Supersaturated Calcium Phosphate Rinse on Oral Mucositis in Head and Neck Patients Receiving Radiation and/or Chemotherapy: Definitive Management of Head-and-Neck Squamous Cell Carcinoma

Abstract

Oral mucositis can effect up to 100% of patients undergoing radiation and/or chemotherapy treatment for head and neck cancer. The most common oral side effects related to radiation therapy for head and neck cancer are mucositis, salivary gland dysfunction and pain. These side effects can also lead to secondary complications such as dehydration, dysquesia and malnutrition. The aim of this investigation was to evaluate the preventative effects of Super saturated calcium phosphate in the treatment of oral mucositis, when compared to historical rates of side effects for salt and soda rinses, which are the standards of care in the clinic. Head and neck radiation therapy commonly causes acute morbidity, including mucositis, thickened sticky saliva, xerostomia, loss of taste and pain. We compared patient preference for a new supersaturated calcium phosphate oral rinse, Super saturated calcium phosphate to our historical rates for patients using salt and soda rinses. 35 patient were evaluated all receiving radiation therapy, 12 of them received both chemotherapy and radiation therapy concurrently, for confirmed squamous cell or adenocarcinoma cancer. They were evaluated utilizing Super saturated calcium phosphate. against the standard of care salt and soda rinses. Historical degrees of the side effects using the standard of care option and the Super saturated calcium phosphate. End points were patients performance status, pain level using 0-10, dysphagia ability to eat orally, weight loss control, mucositis degree 0-10, and taste return after treatment completed 0 to 2 months. Patients were evaluated weekly during treatment. And approx 4-6 weeks for the acute toxicities and subsequent follow up every 4-8 week for 9 months posttreatment. 35 patients evaluated, it was found that the oral toxicities associated with radiation therapy were significantly lower than averages when Super saturated calcium phosphate was utilized. Xerostomia was reported at approximately 15% during treatment for radiation therapy only, and 35% for those receiving both chemotherapy and radiation therapy. All 100% for both. Limited dysphagia at 4-6wks 20% historical 76% (mean), oral pain of 5% historical 3 month post treatment Historical 35%. Pt reported less opioid use and average of 21 days of oxycodone 5/325 historical of 35 plus days. Patients returned to normal diet and weight being maintained after treatments within 42-50 days. Pt reported an 85% satisfaction rate for super saturated calcium phosphate. Use of Super saturated calcium phosphate® oral rinse by patients undergoing head and neck radiation significantly mitigates the severity of acute mucosal toxicity and compares favorably to outcomes with salt and soda rinses.