Membrane temperature offers clue to oral mucositis risk in head and neck cancer

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Thermal imaging can detect small and early changes in the temperature of mucosal surfaces that may signal the development of mucositis in persons with head and neck cancer who are receiving chemotherapy and radiation therapy, according to the results of a pilot study. These mouth sores are a common, painful, and potentially very severe side effect of chemoradiotherapy for patients with this form of cancer, but perhaps could be avoided or minimized if clinicians could predict which patients were at greatest risk.

The pilot study involved 34 participants. All had locally advanced squamous cell carcinoma of the oral cavity or oropharynx, and all received baseline and weekly thermal imaging while undergoing identical chemoradiotherapy regimens. 

As lead author Ezra Cohen, MD, codirector of the head and neck cancer program at the University of Chicago, Chicago, Illinois, and colleagues reported at the Multidisciplinary Head and Neck Cancer Symposium, held January 26-28, 2012, in Phoenix, Arizona (https://www.astro.org/uploadedFiles/Main_Site/News_and_Media/Media_Resources/Press_Kits/122_Cohen.pdf), 53% of the participants developed grade 3 mucositis and 21% developed grade 3 dermatitis. All patients displayed an increase in temperature of oral mucous membranes within the radiation field.

The investigators observed a statistically significant positive association between an early rise in a reference area and mucositis grade. For every 1°C increase in temperature in the reference area, there was a 0.157 increase in average subsequent mucositis grade.

Cohen's team concluded that larger studies are needed to evaluate whether this tool can help predict which patients are in need of early intervention to prevent acute complications.

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