Prospective cohort study of severe oral mucositis after intensity-modulated radiation therapy for head and neck cancer

Oral mucositis (OM) is a common and debilitating adverse effect in patients receiving radiotherapy for head and neck cancer (HNC). Previous studies of associations between OM and clinical outcomes were performed in the era of 3-dimensional conformal radiotherapy planning with low rates of concurrent chemotherapy, and thus may not reflect current practice. A prospective study at Roswell Park Comprehensive Cancer Center (Buffalo, NY) investigated patient-reported OM after intensity-modulated radiotherapy (IMRT) for primary HNC. In this cohort study of 576 patients, 360 (62%) developed severe OM. This was associated with feeding tube placement, hospitalization, weight loss, and opiate use. The authors conclude that OM continues to cause morbidity in HNC patients, contributing to worse quality of life.