Timing of Radiation Treatment Can Improve Oral Mucositis Symptoms

Dentistry Today


Painful sores in the mouth and throat are among the most common adverse side effects caused by radiation therapy for most cancers of the head and neck. Oral mucositis frequently causes difficulties in swallowing, eating, and sleeping and often necessitates prescription opioids or other analgesics for pain control.

By administering these treatments in the morning instead of later in the day, however, clinicians can significantly reduce the severity of mucositis and its related impacts, according to the Roswell Park Comprehensive Cancer Center.

“Acute oral mucositis is not only extremely painful for patients, it also interferes with their care and recovery in a number of ways, from impaired nutritional intake and treatment delays to higher chance of infection, hospitalization, and use of opioids, which comes with a host of additional side effects and risks,” said senior author Anurag Singh, MD, professor of oncology and director or radiation research at Roswell Park’s Department of Radiation Medicine. 

“And while these factors double the costs of supportive care in comparison to milder cases, the few prevention and treatment options available for this condition have limited efficacy and/or supporting evidence,” Singh said.

Hypothesizing that the timing of radiation treatments could be impacting the severity of mucositis, the researchers studied oral mucositis patterns in 190 head and neck cancer patients treated at Roswell Park. They found a significant association between radiation treatment timing and oral mucositis severity in head and neck cancer patients.

“We found that the severity of oral mucositis increases as the time at which radiation treatments were administered got later, peaking at early afternoon,” said Singh. “Our findings highlight a simple and easily implementable solution for reducing severe oral mucositis in head and neck cancer patients, and one that may have significant clinical and quality of life benefits for patients.” 

The researchers believe this is the first study to find significant variation of oral mucositis severity by treatment timing.

“Identifying an optimal time of a day for radiotherapy may substantially prevent severe oral mucositis in head and neck cancer patients,” said first author Fangyi Gu, MD, ScD, assistant professor or oncology in the Department of Cancer Prevention and Control at Roswell Park. “Further studies are worthwhile to confirm our findings and to find optimal treatment times for individual patients.”

The researchers will present the results of their study at the American Association for Cancer Research Annual Meeting 2019 at the Georgia World Congress Center on Wednesday, April 3.

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