The Open Clinical Cancer Journal


ISSN: 1874-1894 ― Volume 5, 2011

Oral Mucositis, Pain and Xerostomia in Patients with Head and Neck Cancer who Received Chemoradiotherapy with or without Cetuximab

Ourania Nicolatou-Galitis*, 1, Triantafyllia Sarri1, Konstantinos Dardoufas2, Vassilis Kouloulias3, Xenophon Vakalis4, Argyro Polychronopoulou5, Dimitrios Demenagas6 , Anastasia Sotiropoulou-Lontou6
1 Clinic of Hospital Dentistry, Dental Oncology Unit, School of Dentistry, University of Athens, Greece
2 Department of Radiotherapy, “Hygeia” Hospital, Athens, Greece
3 Department of Radiotherapy, “Attikon” Hospital, School of Medicine, University of Athens, Greece
4 Department of Radiotherapy, “401 General Militairy Hospital”, Athens, Greece
5 Department of Preventive and Community Dentistry, School of Dentistry, University of Athens, Greece
6 2nd Radiotherapy Department, “O Aghios Savvas” Hospital, Athens, Greece


Goal of work:

To compare the severity of oral mucositis, pain and xerostomia in head and neck cancer patients, who received radiotherapy with cisplatin and cetuximab to that of patients who received radiotherapy with cisplatin alone.


Forty-nine head and neck cancer patients entered the study. Twenty-five patients (Group A) received radiotherapy and cisplatin. Twenty-four patients (Group B) received radiotherapy, cisplatin, and cetuximab.


Oral mucositis was recorded weekly, according to EORTC/RTOG criteria. Pain and xerostomia were assessed using a 10cm visual analogue scale. Antifungal and antiviral treatment and prophylaxis were administered during RT to both groups.


During chemoradiotherapy, severe mucositis, pain and xerostomia were observed in 60%, 64% and 52% respectively in Group A, while the same symptoms were observed in 79%, 58% and 29% respectively in Group B. The differences between the two groups were not statistically significant. At the end of chemoradiotherapy, severe mucositis, pain and xerostomia were recorded in 24%, 32% and 32% in Group A and 37%, 21% and 17% respectively in Group B. The differences between the two groups were, again, statistically not significant. Neither significant differences were found between the two groups with respect to the use of antifungal and antiviral treatment, radiotherapy interruptions and weight loss. In both groups, oral mucositis, pain and xerostomia were significantly reduced at the end of radiotherapy as compared to those during RT, following the anti-infectious treatment and prophylaxis.


Cetuximab, added to cisplatin/radiotherapy, did not increase the severity of oral mucositis, pain and xerostomia, in head and neck cancer patients, with limitations of the study design and its limited number of patients.

Keywords: Cetuximab, head and neck cancer, mucositis, pain, radiotherapy, xerostomia.

Article Information

Identifiers and Pagination:

Year: 2010
Volume: 4
First Page: 6
Last Page: 14
Publisher Id: TOCCJ-4-6
DOI: 10.2174/1874189401004010006

Article History:

Received Date: 2/8/2010
Revision Received Date: 18/2/2010
Acceptance Date: 29/3/2010
Electronic publication date: 26/8/2010
Collection year: 2010

© Nicolatou-Galitis et al.; Licensee Bentham Open.

open-access license: This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License(, which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the School of Dentistry, University of Athens, Bouboulinas 41, N. Psyhico, 154 51 Athens, Greece; Tel: +30 210 6748715; Fax: +30 210 6775567; E-mail:

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