ASSESSMENT OF CERTAIN BIOCHEMICAL PARAMETERS OF BLOOD AND ORAL FLUID IN PATIENTS WITH ORAL CAVITY CANCER AFTER INTRA-ARTERIAL POLYCHEMOTHERAPY

Abstract

Radiation therapy remains one of the key methods for treating oral cavity cancer, used both as a standalone approach and as part of combined or complex treatment strategies. The application of modern high-tech radiation therapy techniques, particularly high-energy radiation sources and large irradiation fields, ensures high clinical effectiveness. However, it also significantly increases the risk of complications. Radiation exposure often exceeds the adaptive-compensatory capacity of the body, which leads to challenges in tumor monitoring, complicates the treatment process, worsens patients’ general condition, causes disability, and ultimately shortens life expectancy.Aim. To study changes in biochemical and general clinical parameters of blood and saliva in patients with oral cavity cancer after selective intra-arterial polychemotherapy, applied either alone or in combination with intra-arterial glucose solution infusion. Materials and Methods. The study involved 143 patients diagnosed with squamous cell carcinoma of the oral floor mucosa of varying differentiation degrees (112 men and 31 women aged 45 to 69 years). General clinical blood and saliva tests were performed before the initiation of treatment and during 7–10 days of inpatient care. Patients were divided into groups depending on the treatment strategy chosen at the initial stage. Biochemical analysis of homeostasis parameters was conducted before and after the course of selective intra-arterial polychemotherapy ‒ in 15 patients of the first group (29.4 %) and 10 patients of the second group (41.6 %), where intra-arterial glucose infusion was additionally applied. Results. After the course of chemotherapy, an increase in the concentration of reduced nicotinamide coenzymes (NADH) and thiol groups (SH-groups) in saliva was observed. At the same time, a statistically significant decrease in the amide formof NAD and a reduction in the NAD/NADH ratio were recorded. These findings indicate a significant disruption of the redox balance in oral cavity tissues under the influence of chemotherapeutic treatment. The results emphasize the need to monitor biochemical markers during treatment and highlight the relevance of developing pharmacological strategies to protect orofacial tissues from chemotherapy-induced damage.Conclusion. The use of selective intra-arterial polychemotherapy, both independently and in combination with intra-arterial glucose infusion, leads to significant alterations in biochemical homeostasis indicators in the saliva of patients with oral cavity cancer. Specifically, increased levels of reduced nicotinamide coenzymes (NADH) and thiol groups were detected, along with a decrease in the amide form of NAD and a reduced NAD/NADH ratio.These markers reflect the development of oxidative stress and redox imbalance in orofacial tissues as a result of chemotherapy. The findings support the necessity of including biochemical marker monitoring in treatment protocols and justify the development and implementation of pharmacological protection methods for oral tissues to mitigate the toxic effects of anticancer therapy.