Management of radiation-induced oral mucositis in head and neck cancer patients: a real-life survey among 25 Italian radiation oncology centers.

AIM: Radiation-induced oral mucositis (RIOM) is the most frequent side effect in head and neck cancer (HNC) patients treated with curative radiotherapy (RT). A standardized strategy for preventing and treating RIOM has not been defined. Aim of this study was to perform a real-life survey on RIOM management among Italian RT centers. METHODS: A 40-question survey was administered to 25 radiation oncologists working in 25 different RT centers across Italy. RESULTS: A total of 1554 HNC patients have been treated in the participating centers in 2021, the majority (median across the centers 91%) with curative intent. Median treatment time was 41 days, with a mean percentage of interruption due to toxicity of 14.5%. Eighty percent of responders provide written oral cavity hygiene recommendations. Regarding RIOM prevention, sodium bicarbonate mouthwashes, oral mucosa barrier agents, and hyaluronic acid-based mouthwashes were the most frequent topic agents used. Regarding RIOM treatment, 14 (56%) centers relied on literature evidence, while internal guidelines were available in 13 centers (44%). Grade (G)1 mucositis is mostly treated with sodium bicarbonate mouthwashes, oral mucosa barrier agents, and steroids, while hyaluronic acid-based agents, local anesthetics, and benzydamine were the most used in mucositis G2/G3. Steroids, painkillers, and anti-inflammatory drugs were the most frequent systemic agents used independently from the RIOM severity. CONCLUSION: Great variety of strategies exist among Italian centers in RIOM management for HNC patients. Whether different strategies could impact patients' compliance and overall treatment time of the radiation course is still unclear and needs further investigation.

Possible Association of Periodontal Disease and Macular Degeneration: A Case-Control Study.

Oral pathogens have been identified in bioptic specimens from Age-Related Macular Degeneration (ARMD) patients, and alveolar bone loss has been related to ARMD. Therefore, the possible association between ARMD and periodontal disease was investigated in the present case-control study, evaluating clinical and radiographic periodontal parameters, primarily, in cases vs. controls and, secondarily, in relation to ARMD risk factors, in cases, to highlight a possible pathogenic link between the disorders. Forty ARMD cases and 40 non-ARMD controls, matched for age (±3 years) and gender and homogeneous for ARMD risk factors, therefore comparable, underwent full-mouth periodontal charting, panoramic radiograph, and medical data, including ARMD risk factors, collection. Statistical analysis was conducted using the language R. Comparisons between groups were made using both traditional t-tests and Yuen's test with bootstrap calibration. Enrolled subjects were ≥55 years old, and 50 females and 30 males were equally distributed among the two groups. No statistically significant difference was found in clinical and radiographic periodontal parameters in cases vs. controls. In the case group, no differences were found when relating the periodontal parameters to ARMD risk factors, except for Clinical Attachment Level values that were statistically significantly higher in hypertensive ARMD subjects. A possible association between periodontal disease and ARMD may be hypothesized in hypertensive ARMD subjects, with hypertension as a possible pathogenic link between the disorders.

Corneal thickness evaluation in healthy eyes: Comparison between two different Scheimpflug devices.

PURPOSE: To evaluate the correlation between corneal thickness (CT) measurements obtained with two Scheimpflug devices, Pentacam HR and Precisio, and to elaborate, if necessary, a regression formula which could make these results comparable. DESIGN: Retrospective, Comparative, Observational study. SETTING: Department of Medicine, Surgery and Dentistry, "Scuola Medica Salernitana" University of Salerno, Italy. METHODS: One hundred twenty four healthy eyes of 124 volunteers (65 males; range: 20-32 years; mean age of 24.8 ± 1.7) were included in this study. CT was measured using Pentacam HR and Precisio in three different points: the pupil center (PC), the corneal apex (CA) and the thinnest point (TP). RESULTS: CT obtained with both devices at the PC, at the CA and at the TP showed a good correlation (r = 0.97, r = 0.97, r = 0.97, respectively), but Pentacam HR measurements were significantly thicker than those provided by Precisio (p < 0.01). The differences between Pentacam HR and Precisio were 21.9 ± 8.8 µm at the PC, 21.9 ± 8.9 µm at the CA, 19.1 ± 9.0 µm at the TP. The calculated regression formulas were: y = 0.9558x + 2.3196 for the PC, y = 0.9519x + 4.5626 for the CA, y = 0.9364x + 15.436 for the TP, where x is the CT measured with Pentacam HR and y is the Precisio measurement. CONCLUSIONS: The findings provided by this study highlight that Precisio measures thinner corneas compared to Pentacam HR. The identified regression formulas could be utilized to make interchangeable the results obtained with these two devices.