Oral Mucositis Severity Assessment by Supplementation of High Dose Ascorbic Acid During Chemo and/or Radiotherapy of Oro-Pharyngeal Cancers – A Pilot Project

Abstract:

Introduction: Prevention or control of oral mucositis during cancer therapy can lead to better treatment outcome. The present study was aimed to evaluate the effect of high dose oral ascorbic acid on severity of oral mucositis induced during treatment period. Methods: After informed consent, patients of both the gender with age 18-70 years, were divided into: Group A (n=19) served as controls with no intervention, Group B (n=20) undergoing chemo-radiotherapy and Group C (n=20) receiving conventional radiotherapy. Subjects in group B and group C received varying oral doses of vitamin C (2, 3 and 4 g). The therapy initiated 48 h before the onset of cancer treatment. Intensity of oral mucositis was analysed on day 0, 7, 14, 21, 28 and 35, using WHO grading of oral mucositis by a radiation oncologist. Results: One-Way ANOVA revealed only mild mucositis in experimental group B and C when compared to group A (control) and significant reduction in mucositis in-group B and C with 2 g and 4 g. WHO grade 4 mucositis were less reported in ascorbic acid supplementation groups. Radiotherapy group (Mean SD 3.2+ 1.64) performed better than the chemo-radiotherapy group (Mean SD 3.7 + 1.38). Over all, those receiving 4gm (mean SD 1.3) had shown significantly better scores than those with 2g (mean SD 3.38) and 3 g (mean SD 4.19). Conclusion: The study showed that oral ascorbic acid during radiotherapy and chemo-radiotherapy could alleviate the severity of oral mucositis in patients with cancers.

Key words: Ascorbic acid, Mucositis, Grading of mucositis, Radiotherapy, Chemotherapy.