiation-induced mucositis. Further studies are needed to determine the optimal dosage and fractionation schedule.
authors.affiliation: Department of Plastic and Reconstructive Surgery, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: J P
authors.initials: JP
authors.lastname: Hong
authors.forename: S-W
authors.initials: SW
authors.lastname: Lee
authors.forename: S Y
authors.initials: SY
authors.lastname: Song
authors.forename: S D
authors.initials: SD
authors.lastname: Ahn
authors.forename: S S
authors.initials: SS
authors.lastname: Shin
authors.forename: E K
authors.initials: EK
authors.lastname: Choi
authors.forename: J H
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D004815:Epidermal Growth Factor / Q000008:administration & dosage*; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000528:radiation effects*; D010865:Pilot Projects; D011832:Radiation Injuries / Q000188:drug therapy* / Q000209:etiology; D011837:Radiation-Protective Agents / Q000008:administration & dosage*; D011878:Radiotherapy / Q000009:adverse effects; D011994:Recombinant Proteins / Q000627:therapeutic use; D013280:Stomatitis / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome; D014945:Wound Healing / Q000187:drug effects
chemical_list: D011837:Radiation-Protective Agents; D011994:Recombinant Proteins; D004815:Epidermal Growth Factor