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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.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title cancer
Publication Year Start




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.