title: Efficacy of elemental diet on prevention for chemoradiotherapy-induced oral mucositis in patients with oral squamous cell carcinoma.
abstract: OBJECTIVE
  Oral mucositis induced by radiation or chemoradiation can compromise the quality of life of oral squamous cell carcinoma (OSCC) patients. The present study was designed to evaluate the preventive effects of elemental diet (ED), Elental®, on radiotherapy- or chemoradiotherapy-induced mucositis in OSCC patients.
  
  
  METHODS
  Seventy-four patients who underwent radiation (60-70 Gy) with/without chemotherapy [S-1, cisplatin (CDDP), CDDP plus S-1] were enrolled in this retrospective study; 37 had received Elental® during treatment (Elental® group) and 37 had not (control group). Factors related to alleviation of oral mucositis were identified by multivariate logistic regression analysis. Rates of completion of chemoradiation treatments were compared between Elental® and control groups according to the treatment regimen. The comparison of the nutritional status between groups was also performed.
  
  
  RESULTS
  Multivariate analysis indicated that the administration of Elental® and no combined chemotherapy (radiation alone) were significant factors associated with the degree of oral mucositis, i.e., most of the patients who consumed Elental® suffered from a lower degree of mucositis compared to the control group. Elental® was associated with a significantly improved rate of completion of chemoradiation (no interruption). There was no significant difference between Elental® group and control group in terms of mean change of body weight or total protein and albumin levels in blood serum before and after (chemo)radiation.
  
  
  CONCLUSIONS
  The present study indicates that Elental® is effective for ameliorating oral mucositis induced by (chemo)radiation in OSCC patients. Elental® was also associated with improved completion rates of (chemo)radiotherapy.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube, 755-8505, Japan. harako@yamaguchi-u.ac.jp.
authors.forename: Koji
authors.initials: K
authors.lastname: Harada
authors.affiliation: Department of Oral and Maxillofacial Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube, 755-8505, Japan.
authors.forename: Tarannum
authors.initials: T
authors.lastname: Ferdous
authors.affiliation: Department of Oral and Maxillofacial Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube, 755-8505, Japan.
authors.forename: Daiju
authors.initials: D
authors.lastname: Horinaga
authors.affiliation: Department of Oral and Maxillofacial Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube, 755-8505, Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Uchida
authors.affiliation: Department of Oral and Maxillofacial Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube, 755-8505, Japan.
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Mano
authors.affiliation: Department of Oral and Maxillofacial Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube, 755-8505, Japan.
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Mishima
authors.affiliation: Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube, 755-8505, Japan.
authors.forename: SungChul
authors.initials: S
authors.lastname: Park
authors.affiliation: Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube, 755-8505, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Hanazawa
authors.affiliation: Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube, 755-8505, Japan.
authors.forename: Shotaro
authors.initials: S
authors.lastname: Takahashi
authors.affiliation: Department of Nursing, Yamaguchi University Hospital, 1-1-1, Minamikogushi, Ube, 755-8505, Japan.
authors.forename: Atsumi
authors.initials: A
authors.lastname: Okita
authors.affiliation: Department of Nursing, Yamaguchi University Hospital, 1-1-1, Minamikogushi, Ube, 755-8505, Japan.
authors.forename: Misaki
authors.initials: M
authors.lastname: Fukunaga
authors.affiliation: Department of Nursing, Yamaguchi University Hospital, 1-1-1, Minamikogushi, Ube, 755-8505, Japan.
authors.forename: Junko
authors.initials: J
authors.lastname: Maruta
authors.affiliation: Department of Nursing, Yamaguchi University Hospital, 1-1-1, Minamikogushi, Ube, 755-8505, Japan.
authors.forename: Naoko
authors.initials: N
authors.lastname: Kami
authors.affiliation: Department of Radiation Oncology, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube, 755-8505, Japan.
authors.forename: Keiko
authors.initials: K
authors.lastname: Shibuya
authors.affiliation: Department of Oral and Maxillofacial Surgery, Yamaguchi University Graduate School of Medicine, 1-1-1, Minamikogushi, Ube, 755-8505, Japan.
authors.forename: Yoshiya
authors.initials: Y
authors.lastname: Ueyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000532:radiotherapy*; D059248:Chemoradiotherapy / Q000009:adverse effects*; D002945:Cisplatin / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D005526:Food, Formulated; D006801:Humans; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000532:radiotherapy*; D052016:Mucositis / Q000178:diet therapy* / Q000188:drug therapy / Q000517:prevention & control; D011788:Quality of Life; D012189:Retrospective Studies; D013280:Stomatitis / Q000139:chemically induced / Q000178:diet therapy / Q000517:prevention & control*
chemical_list: D002945:Cisplatin
keywords: Chemoradiation; Elemental diet; Mucositis; Oral squamous cell carcinoma; Radiation