Radiation mucositis: a new approach to prevention and treatment

Mucosal reactions in patients receiving radiation treatment for head and neck cancer are regarded as unavoidable side-effects. The degree of mucositis experienced is determined by the treatment dose, radiation field size and fractionation schedules prescribed for individual patients. This article reviews a double-blind placebo-controlled trial of an antibiotic pastille which was aimed at reducing the more extreme effects of radiation mucositis. It identifies the role of oral care and hygiene, oral assessment and nursing support within a clinical trial setting. The results showed that the active pastille had a beneficial effect on the degree of mucositis experienced. Patients had a reduction in their weight loss in the active arm of the trial and the amount of yeast bacteria present in the oral cavity of those patients also diminished. It is worth noting that those patients in the placebo arm of the trial received both physical and psychological support from the nursing staff which may not have been available as frequently if they had not been in the trial.