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01.02.2016 | Original Article

Efficacy of elemental diet on prevention for chemoradiotherapy-induced oral mucositis in patients with oral squamous cell carcinoma

verfasst von: Koji Harada, Tarannum Ferdous, Daiju Horinaga, Kenichiro Uchida, Takamitsu Mano, Katsuaki Mishima, SungChul Park, Hideki Hanazawa, Shotaro Takahashi, Atsumi Okita, Misaki Fukunaga, Junko Maruta, Naoko Kami, Keiko Shibuya, Yoshiya Ueyama

Erschienen in: Supportive Care in Cancer | Ausgabe 2/2016

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Abstract

Purpose

Oral mucositis induced by radiation or chemoradiation can compromise the quality of life of oral squamous cell carcinoma (OSCC) patients. The present study was designed to evaluate the preventive effects of elemental diet (ED), Elental®, on radiotherapy- or chemoradiotherapy-induced mucositis in OSCC patients.

Patients and methods

Seventy-four patients who underwent radiation (60–70 Gy) with/without chemotherapy [S-1, cisplatin (CDDP), CDDP plus S-1] were enrolled in this retrospective study; 37 had received Elental® during treatment (Elental® group) and 37 had not (control group). Factors related to alleviation of oral mucositis were identified by multivariate logistic regression analysis. Rates of completion of chemoradiation treatments were compared between Elental® and control groups according to the treatment regimen. The comparison of the nutritional status between groups was also performed.

Results

Multivariate analysis indicated that the administration of Elental® and no combined chemotherapy (radiation alone) were significant factors associated with the degree of oral mucositis, i.e., most of the patients who consumed Elental® suffered from a lower degree of mucositis compared to the control group. Elental® was associated with a significantly improved rate of completion of chemoradiation (no interruption). There was no significant difference between Elental® group and control group in terms of mean change of body weight or total protein and albumin levels in blood serum before and after (chemo)radiation.

Conclusions

The present study indicates that Elental® is effective for ameliorating oral mucositis induced by (chemo)radiation in OSCC patients. Elental® was also associated with improved completion rates of (chemo)radiotherapy.

Rautava J, Luukkaa M, Heikinheimo K, Alin J, Grenman R, Happonen RP (2007) Squamous cell carcinomas arising from different types of oral epithelia differ in their tumor and patient characteristics and survival. Oral Oncol 43:911–919PubMedCrossRef

Funk GF, Karnell LH, Robinson RA, Zhen WK, Trask DK, Hoffman HT (2002) Presentation, treatment, and outcome of oral cavity cancer: a national cancer data base report. Head Neck 24:165–180PubMedCrossRef

Mehrotra R, Singh MK, Pandya S, Singh M (2008) The use of an oral brush biopsy without computer-assisted analysis in the oral lesions: a study of 94 patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 106:246–253PubMedCrossRef

Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61:69–90PubMedCrossRef

Lawoyin JO, Lawoyin DO, Aderinokun G (1997) Intra-oral squamous cell carcinoma in Ibadan: a review of 90 cases. Afr J Med Med Sci 26:187–188PubMed

Sonis ST (2011) Oral mucositis. Anti-Cancer Drugs 22:607–612PubMedCrossRef

Robertson C, Robertson AG, Hendry JH, Roberts SA, Slevin NJ, Duncan WB, MacDougall RH, Kerr GR, O’Sullivan B, Keane TJ (1998) Similar decreases in local tumor control are calculated for treatment protraction and for interruptions in the radiotherapy of carcinoma of the larynx in four centers. Int J Radiat Oncol Biol Phys 40:319–329PubMedCrossRef

Bese NS, Hendry J, Jeremic B (2007) Effects of prolongation of overall treatment time due to unplanned interruptions during radiotherapy of different tumor sites and practical methods for compensation. Int J Radiat Oncol Biol Phys 68:654–666PubMedCrossRef

Withers HR, Taylor JM, Maciejewski B (1998) The hazard of accelerated tumor clonogen repopulation during radiotherapy. Acta Oncol 27:131–146CrossRef

10.

Herrmann T, Jakubek A, Trott KR (1994) The importance of the timing of a gap in radiotherapy of squamous cell carcinomas of the head and neck. Strahlenther Onkol 170:545–549PubMed

11.

Suwinski R, Sowa A, Rutkowski T, Wydmanski J, Tarnawski R and Maciejewski B (2003) Time factor in postoperative radiotherapy: a multivariate locoregional control analysis in 868 patients. Int J Radiat Oncol Biol Phys 56:399–412, 2003.

12.

Russo G, Haddad R, Posner M, Machtay M (2008) Radiation treatment breaks and ulcerative mucositis in head and neck cancer. Oncologist 13:886–898PubMedCrossRef

13.

Sonis ST, Oster G, Fuchs H, Bellm L, Bradford WZ, Edelsberg J, Hayden V, Eilers J, Epstein JB, LeVeque FG, Miller C, Peterson DE, Schubert MM, Spijkervet FK, Horowitz M (2001) Oral mucositis and the clinical and economic outcomes of hematopoietic stem-cell transplantation. J Clin Oncol 19:2201–2205PubMed

14.

Keefe DM, Schubert MM, Elting LS, Sonis ST, Epstein JB, Raber-Durlacher JE, Migliorati CA, DB MG, Hutchins RD, Peterson DE, Mucositis Study Section of the Multinational Association of Supportive Care in Cancer and the International Society for Oral Oncology (2007) Updated clinical practice guidelines for the prevention and treatment of mucositis. Cancer 109:820–831PubMedCrossRef

15.

Peterson DE, Bensadoun RJ, Roila F, ESMO Guidelines Working Group (2009) Management of oral and gastrointestinal mucositis: ESMO clinical recommendations. Ann Oncol 20(Suppl 4):174–177PubMed

16.

Quinn B, Potting CM, Stone R, Blijlevens NM, Fliedner M, Margulies A, Sharp L (2008) Guidelines for the assessment of oral mucositis in adult chemotherapy, radiotherapy and haematopoietic stem cell transplant patients. Eur J Cancer 44:61–72PubMedCrossRef

17.

Henke M, Alfonsi M, Foa P, Giralt J, Bardet E, Cerezo L, Salzwimmer M, Lizambri R, Emmerson L, Chen MG, Berger D (2011) Palifermin decreases severe oral mucositis of patients undergoing postoperative radiochemotherapy for head and neck cancer: a randomized, placebo-controlled trial. J Clin Oncol 29:2815–2820PubMedCrossRef

18.

Bensinger W, Schubert M, Ang KK, Brizel D, Brown E, Eilers JG, Elting L, Mittal BB, Schattner MA, Spielberger R, Treister NS, Trotti 3rd AM (2008) NCCN Task Force Report. Prevention and management of mucositis in cancer care. J Natl Compr Canc Netw 6(Suppl 1):S1–21 quiz S22–24PubMed

19.

Svanberg A, Ohrn K, Birgegard G (2010) Oral cryotherapy reduces mucositis and improves nutrition—a randomised controlled trial. J Clin Nurs 19:2146–2151PubMedCrossRef

20.

Scully C, Epstein J, Sonis S (2004) Oral mucositis: a challenging complication of radiotherapy, chemotherapy, and radiochemotherapy. Part 2: diagnosis and management of mucositis. Head Neck 26:77–84PubMedCrossRef

21.

Cowen D, Tardieu C, Schubert M, Peterson D, Resbeut M, Faucher C, Franquin JC (1997) Low energy helium-neon laser in the prevention of oral mucositis in patients undergoing bone marrow transplant: results of a double blind randomized trial. Int J Radiat Oncol Biol Phys 38:697–703PubMedCrossRef

22.

Online Ajinomoto Products Information, Elental®. http://www.ajinomoto.com/en/aboutus/history/chronicle_2014/09.html

23.

Ikeura T, Takaoka M, Uchida K, Miyoshi H, Okazaki K (2014) Beneficial effect of low-fat elemental diet therapy on pain in chronic pancreatitis. Int J Chronic Dis:1–5, Article ID 862091.

24.

Yamamoto T, Nakahigashi M, Umegae S, Kitagawa T, Matsumoto K (2006) Acute duodenal Crohn’s disease successfully managed with low-speed elemental diet infusion via nasogastric tube: a case report. World J Gastroenterol 12:649–651PubMedPubMedCentral

25.

Yamamoto T, Nakahigashi M, Umegae S, Kitagawa T, Matsumoto K (2005) Impact of elemental diet on mucosal inflammation in patients with active Crohn’s disease: cytokine production and endoscopic and histological findings. Inflamm Bowel Dis 11:580–588PubMedCrossRef

26.

Nakayama G, Morioka D, Murakami T, Takakura H, Miura Y, Togo S (2012) Chylous ascites occurring after low anterior resection of the rectum successfully treated with an oral fat-free elemental diet (Elental(®)). Clin J Gastroenterol 5:216–219PubMedPubMedCentralCrossRef

27.

Choi K, Lee SS, Oh SJ, Lim SY, Lim SY, Jeon WK, Oh TY, Kim JW (2007) The effect of oral glutamine on 5-fluorouracil/leucovorin-induced mucositis/stomatitis assessed by intestinal permeability test. Clin Nutr 26:57–62PubMedCrossRef

28.

Savarese DM, Savy G, Vahdat L, Wischmeyer PE, Corey B (2003) Prevention of chemotherapy and radiation toxicity with glutamine. Cancer Treat Rev 29:501–513PubMedCrossRef

29.

Shou J, Lieberman MD, Hofmann K, Leon P, Redmond HP, Davies H, Daly JM (1991) Dietary manipulation of methotrexate-induced enterocolitis. JPEN J Parenter Enteral Nutr 15:307–312PubMedCrossRef

30.

Ziegler TR, Young LS, Benfell K, Scheltinga M, Hortos K, Bye R, Morrow FD, Jacobs DO, Smith RJ, Antin JH, Wilmore DW (1992) Clinical and metabolic efficacy of glutamine-supplemented parenteral nutrition after bone marrow transplantation. A randomized, double-blind, controlled study. Ann Intern Med 116:821–828PubMedCrossRef

31.

Ogata Y, Takeuchi M, Ishibashi N, Kibe S, Takahashi K, Uchida S, Murakami N, Yahara T, Shirouzu K (2012) Efficacy of Elental on prevention for chemotherapy-induced oral mucositis in colorectal cancer patients. Gan To Kagaku Ryoho 39:583–587 JapanesePubMed

32.

Fukui T, Itoh Y, Orihara M, Yoshizawa K, Takeda H, Kawada S, Yoshioka T (2011) Elental prevented and reduced oral mucositis during chemotherapy in patients esophageal cancer. Gan To Kagaku Ryoho 38:2597–2601 JapanesePubMed

33.

Online Nestle Products Information, VIVONEX® T.E.N. http://www.nestle-nutrition.com/products/Product.aspx?ProductId=a3bc4b10-3701-4020-9742-d947a30ed612

34.

Bieri S, Bentzen SM, Huguenin P, Allal AS, Cozzi L, Landmann C, Monney M, Bernier J (2003) Early morbidity after radiotherapy with or without chemotherapy in advanced head and neck cancer. Experience from four non-randomized studies. Strahlenther Onkol 179:390–395PubMed

35.

Bernier J, Domenge C, Ozsahin M, Matuszewska K, Lefèbvre JL, Greiner RH, Giralt J, Maingon P, Rolland F, Bolla M, Cognetti F, Bourhis J, Kirkpatrick A, Van Glabbeke M, European Organization for Research and Treatment of Cancer Trial 22931 (2004) Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer. N Engl J Med 350:1945–1952PubMedCrossRef

36.

Cooper JS, Pajak TF, Forastiere AA, Jacobs J, Campbell BH, Saxman SB, Kish JA, Kim HE, Cmelak AJ, Rotman M, Machtay M, Ensley JF, Chao KS, Schultz CJ, Lee N, Fu KK, Radiation Therapy Oncology Group 9501/Intergroup (2004) Postoperative concurrent radiotherapy and chemotherapy for high-risk squamous-cell carcinoma of the head and neck. N Engl J Med 350:1937–1944PubMedCrossRef

37.

Lin A, Jabbari S, Worden FP, Bradford CR, Chepeha DB, Teknos TN, Liao JJ, Nyquist GG, Tsien C, Schipper MJ, Urba S, Wolf GT, Eisbruch A (2005) Metabolic abnormalities associated with weight loss during chemoirradiation of head-and-neck cancer. Int J Radiat Oncol Biol Phys 63:1413–1418PubMedCrossRef

38.

Gibson RJ, Keefe DM, Lalla RV, Bateman E, Blijlevens N, Fijlstra M, King EE, Stringer AM, Van der Velden WJ, Yazbeck R, Elad S, Bowen JM, Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) (2013) Systematic review of agents for the management of gastrointestinal mucositis in cancer patients. Support Care Cancer 21:313–326PubMedCrossRef

39.

Hensley ML, Hagerty KL, Kewalramani T, Green DM, Meropol NJ, Wasserman TH, Cohen GI, Emami B, Gradishar WJ, Mitchell RB, Thigpen JT, Trotti 3rd A, Von Hoff D, Schuchter LM (2009) American Society of Clinical Oncology 2008 clinical practice guideline update: use of chemotherapy and radiation therapy protectants. J Clin Oncol 27:127–145PubMedCrossRef

40.

Peterson DE, Bensadoun RJ, Roila F, ESMO Guidelines Working Group (2011) Management of oral and gastrointestinal mucositis: ESMO clinical practice guidelines. Ann Oncol 22:vi78–vi84PubMedPubMedCentralCrossRef

41.

Le QT, Kim HE, Schneider CJ, Muraközy G, Skladowski K, Reinisch S, Chen Y, Hickey M, Mo M, Chen MG, Berger D, Lizambri R, Henke M (2011) Palifermin reduces severe mucositis in definitive chemoradiotherapy of locally advanced head and neck cancer: a randomized, placebo-controlled study. J Clin Oncol 29:2808–2814PubMedCrossRef

42.

Bossi P, Locati LD, Licitra L (2012) Palifermin in prevention of head and neck cancer radiation-induced mucositis: not yet a definitive word on safety and efficacy profile. J Clin Oncol 30:565–567CrossRef

Titel: Efficacy of elemental diet on prevention for chemoradiotherapy-induced oral mucositis in patients with oral squamous cell carcinoma
verfasst von: Koji Harada
Tarannum Ferdous
Daiju Horinaga
Kenichiro Uchida
Takamitsu Mano
Katsuaki Mishima
SungChul Park
Hideki Hanazawa
Shotaro Takahashi
Atsumi Okita
Misaki Fukunaga
Junko Maruta
Naoko Kami
Keiko Shibuya
Yoshiya Ueyama
Publikationsdatum: 01.02.2016
Verlag: Springer Berlin Heidelberg
Erschienen in: Supportive Care in Cancer / Ausgabe 2/2016
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-015-2866-7

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Efficacy of elemental diet on prevention for chemoradiotherapy-induced oral mucositis in patients with oral squamous cell carcinoma