Purpose: To determine the efficacy of cryotherapy in comparison to standard oral care to prevent oral mucositis in head and neck cancer patients during CCRT.

Material and Methods: A quasi-experimental study was conducted at the Radiation Oncology Department of NICRH, Dhaka from 1st November 2020 to 31st October 2021. Total 100 Patients (50 patients in each arm) were included in this study according to inclusion and exclusion criteria by purposive sampling technique. All patients in Arm A and Arm B received total 66 Gray in 33 fractions, 1 fraction per day, 5 fractions per week and inj. Cisplatin 40mg/m² was given intravenously 2/3 hours before radiotherapy on 1st day and then weekly. Arm A received cryotherapy by sucking an ice cube 5 minutes before and after each session of RT for 5 minutes. Arm B received standard oral care by brushing teeth twice daily, using dental floss after each meal and rinsing the mouth by salt water thrice daily. Intervention started from the 1st day of CCRT up to the end of CCRT. WHO oral mucositis grading and visual analogue scale (VAS) were employed to determine the effects. All the information was recorded in a pre-tested semi-structured questionnaire. Pearson chi-square test and Independent sample z test were used to compare variables between two arms. Data were presented in tables and graphs.

Results: Mean age of the patients of Arm A and Arm B was 55.28 ± 7.82 and 55.92 ± 8.33 respectively. Male and female ratio was 6.14:1. Other demographic profile, baseline characteristics were statistically not significant in both arms. The grade-3 mucositis appeared after 5th week in Arm B and after 6th week in Arm A. The incidence of grade-3 mucositis after 5th week during CCRT to 4 weeks after completion of therapy was 6% vs 0%, 14% vs 6%, 22% vs 10%, 14% vs 6%, 8% vs 2%, respectively for arm B and Arm A. p values were <0.05. Total number of patients suffering from grade 3 mucositis was 6 (12%) and 12 (24%) for Arm A and Arm B respectively. p value was <0.05. The mean duration of grade-3 or more mucositis between Arm A and Arm B was 2.04±1.78 and 10±1.72 days respectively. p value was <0.05. The difference of median pain intensity between two arms was not statistically significant for 1st and 2nd week. p value was >0.05. But it was significant after 3rd week during CCRT to 4 weeks after completion of CCRT. p value was <0.05.

Conclusions: Cryotherapy during CCRT may be beneficial to prevent oral mucositis and pain than maintaining standard oral care.

Mohammad Saiful Islam Pathan is a resident physician and assistant professor in the radiotherapy department at Mymensingh Medical College Hospital, Bangladesh. He is an active member of the Bangladesh Society of Radiation Oncologist (BSRO) and is involved in both clinical practice and academic work in radiation oncology. His focus includes advancing cancer treatment and improving patient outcomes through evidence-based radiotherapy.