A randomized, controlled phase II trial of maxillofacial and oral massage in attenuating severe radiotherapy-induced oral mucositis and lipid metabolite changes in nasopharyngeal carcinoma. (October 2021)

• Record Type: Journal Article
• Authors: Yang, Guangrong; Feng, Dan; Li, Feng; Luo, Bangyu; Zhu, Jianbo; Yang, Qiao; Zheng, Linpeng; Dong, Qiang; Chen, Mingjing; Xu, Zihan; Li, Lingchen; Chen, Ping; Sun, Jianguo
• Is Part Of: Radiotherapy and oncology. Volume 163(2021)
• Page Start: 76
• Page End: 82
• Publication Date: 2021-10
• Subjects: Radiotherapy-induced oral mucositis -- Maxillofacial and oral massage -- Nasopharyngeal carcinoma -- Concurrent radiochemotherapy -- Lipid metabolisim; Oncology -- Periodicals; Radiotherapy -- Periodicals; Tumors -- Periodicals; Medical Oncology -- Periodicals; Neoplasms -- radiotherapy -- Periodicals; Radiotherapy -- Periodicals; Radiothérapie -- Périodiques; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Electronic journals; 616.9940642
• DOI: 10.1016/j.radonc.2021.07.024
• Languages: English
• ISSNs: 0167-8140

Abstract

Highlights: Maxillofacial and oral massage (MOM) attenuated radiotherapy-induced oral mucositis. The adverse events of MOM were slight and tolerant. MOM enhanced anti-inflammatory lipid metabolites. MOM has efficacy and safety in nasopharyngeal carcinoma during radiotherapy. Abstract: Purpose: This randomized controlled phase II study investigated the efficacy, safety and underlying mechanism of maxillofacial and oral massage (MOM) in nasopharyngeal carcinoma (NPC) patients receiving intensity-modulated radiotherapy. Methods: A total of 158 NPC patients were randomly assigned 1:1 to routine oral care and medication (the control group) or that with additional MOM (the treatment group). The primary endpoint was the incidence of severe radiotherapy-induced oral mucositis (SRTOM). In addition, the time of initiation and duration of RTOM and SRTOM, adverse events, dynamic changes of lipid metabolites in peripheral blood were analyzed. Results: Seventy-six patients in the treatment group and seventy-nine in the control group completed the trial. The incidence of SRTOM in the treatment group was lower than the control (26.3% vs. 46.8%, P = 0.008). The median initiation time to RTOM and SRTOM was significantly longer in the treatment group than the control (RTOM:12 vs 10 days, hazard ratio [HR] 0.52, P < 0.001; SRTOM: 28.5 vs 19 days, HR 0.5579, P = 0.002). While the median duration time of RTOM and SRTOM in the treatment group was shorter (RTOM: 20.7 vs 24.7 days, P = 0.001; SRTOM: 8.05 vs 13.08 days, P < 0.001). Only 1.3% of patients obtained grade 3 or higher adverse events during MOM. The anti-inflammatory lipids increased significantly after MOM, especially with 10.6 Gy or higher. Conclusion: MOM significantly attenuated the incidence of SRTOM in NPC patients. The adverse events of MOM were slight and tolerant. MOM enhanced anti-inflammatory lipid metabolites, which might be an underlying mechanism.