Randomized trial of a chlorhexidine mouthwash for alleviation of radiation-induced mucositis.
OBJECTIVE
To determine whether a chlorhexidine mouthwash could alleviate radiation-induced oral mucositis.


METHODS
Patients scheduled to receive radiation therapy to include greater than one third of the oral cavity mucosa were selected for study. Following stratification, they were randomized in a double-blind manner to receive a chlorhexidine mouthwash or a placebo mouthwash. Both groups were then similarly evaluated for mucositis and mouthwash toxicity.


RESULTS
Twenty-five patients were randomized to receive the chlorhexidine mouthwash, while 27 received the placebo mouthwash. Treatment arms were well balanced. There was a trend for more mucositis and there was substantially more toxicity (eg, mouthwash-induced discomfort, taste alteration, and teeth staining) on the chlorhexidine arm.


CONCLUSIONS
In contrast to the prestudy hypothesis that a chlorhexidine mouthwash might provide benefit for patients receiving radiation therapy to the oral mucosa, this study provides strong evidence suggesting that a chlorhexidine mouthwash is detrimental in this clinical situation.
Foote
R L
RL
Mayo Clinic, Rochester, MN 55905.
Loprinzi
C L
CL
Frank
A R
AR
O'Fallon
J R
JR
Gulavita
S
S
Tewfik
H H
HH
Ryan
M A
MA
Earle
J M
JM
Novotny
P
P
D000368:Aged; D002710:Chlorhexidine / Q000009:adverse effects / Q000627:therapeutic use*; D016001:Confidence Intervals; D004311:Double-Blind Method; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000187:drug effects / Q000528:radiation effects; D009067:Mouthwashes / Q000627:therapeutic use*; D011832:Radiation Injuries / Q000188:drug therapy*; D011879:Radiotherapy Dosage; D013280:Stomatitis / Q000188:drug therapy* / Q000209:etiology
D009067:Mouthwashes; D002710:Chlorhexidine