Top LIne: There seems to be an endless series of studies seeking to alleviate oral mucositis from radiation. That’s because it’s a major problem with head and neck radiation and there aren’t any highly effective treatments.
The Study: In this trial, 160 patients receiving definitive or postoperative head and neck radiation were randomized to use Streptococcus salivarius K12 (SsK12) oral probiotic during treatment. S. salivarius is part of the oral microbiome. SsK12 is an oral probiotic that colonizes the oral cavity and produces bacteriocin-like inhibitor substance (BLIS), which may have a positive impact on the oral microbiome. SsK12 was administered as a commercially available lozenge three times per day throughout the course of radiation. The most common tumor sites were the nasopharynx (25.9%), oral cavity (17.5%), and oropharynx (14%). There was no difference in the mean oral cavity dose in either arm of the trial (42 Gy in both arms). During treatment, incidence of grade 3-4 mucositis was significantly lower in the SsK12 arm (36.6% v 54.2%). This included a decrease in grade 4 mucositis from 15.3% to 2.8%. Average duration of mucositis was also reduced from 18.3 to 8.9 days. The authors tracked the oral microbiome during treatment and noted decreased abundance of Streptococcus and increase in Selenomonas and Acinetbacter in the control arm. Lower Streptococcus abundance was associated with faster onset and higher incidence of mucositis. This trend was reduced with SsK12 probiotic.
TBL: In this randomized trial, using the oral probiotic, SsK12, three times per day during radiation reduced the rate of severe mucositis. | Peng, J Clin Oncol 2024
The Study: In this trial, 160 patients receiving definitive or postoperative head and neck radiation were randomized to use Streptococcus salivarius K12 (SsK12) oral probiotic during treatment. S. salivarius is part of the oral microbiome. SsK12 is an oral probiotic that colonizes the oral cavity and produces bacteriocin-like inhibitor substance (BLIS), which may have a positive impact on the oral microbiome. SsK12 was administered as a commercially available lozenge three times per day throughout the course of radiation. The most common tumor sites were the nasopharynx (25.9%), oral cavity (17.5%), and oropharynx (14%). There was no difference in the mean oral cavity dose in either arm of the trial (42 Gy in both arms). During treatment, incidence of grade 3-4 mucositis was significantly lower in the SsK12 arm (36.6% v 54.2%). This included a decrease in grade 4 mucositis from 15.3% to 2.8%. Average duration of mucositis was also reduced from 18.3 to 8.9 days. The authors tracked the oral microbiome during treatment and noted decreased abundance of Streptococcus and increase in Selenomonas and Acinetbacter in the control arm. Lower Streptococcus abundance was associated with faster onset and higher incidence of mucositis. This trend was reduced with SsK12 probiotic.
TBL: In this randomized trial, using the oral probiotic, SsK12, three times per day during radiation reduced the rate of severe mucositis. | Peng, J Clin Oncol 2024