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Efficacy and safety of granulocyte macrophage-colony stimulating factor (GM-CSF) on the frequency and severity of radiation mucositis in patients with head and neck carcinoma.
Int J Radiat Oncol Biol Phys. 1997 Mar 15; 37(5):1005-10.IJ

Abstract

PURPOSE

Based on the clinical evidence of mucosal protection by GM-CSF during cytotoxic chemotherapy, a pilot study was undertaken to determine the safety and mucosal reaction of patients receiving GM-CSF while undergoing definitive conventional fractionated radiotherapy in head and neck carcinoma.

METHODS AND MATERIALS

Patients were considered eligible if buccal mucosa and oropharynx were included in the teleradiation field. Ten adult patients with squamous cell carcinoma of head and neck (buccal mucosa--8 and posterior 1/3 tongue--2) were entered into the trial. Radiation therapy was delivered with telecobalt machine at conventional 2 Gy fraction and 5 fractions/week. The radiation portals consisted of two parallel opposing lateral fields. GM-CSF was given subcutaneously at a dose of 1 microg/kg body weight, daily, after 20 Gy until the completion of radiation therapy. Patients were evaluated daily for mucosal reaction, pain, and functional impairment.

RESULTS

The median radiation dose was 66 Gy. Eight patients received > or = 60 Gy. The tolerance to GM-CSF was good. All 10 patients completed the planned daily dose of GM-CSF without interruption. Mucosal toxicity was Grade I in four patients till the completion of radiotherapy (dose range 50-66 Gy). Six patients developed Grade II reaction, fibrinous mucosal lesions of maximum size 1.0-1.5 cm, during radiotherapy. None developed Grade III mucositis. The maximum mucosal pain was Grade I during GM-CSF therapy. In two patients after starting GM-CSF the pain reduced in intensity. Functional impairment was mild to moderate. All patients were able to maintain adequate oral intake during the treatment period. Total regression of mucosal reaction occured within 8 days following completion of radiotherapy.

CONCLUSIONS

GM-CSF administration concurrently with conventional fractionated radiotherapy was feasible without significant toxicity. The acute side effects of radiotherapy namely mucositis, pain, and functional impairment were nil to minimal. The results are suggestive of mucosal protection by GM-CSF during radiotherapy and warrants further study in randomized double blind trial.

Authors+Show Affiliations

Department of Radiotherapy, Kidwai Memorial Institute of Oncology, Bangalore, India.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

9169806

Citation

Kannan, V, et al. "Efficacy and Safety of Granulocyte Macrophage-colony Stimulating Factor (GM-CSF) On the Frequency and Severity of Radiation Mucositis in Patients With Head and Neck Carcinoma." International Journal of Radiation Oncology, Biology, Physics, vol. 37, no. 5, 1997, pp. 1005-10.
Kannan V, Bapsy PP, Anantha N, et al. Efficacy and safety of granulocyte macrophage-colony stimulating factor (GM-CSF) on the frequency and severity of radiation mucositis in patients with head and neck carcinoma. Int J Radiat Oncol Biol Phys. 1997;37(5):1005-10.
Kannan, V., Bapsy, P. P., Anantha, N., Doval, D. C., Vaithianathan, H., Banumathy, G., Reddy, K. B., Kumaraswamy, S. V., & Shenoy, A. M. (1997). Efficacy and safety of granulocyte macrophage-colony stimulating factor (GM-CSF) on the frequency and severity of radiation mucositis in patients with head and neck carcinoma. International Journal of Radiation Oncology, Biology, Physics, 37(5), 1005-10.
Kannan V, et al. Efficacy and Safety of Granulocyte Macrophage-colony Stimulating Factor (GM-CSF) On the Frequency and Severity of Radiation Mucositis in Patients With Head and Neck Carcinoma. Int J Radiat Oncol Biol Phys. 1997 Mar 15;37(5):1005-10. PubMed PMID: 9169806.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficacy and safety of granulocyte macrophage-colony stimulating factor (GM-CSF) on the frequency and severity of radiation mucositis in patients with head and neck carcinoma. AU - Kannan,V, AU - Bapsy,P P, AU - Anantha,N, AU - Doval,D C, AU - Vaithianathan,H, AU - Banumathy,G, AU - Reddy,K B, AU - Kumaraswamy,S V, AU - Shenoy,A M, PY - 1997/3/15/pubmed PY - 1997/3/15/medline PY - 1997/3/15/entrez SP - 1005 EP - 10 JF - International journal of radiation oncology, biology, physics JO - Int. J. Radiat. Oncol. Biol. Phys. VL - 37 IS - 5 N2 - PURPOSE: Based on the clinical evidence of mucosal protection by GM-CSF during cytotoxic chemotherapy, a pilot study was undertaken to determine the safety and mucosal reaction of patients receiving GM-CSF while undergoing definitive conventional fractionated radiotherapy in head and neck carcinoma. METHODS AND MATERIALS: Patients were considered eligible if buccal mucosa and oropharynx were included in the teleradiation field. Ten adult patients with squamous cell carcinoma of head and neck (buccal mucosa--8 and posterior 1/3 tongue--2) were entered into the trial. Radiation therapy was delivered with telecobalt machine at conventional 2 Gy fraction and 5 fractions/week. The radiation portals consisted of two parallel opposing lateral fields. GM-CSF was given subcutaneously at a dose of 1 microg/kg body weight, daily, after 20 Gy until the completion of radiation therapy. Patients were evaluated daily for mucosal reaction, pain, and functional impairment. RESULTS: The median radiation dose was 66 Gy. Eight patients received > or = 60 Gy. The tolerance to GM-CSF was good. All 10 patients completed the planned daily dose of GM-CSF without interruption. Mucosal toxicity was Grade I in four patients till the completion of radiotherapy (dose range 50-66 Gy). Six patients developed Grade II reaction, fibrinous mucosal lesions of maximum size 1.0-1.5 cm, during radiotherapy. None developed Grade III mucositis. The maximum mucosal pain was Grade I during GM-CSF therapy. In two patients after starting GM-CSF the pain reduced in intensity. Functional impairment was mild to moderate. All patients were able to maintain adequate oral intake during the treatment period. Total regression of mucosal reaction occured within 8 days following completion of radiotherapy. CONCLUSIONS: GM-CSF administration concurrently with conventional fractionated radiotherapy was feasible without significant toxicity. The acute side effects of radiotherapy namely mucositis, pain, and functional impairment were nil to minimal. The results are suggestive of mucosal protection by GM-CSF during radiotherapy and warrants further study in randomized double blind trial. SN - 0360-3016 UR - https://www.unboundmedicine.com/medline/citation/9169806/Efficacy_and_safety_of_granulocyte_macrophage_colony_stimulating_factor__GM_CSF__on_the_frequency_and_severity_of_radiation_mucositis_in_patients_with_head_and_neck_carcinoma_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0360-3016(97)00105-3 DB - PRIME DP - Unbound Medicine ER -