Chemotherapy induced oral mucositis: prevention is possible. 2018

E Una Cidon
Medical Oncology, Royal Bournemouth and Christchurch Hospital NHS Foundation Trust, Bournemouth, UK. aunacid@hotmail.com; Esther.unacidon@rbch.nhs.uk.

BACKGROUND Oral mucositis (OM) is an inflammation of the oral mucosa which occurs in 20-40% of patients receiving conventional chemotherapy (CM). Many different substances have been used separately to treat or prevent OM but no standard procedure has been settled as definitive. We conducted a prospective study to examine whether rinses with a mixture of soluble prednisolone, nystatin and salt water applied before the expected OM appears, would reduce the incidence of grade 2-3 OM in subsequent cycles of CM. METHODS Prospective study of breast cancer patients undergoing neoadjuvant or adjuvant treatment with FEC (5 fluorouracil, epirubicin, cyclophosphamide) or docetaxel who developed OM grade 2 or 2-3 with the previous cycle. The specific mouthwash consisted of a combination of 100 mL of water, 5 mg of soluble prednisolone, 2 drops of nystatin and 2.300 mg of salt (1 teaspoon). Patients received clear instructions on how to use it. The primary end-point was the incidence of OM grade 2-3 with the following cycle of CM. Secondary end-points were the rate of CM dose reduction (DR) and the incidence of OM grade 0, 1 and 2 with the following treatment. RESULTS Sixty-eight patients were included. Twenty-three developed OM grade 2-3 after first cycle. After using this mouthwash, only two cases developed grade 2-3 OM. Only four cases needed a CM DR. CONCLUSIONS Our study showed a significant reduction in the rate of OM grade 2-3 in patients using the especial mouthwash. This mouthwash is currently used as standard in our institution. Further evaluation in other centres to confirm these results is needed.

UI MeSH Term Description Entries
D011446 Prospective Studies Observation of a population for a sufficient number of persons over a sufficient number of years to generate incidence or mortality rates subsequent to the selection of the study group. Prospective Study,Studies, Prospective,Study, Prospective
D001943 Breast Neoplasms Tumors or cancer of the human BREAST. Breast Cancer,Breast Tumors,Cancer of Breast,Breast Carcinoma,Cancer of the Breast,Human Mammary Carcinoma,Malignant Neoplasm of Breast,Malignant Tumor of Breast,Mammary Cancer,Mammary Carcinoma, Human,Mammary Neoplasm, Human,Mammary Neoplasms, Human,Neoplasms, Breast,Tumors, Breast,Breast Carcinomas,Breast Malignant Neoplasm,Breast Malignant Neoplasms,Breast Malignant Tumor,Breast Malignant Tumors,Breast Neoplasm,Breast Tumor,Cancer, Breast,Cancer, Mammary,Cancers, Mammary,Carcinoma, Breast,Carcinoma, Human Mammary,Carcinomas, Breast,Carcinomas, Human Mammary,Human Mammary Carcinomas,Human Mammary Neoplasm,Human Mammary Neoplasms,Mammary Cancers,Mammary Carcinomas, Human,Neoplasm, Breast,Neoplasm, Human Mammary,Neoplasms, Human Mammary,Tumor, Breast
D004358 Drug Therapy The use of DRUGS to treat a DISEASE or its symptoms. One example is the use of ANTINEOPLASTIC AGENTS to treat CANCER. Chemotherapy,Pharmacotherapy,Therapy, Drug,Chemotherapies,Drug Therapies,Pharmacotherapies,Therapies, Drug
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000971 Antineoplastic Combined Chemotherapy Protocols The use of two or more chemicals simultaneously or sequentially in the drug therapy of neoplasms. The drugs need not be in the same dosage form. Anticancer Drug Combinations,Antineoplastic Agents, Combined,Antineoplastic Chemotherapy Protocols,Antineoplastic Drug Combinations,Cancer Chemotherapy Protocols,Chemotherapy Protocols, Antineoplastic,Drug Combinations, Antineoplastic,Antineoplastic Combined Chemotherapy Regimens,Combined Antineoplastic Agents,Agent, Combined Antineoplastic,Agents, Combined Antineoplastic,Anticancer Drug Combination,Antineoplastic Agent, Combined,Antineoplastic Chemotherapy Protocol,Antineoplastic Drug Combination,Cancer Chemotherapy Protocol,Chemotherapy Protocol, Antineoplastic,Chemotherapy Protocol, Cancer,Chemotherapy Protocols, Cancer,Combinations, Antineoplastic Drug,Combined Antineoplastic Agent,Drug Combination, Anticancer,Drug Combination, Antineoplastic,Drug Combinations, Anticancer,Protocol, Antineoplastic Chemotherapy,Protocol, Cancer Chemotherapy,Protocols, Antineoplastic Chemotherapy,Protocols, Cancer Chemotherapy
D013280 Stomatitis INFLAMMATION of the soft tissues of the MOUTH, such as MUCOSA; PALATE; GINGIVA; and LIP. Oral Mucositis,Mucositis, Oral,Oromucositis,Mucositides, Oral,Oral Mucositides,Oromucositides,Stomatitides

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