Late oral mucosa alterations after radiotherapy for head and neck cancer assessed by exfoliative cytology.

AIM

Late oral mucosa changes after radiotherapy for head and neck cancer have been poorly studied. This study aimed to determine long-term effects of radiotherapy on oral mucosa using exfoliative oral cytology.

PATIENTS AND METHODS

Fifty patients with cancer were enrolled, five of whom in order to validate microscopic analysis. Smears were collected at programmed visit; a score was used to rank possible cytological alterations. Presence of inflammation was also microscopically described and compared to blood count tests.

RESULTS

Epithelial cells revealed a peculiar 'folding' phenotype, not related to chemotherapy, total dose, or to the effective dose delivered to mucosa. Inflammation described was related to the score for 'folding' cells; moreover, score decreased in the presence of a higher lymphocyte count, while it was not altered by neutrophil count.

CONCLUSION

We suggest application of exfoliative cytology to study radiation injury and the variability of individual response of oral mucosa to radiation.