Appraisal of late radiation-induced oral microvascular changes at the patient-side

Publication date: Available online 31 January 2018
Source:International Journal of Radiation Oncology*Biology*Physics
Author(s): Renée Helmers, Nina F. Straat, Arash Navran, Tim A.P. Nai Chung Tong, David N. Teguh, Robert A. van Hulst, Jan de Lange, Dan M.J. Milstein
ObjectivesLate radiation-induced tissue toxicity in the head and neck (HN) region is associated with ulceration and osteoradionecrosis as a result of a detrimental effect on the underlying tissue microvasculature. The aim of this investigation was to determine the clinical feasibility of examining and measuring late irradiation changes in the oral microcirculation of HN cancer patients using the novel CytoCam video microscope system.Materials and methodsIn 30 HN cancer patients and 30 age-matched controls, bilateral video images were recorded noninvasively of the oral microcirculation of the buccal mucosa and mandibular gingiva. Tissue perfusion parameters such as functional capillary density (FCD), buccal blood vessel diameter (Øbv), and microcirculatory flow index (MFI) were analyzed.ResultsNo difference was observed for mean buccal mucosa FCD in irradiated vs. healthy tissue, whereas a lower mean gingival FCD in irradiated vs. healthy tissue was observed (34±17 cpll/mm² vs. 68±19 cpll/mm²; p<0.001). A significant difference in mean buccal Øbv of 16±3 μm was measured compared to 14±1 μm in control buccal mucosa (p<0.001). No significant difference in MFI was observed between the two groups.ConclusionQuantifying oral microcirculatory injury associated with late irradiation effects using the CytoCam was feasible in HN cancer patients. Results indicate that marked differences in tissue-specific microcirculatory measurements of angioarchitecture, diminished capillary density, and extensively dilated blood vessel diameters are associated with late irradiation effects in HN cancer patients.

Teaser

Late irradiation microvascular effects in oral mucosa can easily be measured at the patient sideAnatomic differences in angioarchitecture and angiomorphology highlight pathologies Decreased capillary density in mandibular gingiva is associated with late radiation-induced microvascular effects Oral mucosal perfusion and microangiopathies occur differently in different tissues


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