Topical application of platelet supernatant gel in the management of radiotherapy-induced mucositis: a case report.

Abstract

Radiotherapy is the treatment of cancer and other diseases with ionising radiation. Oral cancer is the sixth most common cancer in the world1–2. Surgery and radiotherapy have been the standard loco-regional treatment modalities employed in oral cancer with a high cure rate1. Radiotherapy, principally used with curative intent3, is indicated for the majority of patients with head and neck cancers1. Oral mucositis, inflammation and ulceration that occurs in the oral cavity, is a major complication associated with radiotherapy administered to the head and neck area. It is associated with significant morbidity characterised by pain, odynodysphagia, dysgeusia, malnutrition, dehydration, and also increases the risk of systemic infections in immunocompromised patients4,5. Its severity is dependent on the type of ionising radiation, the volume of irradiated tissue, the dose per day, and cumulative dose. Patients undergoing radiotherapy for head and neck cancer receive approximately 200 cGy of radiation per day, 5 days a week, for 5 to 7 consecutive weeks4,5. Often the mucositis is of such severity that it requires parental analgesia, interruption of radiotherapy, and hospitalisation. This is of marked concern because there is strong clinical and radiobiological evidence that protraction of overall time of radiotherapy has an adverse influence on the curability of certain human tumours, particularly squamous cell carcinoma of the head and neck region6. Interventions are an area of interest and are constantly evolving in order to identify new therapeutic solution able to improve the quality of life of patients7. Platelet supernatant gel is a product derived from blood and is intended for non-transfusional therapeutic purposes. It increases and enhances natural haemostasis as well as processes of tissue repair and regeneration. It is produced by collecting the supernatant obtained after the activation of coagulation of platelet concentrate. The ensuing supernatant is rich in platelet growth factors that stimulate tissues growth and regeneration8–10. Platelet supernatant gel acts in synergy with plasma-derived factors to activate a complex network of autocrine functions that modulate healing11–13. The properties of platelet supernatant have been exploited in several medical and surgical specialties14–18, and new uses for platelet gel are currently under investigation. Taking into account this background, we used platelet supernatant gel in the management of a patient with a severe radiation-induced oral mucositis.