• Incidence of grade 1 or 2 oral mucositis by Radiation Therapy Oncology Group Acute Radiation Morbidity Scoring Criteria Oral Mucosa Assessment Scale at baseline, during radiotherapy, and once a month for 3 months after radiotherapy
  
• Incidence of grade 3 or 4 oral mucositis by Radiation Therapy Oncology Group Acute Radiation Morbidity Scoring Criteria Oral Mucosa Assessment Scale at baseline, during radiotherapy, and once a month for 3 months after radiotherapy
  

• Quality of life at baseline, during radiotherapy, and once a month for 3 months after radiotherapy
  
• Functional status by Karnofsky Performance Status Scale at baseline, during radiotherapy, and once a month for 3 months after radiation therapy
  
• Severity and quality of pain by questionnaires at baseline, during radiotherapy, and once a month for 3 months after radiotherapy
  

DISEASE CHARACTERISTICS:

• Histopathologically confirmed diagnosis of head and neck cancer
• Scheduled to undergo continuous course of conventional or hyperfractionated radiotherapy or intensity-modulated radiotherapy (IMRT) with or without concurrent chemotherapy
• Planning to receive a total radiation dose ≥ 5,500 cGy, administered in a single daily fraction of 180-220 cGy (5 days a week) or twice daily fractions of 110-150 cGy
• Normal baseline oral examinations (no pre-existing lesion)
• No T1 or T2 glottic tumors

PATIENT CHARACTERISTICS:

• Karnofsky performance status 60-100%
• Mentally capable of participating in research protocol
• Expected survival > 4.5 months
• No other serious concurrent medical illness
• Absolute neutrophil count ≥ 1,500/mm^3
• Platelet count ≥ 100,000/mm^3
• Creatinine ≤ 2.0 mg/dL
• Bilirubin ≤ 2.0 mg/dL
• AST < 5 times upper limit of normal
• HIV negative
• No history of insulin-dependent diabetes mellitus
• No prior hypersensitivity reaction to yeast material
• No recent history of oral ulceration, herpes simplex, oral candidiasis, severe gingivitis, active or chronic mucositis, or xerostomia
• No current New York Heart Association class II-IV congestive heart failure
• Not pregnant or nursing
• Fertile patients must use effective contraception

PRIOR CONCURRENT THERAPY:

• No unresolved adverse event from previous therapy
• No prior radiotherapy to the head and neck
• No prior or concurrent brachytherapy
• No prior participation in this study
• No chemotherapy, radiotherapy, or other investigational drugs within the past 4 weeks
• No major surgery within the past 2 weeks
• No systemic sargramostim (GM-CSF) within the past 7 days
• No systemic filgrastim (G-CSF) within the past 24 hours
• No systemic long-acting pegfilgrastim within the past 14 days
• No antibiotics, antifungals, or antivirals for oral conditions at baseline
• No other concurrent chemotherapy agent
• No concurrent enrollment on other head and neck studies
• No other concurrent investigational drugs

• No concurrent administration of any of the following:

  • "Magic or miracle mouthwash" containing a palliative mixture of topical anesthetics/analgesics, coating agents, and other medications without an approved indication for topical oral use except liquid antacid formulations (e.g., Maalox® or Mylanta® or their generic equivalents)
  • Other concurrent over-the-counter or prescription mouthwashes beyond the systematic oral care protocol provided by the study or any other drugs or agents to aid in oral hygiene (e.g., chlorhexidine, gluconate, pilocarpine, amifostine, sucralfate tablets or slurry, or benzydamine)
  • Use of corticosteroids for chronic conditions OR within the past 7 days