Oral mucositis in patients undergoing radiotherapy for head and neck cancer: An observational cross-sectional study

Abstract

Background: Radiotherapy (RT) is indispensable in the treatment of head and neck cancer (HNC). Oral mucositis (OM) is a complication in HNC patients undergoing RT. This study aimed to identify the incidence, distribution of OM, and its effect on treatment breaks in a section of HNC in patients in Iraq. Methods: This is an observational, descriptive cross-sectional study. In total, 50 patients with primary HNC, treated with external beam RT, from 30th April to 10th September 2017 at  Baghdad Radiation Oncology and Nuclear Medicine Center were included in the study. Cases of OM were graded according to the World Health Organization scale. Results: 80% of patients were below 65 years, and the male/female ratio was 2.6:1. Tumor sub-sites were nasopharynx (36%), larynx (22%), parotid (14%) and tongue (12%). 74% were smokers during or before starting RT. 86% were in stages III or IV. Incidence of OM was 72%; 16% grade I, 40% grade II, and 16% grade III. OM occurred in 93% females and 64% males, and 79% received concurrent regimens. Conclusions: OM occurred in HNC treated by RT, more in females, who received chemotherapy plus RT, and those with tumors of the oral cavity and nasopharynx. OM-related unplanned breaks may interrupt treatment schedule. HNC imposes a double burden in Iraq as it attacks a productive age group, and the vast majority of the patients included in this study were diagnosed in advanced stages.