الفهرس 
EpidemiologyOnly 14 pages are availabe for public view
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Abstract
Radiation-induced oral mucositis and other complications such as skin toxicity, taste changes, and dysphagia are considered serious nonhematological complications in patients with head and neck cancer receiving radiotherapy. Furthermore, unplanned radiation treatment breaks resulting from oral mucositis and the associated acute side effects may reduce the response to radiation treatment
The aim of the present study is to evaluate impact of vitamin D supplementation on oral mucositis and other radiotherapy-related toxicities in head and neck cancer patients receiving RT (adjuvant) or CRT, and to assess its effect on response to treatment.
This prospective study carried out on Sixty-eight patients diagnosed at the Clinical Oncology and Nuclear Medicine department, Menoufia University, between February 2022 and September 2022.
The Patient’s clinical data were collected from the files archived at the Clinical Oncology and Nuclear Medicine Department, Menoufia University.
The included patients were equally classified into two groups: group (1) (intervention arm) and group (2) (control arm). Initial serum vitamin D level will be evaluated for the intervention arm before treatment and subgroup analysis of (intervention arm) based on the reference range of vitamin D deficiency < 20 ng/mL, insufficient between 21-29 ng/Ml and sufficient between 30-100 ng/Ml to calculate the doses of vitamin D either prophylactic or therapeutic.
The age of the intervention group ranged between 20 and 83 years, with a mean ±SD of 56± 13 years, while that of the control group ranged between 21 and 84 years (mean±SD, 56.1 ± 13.3).The median age of all study groups was 58 years. Larynx cancer was the most common diagnosis in the studied group, representing 26 cases out of 68 (38.4%), 12 cases in the intervention group (35.3%), and 14 cases in the control group (41.2%).
Squamous cell carcinoma was the most common pathological type in each group, representing 23 of 34 cases (67.6%) in each group and 46 cases in the studied group (67.6%).
Most of the cases were stage 1V represents 21 cases out of 68 (30.9), followed by stage II in 19 cases (27.9), and 6 in both stage I and stage III cases (14 cases, 20.6) according to TNM staging.
Vitamin D supplementation significantly improved oral microsites on weekly assessment by WHO score with a p-value < 0.001 at week one, two, three, four, five, six and the p-value was 0.042 at seventh week
In the second week of radiotherapy, significantly lower incidence of oral mucosities was observed in the intervention group than the control group. Sixteen patients in the control group developed OM grade 2 (47.1%) and 3 patients developed OM grade 3 (8.8%), with no recorded cases developing OM grade 2 or 3 in the intervention arm. (P value <0.001)
As the treatment weeks passed, there was a significant difference between the studied groups regarding OM which was more frequent in the control group .In the fourth week three cases developed OM grade 4(10%) in the control group . P value <0.001
It is important to document that the patients who developed grade 4 mucositis required urgent intervention, hospitalization and interruption of treatment.