Utility of Mucositis Predictive Tools in Patients Receiving Chemo Radiotherapy for Various Indications

Abstract

Background: Mucositis is a debilitating and a common complication in patients receiving Chemo radiotherapy with varying incidence and severity. Certain clinical factors are associated with the incidence and severity of mucositis in different patient populations.  Early prediction tools using such clinical factors may help the clinician to adopt various preventive strategies in  high risk subjects. Aim : To assess the utility of two different  tools in terms of  predicting mucositis of varying severity. Methods- We conducted a prospective observational ( non intervention study) with a total of 438 patients from Jan 2019 till Nov 2020 & followed up-to April 2021 using two published tools for predicting the severity of mucositis.  The population consists of  head and neck squamous cell cancer patients  , assigned to receive chemoradiotherapy and classified into three risk groups , low , intermediate and high , using  the above mentioned tools .  They were followed up to determine the incidence and severity of mucositis. Results: The study results show that  the incidence of grade III/IV mucositis in the low risk group is 9.8% ,the intermediate risk group is 55.2% and the high risk group is 93.3% all of which is  consistent with literature as well. There is no difference between the two tools in terms of predicting the incidence and either of them can be used in risk stratifying the subjects. Conclusion: Identifying high risk patients before the start of chemoradiotherapy for predicting mucositis can help the clinicians adopt strict preventive  measures to prevent or reduce the severity of the serious adverse effect and thus improving the quality of life through the treatment and also avoid treatment interruption.