2Istanbul University of Istanbul Faculty of Dentistry, Istanbul
3Departments of Basic Oncology, Istanbul University Institute of Oncology, Istanbul
4Department of Microbiology, Istanbul University Istanbul Faculty of Medicine, Istanbul OBJECTIVES
Mucositis is a common toxicity in head and neck cancer irradiation, and can cause dose-limiting in patients. There is no widely accepted effective treatment or prevention. The purpose of this study was to investigate the efficacy of granulocyte macrophage colony-stimulating factor (GM-CSF) as a mouthwash to prevent radiation therapy (RT)-induced oral mucositis.
METHODS
Thirty-two head and neck cancer patients were enrolled in the
study and evaluated prospectively. Lesions were scored using
the Radiation Therapy Oncology Group (RTOG) criteria.
Variables were age, sex, history of smoking, anatomic region,
cancer stage, radiation area, and applied surface area.
RESULTS
Grade III-IV mucositis developed in 22 patients (68%) during
RT. The only statistically significant relation was between
the presence of mucositis and a history of smoking (p=0.04,
chi-square). Topical GM-CSF (400 μg 250 cc/day) application
had no effect on 1 patient (4%), while 14 patients (64%)
showed some improvement and 7 patients (32%) had complete
healing. The results of subjective and objective scores
were well correlated. GM-CSF had no effect on oral flora, and
there was no change in peripheral neutrophil counts.
CONCLUSION Topical use of GM-CSF shows promising effects in controlling RT-induced oral mucositis.
Keywords : Cytokine; GM-CSF; mucositis; radiotherapy; toxicity