Salivary Lactate Dehydrogenase (LDH) as a Marker for Radiation-induced Mucositis in Head and Neck Cancers: A Preliminary Study

Abstract

<strong>Background:</strong> In this study, we sought to understand the usefulness of salivary lactate<br />dehydrogenase as a predictive marker for the development of radiation-induced<br />mucositis.<br /><strong>Methods:</strong> This was a prospective study with head and neck cancer patients who<br />required curative radiotherapy (>60Gy). We collected patients' saliva before the onset<br />of radiation and after 2 Gy of radiation to assess lactate dehydrogenase levels. The patients<br />received the stipulated oral and dental care. Data on incidence and severity of mucositis<br />was collected using a preform sheet and oral mucositis assessment scale published by<br />the Radiation Therapy Oncology Group throughout the 7-week treatment period.<br /><strong>Results:</strong> Salivary lactate dehydrogenase increased with exposure to radiation<br />(P<0.0001) and there was an observed association with mucositis severity (P<0.0001;<br />r = 0.515).<br /><strong>Conclusion:</strong> The present results have established, for the first time, that salivary<br />lactate dehydrogenase could be a useful predictive marker to understand the development<br />of radiation-induced mucositis in patients with head and neck cancer. The proximity<br />of the oral cavity for regular observation and saliva collection is an added advantage.