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

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