[Radiotherapy of head-neck neoplasms: prevention of inflammation of the mucosa by sucralfate treatment]

Abstract

The mucosal protective effect of sucralfate (Ulcogant) was evaluated in a prospective randomised clinical study during radiation therapy. Twenty-four patients received 1 g of a sucralfate suspension 4 times a day orally for 5 min each. This group was compared with a control group of 21 patients receiving standard oral hygiene consisting of frequent tooth cleaning and disinfection of the oral and pharyngeal mucosa. The radiation technique was telecobalt therapy in two opposing fields using the shrinking field technique, with an electron boost to the posterior lymph nodes; the dosage was 60-70 Gy in daily fractions of 2 Gy. Mucosal reactions, pain and difficulty in swallowing were recorded twice a week. We also checked the patient's weight during treatment. The patients showed significant differences in all parameters, and lower weight loss compared with the control group. Minimal or absent mucosal inflammation pain or dysphagia were found in 88%, 79% and 83% respectively, while 43% and 29% and 52% of the controls had such mild radiation side-effects. Local effectivity appeared to be less in the hypopharynx due to shorter time of application compared with mouth and oropharynx. There were no side-effects from the sucralfate. Sucralfate prophylaxis is effective and easy to apply in the protection of mucosa during irradiation therapy.