Study: Humidifying mouth, throat during radiotherapy cuts mucositis

Head and neck cancer (HNC) patients who received daily humidification of the mouth and throat during radiation therapy treatment spent nearly 50% fewer days hospitalized to manage their side effects, such as mucositis, according to research presented at the recent Multidisciplinary Head and Neck Cancer Symposium in Scottsdale, AZ.

Mucositis, inflammation and ulceration of the mouth and throat, is a painful side effect of radiation therapy that can negatively affect patients' quality of life. Using humidification is based on the fact that moisturizing wounds generally helps them heal faster, according to the researchers.

The study by the Trans Tasman Radiation Oncology Group (TROG) evaluated 210 HNC patients in New Zealand and Australia from June 2007 to June 2011.

Patients in the phase III trial were randomized to institutional standard of care (control group) or humidification. The humidified air was delivered through the nose via a plastic interface (mask-type apparatus) that can be worn by patients while sleeping or sitting.

Patients began humidification on the first day of radiation therapy and continued until the ulceration in their mouth and throat had resolved. On average, humidification patients spent 57% as many days in the hospital to manage side effects, compared with the controls (control = 4.1 days, humidification = 2.3 days).

The humidifier group also resumed close-to-normal eating patterns at significantly higher rates three months after radiotherapy.

Only 43 patients (42%) of the patients in the humidification group met the defined benchmark of humidification compliance and were able to contribute to the per protocol analysis; the mean average use of humidification for these patients was 3.6 hours per day (range of use = 0 to 14 hours/day).

The functional mucositis score -- based on clinician assessment of patients' mucositis symptoms -- was reduced among patients who met humidification compliance benchmarks. The proportion of compliant humidification patients who didn't require a feeding tube also increased.

The results are encouraging because humidification was favored across clinician-reported outcomes, patient-reported outcomes, and independent data such as hospitalizations, the researchers noted.

The next step is to work at increasing the number of patients who use humidifiers effectively, they said.

The 2014 Multidisciplinary Head and Neck Cancer Symposium was sponsored by the American Society for Radiation Oncology (ASTRO), the American Society of Clinical Oncology (ASCO), and the American Head & Neck Society (AHNS).