Oral Mucositis and Salivary Nitric Oxide Levels in Patients on Radiotherapy for Head and Neck Tumors

Introduction: Mucositis has been a complication of great importance in antineoplastic treatments of head and neck tumors because when not treated properly it can lead to the interruption of radiotherapy or chemotherapy. Knowing that mucositis is a common inflammatory condition in patients undergoing radiotherapy and that nitric oxide (NO) can be a marker of inflammation.

Aim: to seek an association between mucositis, pain and NO levels in patients diagnosed with squamous cell carcinoma (SCC) in different periods of radiotherapy.

Methodology: Clinical examination was performed weekly to investigate presence of mucositis, in which the degree and intensity of pain were evaluated by using the visual analogue scale (VAS) and mouthwash samples were collected from twenty patients. In the collected samples, the concentrations of NO were measured by using the Griess method.

Results: of the twenty patients, two were excluded due to worsening of the clinical picture. Of the 18 patients who had their treatment finished, ten had some degree of mucositis and pain, with the highest levels being observed in the last week of treatment. As for the levels of NO, it was observed that low values varied widely among the patients and weeks studied. There was a statistically significant positive correlation between mucositis degrees and pain intensities, although the NO levels were correlated neither with mucositis nor with pain intensity throughout the experimental weeks.

Conclusion: Although NO is an inflammatory mediator involved in diseases of the oral cavity, its presence cannot be associated with mucositis and pain in patients with head and neck cancer who are on radiotherapy.