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ORIGINAL ARTICLE
Year : 2021  |  Volume : 12  |  Issue : 1  |  Page : 10-14

Correlation of oral mucositis with timing of radiation in head and neck cancer - A prospective randomized study on chronoradiotherapy


1 Department of Radiation Oncology, BGS Clinical Global Hospital, Bengaluru, Karnataka, India
2 Department of Radiation Oncology, Ramaiah Medical College, Bengaluru, Karnataka, India

Correspondence Address:
Dr. T R Arulponni
Department of Radiation Oncology, Ramaiah Medical College, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jrcr.jrcr_62_20

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Context: Study to reduce oral mucositis using chronoradiotherapy. Aims: This study aims to assess and compare oral mucositis and weight loss between two groups of patients on radiation-morning and evening group. Settings and Design: Prospective randomized study. Subjects and Methods: Sixty-four head and neck cancer patients were enrolled in the study. They were allotted into two arms, i.e., morning-arm A and evening-arm B using randomization. Baseline weight was recorded for all the patients. Weight and the grade of mucositis were recorded weekly during radiotherapy (RT) and at 2nd and 6th week post treatment in both the arms. Mucositis was graded based on the Radiation Therapy Oncology Group acute radiation morbidity scoring criteria. Statistical Analysis Used: The analysis of different grades and the incidence of mucositis at weekly intervals and follow-up were compared using Chi-square test. Weight loss was compared using t-test. Results: The progression of mucositis to higher grades was delayed by a week in the morning arm compared to the evening arm. Arm A (morning arm) developed Grade 3 mucositis in 21.9% patients versus 25% in the arm B (evening arm). Conclusions: Circadian rhythm has an impact on mucositis trending toward morning RT being less toxic with delayed progression and thereby decreased weight loss and better tolerance to radiation.


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