Intralesional corticosteroid therapy for non-healing persistent radiation-induced oropharyngeal mucositis.

Autor: Khawaja SN; Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7A Block R-3, Phase 2, M.A. Johar Town, Lahore, 54782, Punjab, Pakistan. khawajashehryar@gmail.com.; Department of Diagnostic Sciences, School of Dental Medicine, Tufts University, Boston, MA, USA. khawajashehryar@gmail.com., Rehman SA; Department of Internal Medicine, Shaukat Khanum Memorial Cancer Hospital and Research Centre, 7A Block R-3, Phase 2, M.A. Johar Town, Lahore, 54782, Punjab, Pakistan., Shazib MA; Workman School of Dental Medicine, High Point University, High Point, NC, USA., Jamshed A; Department of Clinical and Radiation Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan.
Jazyk: angličtina
Zdroj: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer [Support Care Cancer] 2024 Nov 02; Vol. 32 (11), pp. 765. Date of Electronic Publication: 2024 Nov 02.
DOI: 10.1007/s00520-024-08963-9
Abstrakt: Purpose: Oropharyngeal mucositis is a common complication of anticancer therapy. This study aimed to determine the effectiveness and safety of intralesional corticosteroid therapy (ICT) in the management of persistent mucositis.
Methods: A retrospective chart review of patients who underwent ICT in the oral cavity to manage oral mucositis managed with basic oral care and preventive modalities and persisting at least 6 weeks after head and neck radiation or chemoradiation therapy completion between November 2017 and September 2023 was performed. Bio-demographic data, cancer and anticancer therapy characteristics, medical history, and mucositis-related variables were extracted from electronic medical records.
Results: Among the 34 participants, 22 (64.7%) were male. Twenty (58.8%) participants received radiotherapy; the rest received chemoradiation therapy. Before the ICT, the median mucositis lesion surface area was 225 mm 2 (range 9-2025 mm 2 ), and 22 (64.7%) patients had grade III mucositis. Post-intervention, the median size was reduced to 0 mm 2 (range 0-1600 mm 2 ). Clinically effective response (≥ 75% size and symptom reduction) was observed in 28 (82.4%) participants over a median of 26 days (7-60 days). Within this cohort, complete healing of the lesion was seen in 18 (64.3%) subjects. Overall, 25 (73.5%) participants experienced a downgradation in the mucositis stage. Local complications from injections were found in two (5.7%) participants. A correlation was found between clinically effective relief and absence of trismus (p = .03) and smaller pre-procedure surface area (p = .009).
Conclusion: The ICT represents a viable option in managing non-healing, persistent radiation, and chemoradiation-induced oral mucositis. The modality was well tolerated and had no systemic complications.
(© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
Databáze: MEDLINE
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