Management of radiation-induced oral mucositis in head and neck cancer patients: a real-life survey among 25 Italian radiation oncology centers.
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Bergamaschi Luca, Vincini Maria Giulia, Zaffaroni Mattia, Pepa Matteo, Angelicone Ilaria, Astone Antonio, Bergamini Cristiana, Buonopane Sergio, Conte Mario, De Rosa Nicola, Deantoni Chiara, Dell'Oca Italo, Di Gennaro Davide, Di Muzio Nadia, Osti Mattia Falchetto, Federico Manuela, Ferini Gianluca, Franzese Ciro, Gatti Marco, Grillo Antonietta, Iorio Vincenzo, Manzo Roberto, Marmiroli Luca, Martin Giuseppe, Mazzuca Federica, Molinaro Maria Angela, Muto Matteo, Pacelli Roberto, Pepe Alfonsina, Perillo Annarita, Russo Donatella, Salerno Francesca, Spadaro Pietro, Viola Anna, Iorio Giuseppe Carlo, Muto Paolo, Ricardi Umberto, Alterio Daniela
Аннотация
METHODS: A 40-question survey was administered to 25 radiation oncologists working in 25 different RT centers across Italy.
RESULTS: A total of 1554 HNC patients have been treated in the participating centers in 2021, the majority (median across the centers 91%) with curative intent. Median treatment time was 41 days, with a mean percentage of interruption due to toxicity of 14.5%. Eighty percent of responders provide written oral cavity hygiene recommendations. Regarding RIOM prevention, sodium bicarbonate mouthwashes, oral mucosa barrier agents, and hyaluronic acid-based mouthwashes were the most frequent topic agents used. Regarding RIOM treatment, 14 (56%) centers relied on literature evidence, while internal guidelines were available in 13 centers (44%). Grade (G)1 mucositis is mostly treated with sodium bicarbonate mouthwashes, oral mucosa barrier agents, and steroids, while hyaluronic acid-based agents, local anesthetics, and benzydamine were the most used in mucositis G2/G3. Steroids, painkillers, and anti-inflammatory drugs were the most frequent systemic agents used independently from the RIOM severity.
CONCLUSION: Great variety of strategies exist among Italian centers in RIOM management for HNC patients. Whether different strategies could impact patients' compliance and overall treatment time of the radiation course is still unclear and needs further investigation.