title: Effect of Fractionated Dose of Radiotherapy on Oral Mucosa in Head and Neck Cancer Patients: A Cytological Assessment.
abstract: BACKGROUND
  Cancer therapy couples with it a plethora of complications of short and long term effects which can be so distressing that patient may tolerate only lower less-effective doses of therapy, may postpone treatments or will discontinue treatment entirely. Fractionated dose of radiotherapy coupled with therapy induce local or systemic infections due to high cellular turnover rates of the oral mucosa, diverse and complex microflora and trauma to oral tissues. Several mucosal abnormalities often results in epithelial and glandular destruction and inflammation, which can be so devastating that it may cause atypical changes on the area exposed to radiation. Thus, the aim of this study was to investigate the feasibility of using cytological evaluation to detect oral epithelial atypia among Head and Neck cancer patients receiving fractionated dose of radiotherapy.
  
  
  METHODS
  Study was conducted on 125 head and neck cancer patients receiving radiotherapy. Subjects were divided into 5 study groups on the basis of fractionated dose of radiotherapy from 10th-50th fractions respectively. Mucosal changes were evaluated by exfoliative cytology and atypical changes and inflammatory cell infiltration were assessed.
  
  
  RESULTS
  Without prior knowledge of the subjects' group, oral epithelial atypia was detected with increase fractionated dose of radiation. Dense inflammatory nfiltrate were identified in nearly all study groups irrespective of dose of radiotherapy.
  
  
  CONCLUSIONS
  Cytological atypia and inflammatory infiltrates were detected after exposure to radiotherapy.
authors.affiliation: Dept. of Oral and Maxillofacial Pathology and Microbiology, College of Dentistry, Jazan University, Jazan, Saudi Arabia.
authors.forename: S
authors.initials: S
authors.lastname: Khan
authors.affiliation: Dept. of Prosthodontics, College of Dentistry, Jazan University, Saudi Arabia.
authors.forename: Sma
authors.initials: S
authors.lastname: Feroz
authors.affiliation: Dept. of Oral Pathology and Microbiology, People's Dental Academy, Bhopal (MP), India.
authors.forename: M
authors.initials: M
authors.lastname: Jain
authors.affiliation: Department of Oral Pathology and Microbiology, People's College of Dental Sciences and Research Centre, Bhopal (MP), India.
authors.forename: V
authors.initials: V
authors.lastname: Mathur
authors.affiliation: Consulting Clinical Psychologist.
authors.forename: Sameera
authors.initials: S
authors.lastname: Khan
mesh_terms: D003581:Cytodiagnosis / Q000379:methods; D019583:Dose Fractionation, Radiation; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D009061:Mouth Mucosa / Q000473:pathology / Q000528:radiation effects*
keywords: Atypia; cytology; inflammatory infiltrate.; oral mucosa; radiotherapy