The correlation between epidermal growth factor levels in saliva and the severity of oral mucositis during oropharyngeal radiation therapy.
|Abstract||Epidermal growth factor (EGF) is present in biologic fluids, including saliva, and plays a role in maintenance of the epithelial barrier and in healing of damaged mucosa. The purpose of this study was to assess the relation between salivary EGF and the severity of oral mucositis in patients with carcinoma of the head and neck during radiation therapy.|
Therapeutic effect of recombinant human epidermal growth factor (RhEGF) on mucositis in patients undergoing radiotherapy, with or without chemotherapy, for head and neck cancer: a double-blind placebo-controlled prospective phase 2 multi-institutional clinical trial.
|Publication Year Start||2001-01-01|
PMID- 11147596 OWN - NLM STAT- MEDLINE DCOM- 20010118 LR - 20041117 IS - 0008-543X (Print) IS - 0008-543X (Linking) VI - 89 IP - 11 DP - 2000 Dec 1 TI - The correlation between epidermal growth factor levels in saliva and the severity of oral mucositis during oropharyngeal radiation therapy. PG - 2258-65 AB - BACKGROUND: Epidermal growth factor (EGF) is present in biologic fluids, including saliva, and plays a role in maintenance of the epithelial barrier and in healing of damaged mucosa. The purpose of this study was to assess the relation between salivary EGF and the severity of oral mucositis in patients with carcinoma of the head and neck during radiation therapy. METHODS: Whole resting saliva (WRS) and whole stimulated saliva (WSS) were collected prior to radiation and each week during radiation treatment for 11 men and 7 women. Oral mucositis was evaluated using the National Cancer Institute (NCI) scale of 0-4 and the Oral Mucositis Assessment Scale (OMAS), which evaluates the extent of erythema (scale of 0-2) and ulcerations (scale of 0-3) in nine oral sites. The overall OMAS score of 0-45 reflected the mucosal condition. EGF was assayed in the saliva specimens. RESULTS: The total mean radiation dose delivered to the head and neck was 5667 centigrays (cGy) in a mean of 24 fractions. Ulcerative oral mucositis occurred in 94% of patients. The mean OMAS score ranged from 2.83 in the first week of treatment to 14.77 in the fifth week. The mean WRS and WSS volumes decreased significantly from pretreatment to the first week of radiation treatment and then remained stable. A similar pattern was seen for the mean total output of EGF. A significant and negative correlation was found between higher levels of EGF in stimulated saliva and low OMAS score, reflecting less severe erythema and ulceration. A general trend showing that less tissue damage was associated with a higher EGF level in resting saliva also was illustrated. EGF levels were correlated with the OMAS score; however, no correlation was found when assessing the NCI score, which combines tissue damage with function and symptoms in a single score. CONCLUSIONS: Radiation-induced mucositis appeared to be modified by saliva volume, total EGF, and concentration of EGF in the oral environment. Saliva volume and total EGF output decreased significantly in the first weeks of treatment and remained reduced throughout radiation therapy. The findings suggest that higher levels of EGF in saliva, particularly in stimulated saliva, prior to and during radiation treatment may be associated with less severe mucosal damage due to radiation therapy. It is also postulated that human EGF may affect the development and healing of radiation-damaged mucosa. FAU - Epstein, J B AU - Epstein JB AD - Department of Dentistry, Vancouver Hospital and Health Sciences Center, British Columbia, Canada. [email protected] FAU - Gorsky, M AU - Gorsky M FAU - Guglietta, A AU - Guglietta A FAU - Le, N AU - Le N FAU - Sonis, S T AU - Sonis ST LA - eng PT - Journal Article PL - United States TA - Cancer JT - Cancer JID - 0374236 RN - 62229-50-9 (Epidermal Growth Factor) SB - AIM SB - IM MH - Adult MH - Aged MH - Epidermal Growth Factor/*metabolism MH - Female MH - Head and Neck Neoplasms/metabolism/*radiotherapy MH - Humans MH - Male MH - Middle Aged MH - Mouth Mucosa/metabolism/pathology/radiation effects MH - Oropharynx/metabolism/*radiation effects MH - Radiation Injuries/etiology/*metabolism/pathology MH - Saliva/*metabolism/radiation effects MH - Stomatitis/etiology/*metabolism/pathology EDAT- 2001/01/09 11:00 MHDA- 2001/02/28 10:01 CRDT- 2001/01/09 11:00 PHST- 2001/01/09 11:00 [pubmed] PHST- 2001/02/28 10:01 [medline] PHST- 2001/01/09 11:00 [entrez] AID - 10.1002/1097-0142(20001201)89:11<2258::AID-CNCR14>3.0.CO;2-Z [pii] PST - ppublish SO - Cancer. 2000 Dec 1;89(11):2258-65.