title: Quantitative Analysis of Acute Phase Proteins in Post Chemo-Radiation Mucositis.
abstract: OBJECTIVE
  Oral mucositis induced by radiation is an inevitable but transient side-effect of radiotherapy. Acute phase proteins are a class of proteins whose phase concentrations fluctuate in response to inflammation. The best known of the acute phase proteins is C-reactive protein, a protein that rises in the blood with inflammation.
  
  
  METHODS
  30 patients undergoing chemo - radiotherapy for head and neck cancer were clinically evaluated for mucositis on day 0, 7, 14, 28 and 42. Blood investigations like C-reactive protein, erythrocyte sedimentation rate and total leukocyte count were also conducted.
  
  
  RESULTS
  There was a significant increase in the severity of mucositis during the course of treatment followed by a gradual decrease in severity towards the end of radiotherapy. Comparison of C-reactive protein levels from day 0 to day 42 in the study group showed a significant increase towards the end of radiotherapy. There was a significant increase in erythrocyte sedimentation rate levels till day 14 followed by a decrease towards the end of radiotherapy whereas total leukocyte count showed a significant decrease from day 0 to day 7 followed by an increase towards the end of radiotherapy.
  
  
  CONCLUSIONS
  The oral mucosa bears only a small clinical spectrum of the side-effect conveyed by chemo-radiation. Both widespread and late effects do occur, and tissues may never return to normal completely. Inflammatory serum markers like C-reactive protein, erythrocyte sedimentation rate and total leukocyte count can thus be used as an objective measure to study the complexities of radiation mucositis which is documented as one of the worst side effects of head and neck cancer therapy.
authors.affiliation: Lecturer, Department of Oral Pathology and Microbiology, A. B. Shetty Memorial Institute of Dental Sciences , Deralakatte, Mangalore, India .
authors.lastname: Chethana
authors.affiliation: Professor, Department of Oral Pathology and Microbiology, Century International Institute of Dental sciences and Research Centre, Kerala University of Health Sciences , Poinachi, Thekkil (Via), Kasaragod, Kerala, India .
authors.forename: Pratima S
authors.initials: PS
authors.lastname: Rao
authors.affiliation: Professor, Department of Oral Pathology and Microbiology, Century International Institute of Dental sciences and Research Centre, Kerala University of Health Sciences , Poinachi, Thekkil (Via), Kasaragod, Kerala, India .
authors.forename: Lal P
authors.initials: LP
authors.lastname: Madathil
authors.affiliation: Head, Radiation Oncology Division, Mangalore Institute of Oncology , Pumpwell, Mangalore, Karnataka, India .
authors.forename: Suresh
authors.initials: S
authors.lastname: Rao
authors.affiliation: Professor & Head, Department of Oral Pathology and Microbiology, A. B. Shetty Memorial Institute of Dental Sciences , Deralakatte, Mangalore, India .
authors.forename: Pushparaja
authors.initials: P
authors.lastname: Shetty
authors.affiliation: Senior Lecturer, Department of Oral Pathology and Microbiology, Babu Banarasi Das College of Dental Sciences , Lucknow, India .
authors.forename: Madhvika
authors.initials: M
authors.lastname: Patidar
keywords: Acute phase response; C-reactive protein; Chemotherapy; Oral mucositis; Radiotherapy