Acute mucosal radiation reactions in patients with head and neck cancer. Patterns of mucosal healing on the basis of daily examinations.
OBJECTIVE
The goal of this research was to evaluate the healing processes of acute mucosal radiation reactions (AMRR) in patients with head and neck cancer.


METHODS
In 46 patients with oral and oropharyngeal cancer patients irradiated with conventional (n = 25) and accelerated (n = 21) dose fractionation AMRR was evaluated daily during and after radiotherapy. Complex of morphological and functional symptoms according to the Dische score were collected daily until complete healing.


RESULTS
Duration of healing after the end of radiotherapy ranged widely (12-70 days). It was on the average 8 days longer for accelerated than for conventional radiotherapy (p = 0.016). Duration of dysphagia was also longer for accelerated irradiation (11 days, p = 0.027). Three types of morphological symptoms were observed as the last symptom at the end of AMRR healing: spotted and confluent mucositis, erythema, and edema. Only a slight correlation between healing duration and area of irradiation fields (r = 0.23) was noted. In patients with confluent mucositis, two morphological forms of mucosal healing were observed, i.e., marginal and spotted. The spotted form was noted in 71% of patients undergoing conventional radiotherapy and in 38% of patients undergoing accelerated radiotherapy. The symptoms of mucosal healing were observed in 40% patients during radiotherapy.


CONCLUSIONS
The wide range of AMRR healing reflects individual potential of mucosa recovery with longer duration for accelerated radiotherapy. Two morphological forms of confluent mucositis healing were present: marginal and spotted. Healing of AMRR during radiotherapy can be observed in a significant proportion of patients.
1st Department of Radiation Oncology, Maria Sklodowska-Curie Memorial Cancer Center and Institute of Oncology, Gliwice Branch, Ul. Wybrzeże Armii Krajowej 15, 44-101, Gliwice, Poland. awygoda@poczta.onet.pl
A
A
Wygoda
K
K
Składowski
T
T
Rutkowski
M
M
Hutnik
M
M
Goleń
B
B
Pilecki
W
W
Przeorek
B
B
Lukaszczyk-Wideł
D000328:Adult; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D019583:Dose Fractionation, Radiation; D004307:Dose-Response Relationship, Radiation; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000528:radiation effects*; D009062:Mouth Neoplasms / Q000532:radiotherapy*; D052016:Mucositis / Q000175:diagnosis*; D009959:Oropharyngeal Neoplasms / Q000532:radiotherapy*; D011832:Radiation Injuries / Q000175:diagnosis*; D011882:Radiotherapy, High-Energy / Q000009:adverse effects / Q000379:methods*; D020545:Respiratory Mucosa / Q000528:radiation effects*; D000077195:Squamous Cell Carcinoma of Head and Neck; D014945:Wound Healing / Q000528:radiation effects*