Oral complications of radiotherapy: approaches to prevention and treatment

The use of high-energy radiation sources covering large areas of head and neck, together with increased chances for clinical recovery leads to increased rates of radiation complications - a variety of changes in the surrounding healthy tissues and organs. One of the most common oral mucosa complications of radiation therapy is radiation mucositis. Its pathogenesis is based on developing erythematous lesions that turn into ulcer defects with a trend of merging to form an increasingly large focuses. After reaching its peak, inflammatory reaction regresses. The incidence of radiation mucositis is over 60% at standard mode radiotherapy and nearly 100% at hyperfractionated radiotherapy. In addition to the pecularities of radiotherapy, the incidence of mucositis also depends on the tumor type, patient’s age, the initial state of the oral cavity, the patient’s nutritional status. Cryotherapy using a helium-neon laser and drugs (pentoxifylline, thalidomide, simvastatin, analgesics, anesthetics) are recommended for treatment. Reducing the procedure time by improving medical technology, using pulsed fluoroscopy instead of constant, using additional protective filters and changing the X-ray beam focus site may significantly reduce the frequency of radiation complications.

radiotherapy, oropharyngeal cancer, mucositis