Barrier-forming lipid solution for severe oral mucositis: effect on oral intake interruption in head and neck cancer

Oral mucositis (OM) is a localised adverse event of treatment strategies for head and neck cancer, often confined to the irradiated area. Barrier-forming lipid solutions (BLS) have been used to alleviate OM-related symptoms; however, their clinical efficacy remains unclear. This study aimed to evaluate the effects of BLS on OM severity, clinical symptoms, and perioperative nutritional status in patients receiving treatment strategies.

This retrospective study included 200 patients treated with treatment strategies for head and neck cancer at Gunma University Hospital between 2012 and 2021. The patients were categorised into BLS-use and non-use groups. The predictor variables included demographics, smoking and alcohol history, radiation dose, OM severity (common terminology criteria for adverse events [CTCAE] v4.0), and nutritional indices (weight loss rate, serum albumin, prognostic nutritional index [PNI], and modified Glasgow prognostic score[mGPS]) at three time points (pre-treatment, post-treatment, and at discharge). Univariate analysis was performed. Additionally, OM severity, oral intake interruption, and nutritional support (parenteral [PN] or enteral nutrition [EN]) were evaluated among patients with CTCAE Grade 3 OM.

Among all 200 patients, the BLS-use group showed a significantly shorter duration of oral intake interruption despite receiving a higher radiation dose (both p < 0.001). In the subgroup of 51 patients with Grade 3 OM, the BLS-use group had significantly shorter durations of oral intake interruption, PN (32.0[16.0-42.0]) vs. (75.0[51.0-115.0]) days, p < 0.001), and EN (26.0[15.0-50.0] vs. 47.0[29.0-78.8] days, p = 0.034).

BLS use was associated with a reduced duration of oral intake interruption despite higher radiation exposure. In patients with CTCAE Grade 3 OM, BLS use was also associated with shorter durations of parenteral and enteral nutritional support.