Pharmacological protection from radiation ± cisplatin-induced oral mucositis

Int J Radiat Oncol Biol Phys. 2012 Jul 15;83(4):1284-90. doi: 10.1016/j.ijrobp.2011.09.026. Epub 2011 Dec 22.

Abstract

Purpose: To evaluate if two pharmacological agents, Tempol and D-methionine (D-met), are able to prevent oral mucositis in mice after exposure to ionizing radiation ± cisplatin.

Methods and materials: Female C3H mice, ∼8 weeks old, were irradiated with five fractionated doses ± cisplatin to induce oral mucositis (lingual ulcers). Just before irradiation and chemotherapy, mice were treated, either alone or in combination, with different doses of Tempol (by intraperitoneal [ip] injection or topically, as an oral gel) and D-met (by gavage). Thereafter, mice were sacrificed and tongues were harvested and stained with a solution of Toluidine Blue. Ulcer size and tongue epithelial thickness were measured.

Results: Significant lingual ulcers resulted from 5 × 8 Gy radiation fractions, which were enhanced with cisplatin treatment. D-met provided stereospecific partial protection from lingual ulceration after radiation. Tempol, via both routes of administration, provided nearly complete protection from lingual ulceration. D-met plus a suboptimal ip dose of Tempol also provided complete protection.

Conclusions: Two fairly simple pharmacological treatments were able to markedly reduce chemoradiation-induced oral mucositis in mice. This proof of concept study suggests that Tempol, alone or in combination with D-met, may be a useful and convenient way to prevent the severe oral mucositis that results from head-and-neck cancer therapy.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Animals
  • Chemoradiotherapy / adverse effects
  • Cisplatin / adverse effects*
  • Cyclic N-Oxides / therapeutic use*
  • Female
  • Methionine / therapeutic use*
  • Mice
  • Mice, Inbred C3H
  • Radiation Injuries, Experimental / prevention & control*
  • Radiation-Protective Agents / therapeutic use*
  • Radiation-Sensitizing Agents / adverse effects*
  • Spin Labels
  • Stomatitis / etiology
  • Stomatitis / prevention & control*

Substances

  • Cyclic N-Oxides
  • Radiation-Protective Agents
  • Radiation-Sensitizing Agents
  • Spin Labels
  • Methionine
  • Cisplatin
  • tempol