Daily Humidification of the Mouth and Throat During Radiation for Head and Neck Cancer Reduces Mucositis


Key Points

  • Study results show, on average, patients receiving humidification spent 2.3 days in the hospital to manage side effects, compared with 4.1 days for the control group.
  • The return of eating patterns in patients receiving humidification was close to normal 3 months after radiotherapy, significantly higher than the control group.
  • Only 42% of patients met the humidification compliance benchmark, but those who were compliant had a significantly reduced functional mucositis score.

New study findings show that patients with head and neck cancer receiving daily humidification of the mouth and throat during radiation therapy had reduced symptoms of muscositis and spent nearly 50% fewer days in the hospital to manage their treatment side effects. The study by Macann et al was presented at the 2014 Multidisciplinary Head and Neck Cancer Symposium.

Study Details

Researchers from the Trans Tasman Radiation Oncology Group evaluated 210 patients with head and neck cancer in New Zealand and Australia receiving radiation therapy. The study investigated the management of side effects from radiotherapy to the mouth and throat region.

Patients were randomly assigned to either their institutional standard of care (control arm) or humidification using the Fisher & Paykel Healthcare MR880 humidifier. The humidified air was delivered through the nose via a plastic mask, which could be worn throughout the day or while the patient was sleeping, from the first day of radiation therapy and continued until inflammation and ulceration of the mouth and throat had resolved.

“[Radiation] treatment causes severe ulceration in the mouth and throat, resulting in pain and problems with maintaining nutrition and a number of other symptomatic issues,” Andrew Macann, MBcHB, FRANZCR, a radiation oncologist at Auckland City Hospital in New Zealand and the lead author of the study, said at a press briefing. “The rationale for using the humidifier is based on the fact that moisturizing wounds generally enables them to heal faster.”

Humidification Reduces Symptoms, but Compliance an Issue

Only 43 patients (42%) in the humidification arm met the defined benchmark of humidification compliance and were able to contribute to the per-protocol analysis. The humidifier was used a mean of 3.6 hours per day. On average, humidification patients spent 2.3 days in the hospital to manage side effects, compared with 4.1 days in the control arm. In addition, at 3 months after radiotherapy, the return of eating patterns in the humidification patients was significantly closer to normal than in the control group.

In patients who met the humidification compliance benchmark, the area under the curve for Common Terminology Criteria Adverse Events (CTCAE) version 3.0 functional mucositis score (a clinical assessment of mucositis symptom burden for patients) was significantly reduced (control = 8.63 vs humidification per protocol = 6.74). The proportion of compliant humidification patients who never required a feeding tube was also increased (control = 0.73 vs humidification per protocol = 0.85).

“Although patients in the study did not use the humidifiers as much as was hoped, we obtained feedback about why some of the patients did not like using the humidifier, and our next step is to work at increasing the proportion of patients who use the humidifier,” said Dr. Macann.

The study authors reported no conflicts of interest.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.