Background: The purpose was to evaluate prevention of oral mucositis (OM) using chlorhexidine compared with placebo and with oral cooling (cryotherapy) during fluorouracil (5-FU)-based chemotherapy in gastrointestinal (GI) cancer.
Methods: Patients with previously untreated GI cancer receiving bolus 5-FU/leucovorin chemotherapy were randomized to chlorhexidine mouthrinse 3 times a day for 3 weeks (Arm A), double-blind placebo (normal saline) with the same dose and frequency (Arm B), or cryotherapy with crushed ice 45 minutes during chemotherapy (Arm C). Patients self-reported on severity (CTC-grading) and duration of OM.
Results: Among 225 patients randomized, 206 answered the questionnaire (70, 64, and 63 patients in Arms A, B, and C, respectively) and were well balanced with respect to diagnoses, stage, age, sex, smoking habits, and performance status. Mucositis grade 3-4 occurred more frequently in Arm B (33%) than in A (13%, P< .01) and C (11%, P< .005). Duration was significantly longer in B than in both A (P= .035) and C (P= .003).
Conclusions: The frequency and duration of OM are significantly improved by prophylactic chlorhexidine and by cryotherapy. The latter is easy and inexpensive but has limited use, as it is drug- and schedule-dependent. The current study is the first double-blind randomized evaluation of prophylactic chlorhexidine in a large adult patient population with solid tumors receiving highly OM-inducing chemotherapy. A role for chlorhexidine in the prevention of OM is suggested, which should be evaluated further.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1002/cncr.23328 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Investigation of Genetic Polymorphisms Related GSTM1, GSTT1, GSTP1 Genes and their Association with Radiotherapy Toxicity among Head and Neck Cancer Patients.
Asian Pac J Cancer Prev
January 2025
Department of Molecular Biology & Genetics, Krishna Institute of Allied Sciences, Krishna Vishwa Vidyapeeth "Deemed to be University", Taluka-Karad, Dist- Satara, Pin-415 539, (Maharashtra) India.
Background: In this study we explored the association of polymorphisms of glutathione s transferase gene including GSTM1, GSTT1 and GSTP1 with adverse acute normal tissue reactions resulted from radiotherapy in HNC patients. We assessed the association of GSTM1 and GSTT1 null genotypes and Ile105Val of exon-5 and Ala114Val of exon-6 of GSTP1 gene polymorphisms with the risk of acute skin toxicity reactions after therapeutic radiotherapy in HNC patients.
Methods: Four hundred HNC patients administered with Intensity modulated radiation therapy were enrolled in this study for the evaluation of radiotherapy associated toxicity reactions.
The relevance of dental management prior to radiation therapy with severe oral mucositis in head and neck cancer patients.
J Dent Sci
January 2025
Department of Oral Medicine, Peking University School and Hospital of Stomatology & National Center of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices & Beijing Key Laboratory of Digital Stomatology & NHC Research Center of Engineering and Technology for Computerized Dentistry & NMPA Key Laboratory for Dental Materials, Beijing, China.
Background/purpose: Dental management prior to radiotherapy is often time-critical, and there are no studies on whether manipulations such as tooth extraction influence the risk of severe radiation-induced oral mucositis (ROM) during radiotherapy. Therefore, the aim of this study was to describe the relationship between dental management and the incidence of severe ROM.
Materials And Methods: A retrospective analysis was conducted on 144 head and neck cancer (HNC) patients who received dental management before radiotherapy at Peking University Cancer Hospital, from January 2016 to December 2017.
Improved Efficacy of a Predictive Model for Swallowing-Induced Breakthrough Pain Based on a Redefined Delineation Method in Locally Advanced Nasopharyngeal Carcinoma.
Adv Radiat Oncol
February 2025
Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Purpose: The objective of this study was to explore the performance of a predictive model for swallowing-induced breakthrough pain established using a redefined delineation method based on the common occurrence sites of radiation-induced oral mucositis (RIOM) in locally advanced nasopharyngeal carcinoma (NPC).
Methods And Materials: A total of 208 patients with locally advanced NPC were included in the study cohort, and the test cohort consisted of 88 patients. The oral mucosa structure was contoured using oral cavity contour (OCC), mucosal surface contour (MSC), and oral-pharyngeal mucosa (OPM) methods, and relevant dosimetric parameters were collected.
Systemic Lupus Erythematosus Presenting as Anorexia Nervosa in a Middle-Aged Woman: A Rare Case Report and Literature Review.
Immun Inflamm Dis
January 2025
Department of Internal Medicine, Al-Khor Hospital, Hamad Medical Corporation, Doha, Qatar.
Background: Systemic lupus erythematosus (SLE) is a complex autoimmune disease with multisystemic involvement and unclear etiology. Although SLE could be linked to multiple neuropsychiatric manifestations, the co-occurrence of anorexia nervosa was only described through a few case reports that mainly affected children and adolescents.
Case Presentation: a 40-year-old Filipina woman presented to hospital with a 3-day history of agitation, anorexia and auditory hallucinations.
Clinical efficacy of lasers in the management of recurrent aphthous ulcers of oral cavity: a systematic review of randomized control trials.
Lasers Med Sci
January 2025
College of Dentistry, Ajman University, Ajman, United Arab Emirates.
Recurrent aphthous stomatitis (RAS) is one of mankind's most common diseases with a nonspecific etiology. Lasers are gaining traction in dentistry due to their remarkable effects on pain reduction. Their convenience and lack of side effects have made them an attractive alternative to conventional interventions.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!