Oral mucositis in morning vs. evening irradiated patients: a randomised prospective study.

Purpose: Patients of head and neck cancer undergoing radiotherapy develop oral mucositis. The severity of mucositis may also depend on the time of administration of radiation apart from patient-related factors. The most radiosensitive phase of the cell cycle (G2-M) occurs in the late afternoon and evening in human oral mucosa; therefore, it is more vulnerable to radiation injury in the evening. The present study evaluated prospectively the severity of acute oral mucositis in head and neck carcinoma patients irradiated in the morning (08:00–11:00 h) versus late afternoon/evening (15:00–18:00 h).Method: A total of 212 patients of head and neck carcinoma were randomised to morning (08:00–11:00 h) and evening (15:00–18:00 h) groups. The grades of oral mucosa ulceration were compared in the two groups.Results: The grades of mucositis were marginally higher in the evening-irradiated group than in the morning-irradiated group 38% vs. 26% (p = 0.08).Conclusion: The observed incidence of grade III/IV mucositis in ...