Assessment and Prevalence of Concomitant Chemo-Radiotherapy-Induced Oral Mucositis in Patients with Oral Squamous Cell Carcinoma.

Background Quantification of oral mucositis that progresses during concomitant chemo-radiotherapy (CCRT) is essential for its management. It is important to determine the methods that are simple, reliable and beneficial in foreseeing mucositis at earlier stages of treatment. Materials and Methods A prospective study was conducted on 100 oral cancer patients receiving CCRT following the inclusion criteria. Patients were evaluated for mucositis by using the World Health Organization (WHO) scale, the Oral Mucositis Assessment Scale (OMAS) and by exfoliative cytology. Clinical examination and procedure of oral cavity were performed before, on days 5, 17t and at the end of treatment. Results Oral mucositis was observed in all oral squamous cell carcinoma (OSCC) patients receiving CCRT on different days with noteworthy increase from day 5 of CCRT to the end of treatment. For OMAS and WHO grading related to ulceration and erythema, Grade 1 (7.2%; 34%; 18%), Grade 2 (29%; 19%; 21%) and Grade 3(19%; 12%) were most frequently seen at the end of CCRT, accordingly. There was statistically significant increase in the percentage of immature cells at the end of CCRT (99%). A significant association (p< 0.0000) was observed among the days of smear and maturation stages of epithelial cells as well as among WHO mucositis grading, OMAS and types of epithelial cells, respectively. Conclusion Oral mucositis is frequently related to adverse clinical outcomes, affecting the patient?s quality of life. It is essential to develop methods that can be employed for the assessment of CCRT associated oral mucositis.