Treatment of symptomatic oral mucositis with sodium hyaluronate and synthetic amino acid precursors of collagen in patients undergoing haematopoietic stem cell transplantation.

The purpose of the study is to evaluate the clinical effects of Mucosamin® (a spray preparation containing sodium hyaluronate combined with a pool of amino acids of precursor collagen, including L-Proline, L-Leucine, L-Lysine and glycine) on wound healing and pain management of oral mucositis after hematopoietic stem cell transplantation. The importance of professional dental hygiene by dental hygienist in reducing the severity of oral mucositis as unique therapy or in addition to therapy with Mucosamin® was also evaluated. One hundred thirty-seven patients undergoing hematopoietic stem cell transplantation were recruited in a case-control study and divided into 4 groups: Group A: professional oral hygiene + Mucosamin®; Group B: professional oral hygiene + standard treatment with chlorhexidine 0.20%;; Group C: only Mucosamin®; Group D: only standard treatment with chlorhexidine 0.20%. The following evaluations were made: WHO mucositis scale, OMAS mucositis scale, VAS, periodontal recording, days of mucositis. Comparing the groups at the onset of OM on WHO scale, it was observed that Group A grade 1 occurrence was more statistically significant than Group B (p= 0.03*); comparison between Group A and D showed a statistically significant difference in favour of Group A (p= 0.0002*). Also OMAS scale showed a statistically significant difference between groups who assumed Mucosamin, who developed lower OM grade (p = 0.001*). There was a statistically significant difference between group A compared with group B over the overall duration of OM (p = 0.02*), as well as between group A and group D (p=0.03*). According to the present study the combination of a careful debridement, correct oral hygiene during hospitalization and the use of Mucosamin® exponentially reduces the severity and duration of mucositis and consequently the discomfort of the patient. Moreover, it can be stated that the use of Mucosamin® also results in a reduction in the extent of chemotherapy lesions. Hyaluronic acid and amino acid-based sprays can be a valuable therapeutic aid in the treatment of mucositis.

SU-E-T-431: Investigation of BrachyVision™ Acuros™ Using Varian Surface Applicators.

PURPOSE: Conical brachytherapy surface applicators with diameters ranging from 10 mm to 45 mm have been developed by Varian Medical Systems, Inc. These applicators are designed to be used with the GammaMedplus iX and VariSource iX high-dose rate Ir-192 afterloaders, allowing for conformal dose delivery for the treatment of surface lesions. Treatment plans for these applicators are created in BrachyVision Acuros. Few studies have been completed with Acuros in clinical situations. The purpose of this work is to perform a comparison of the Acuros-calculated dose distributions with those calculated using Monte Carlo and measured with various detectors. METHODS: Surface applicator treatment plans for each source/applicator combination were created using Acuros and a virtual water phantom. Simulations to characterize the dose distributions were completed using MCNP5 based on specifications provided by the manufacturer. A collision kerma tally was used to determine the dose distributions at the surface and at depth in water. Experimental verification of the depth-dose and surface dose distributions was completed using an ionization chamber, and TLDs and film, respectively. Acuros-calculated depth-dose and isodose values were compared to the Monte Carlo and experimental values. RESULTS: Assessment of the surface dose distributions shows a peak at the center of the applicator with rapid fall off to the edges. The TPS-calculatedpercentage depth-dose curves were within 3.7% of the MC and 5.8% of the measured for the 30 mm applicator and were within 4.4% of the MC and measured for the 35 mm applicator. CONCLUSIONS: BrachyVision Acuros is capable of calculating the depth-dose and surface dose distributions for the simple water phantom case with surface applicators. Investigation of additional treatment geometries and applicators is ongoing. Conflict ofInterest: Varian Medical Systems, Inc. provided financial support, software, sources, and applicators. Varian Medical Systems, Inc. provided financial support, software, sources, and applicators.