Sucralfate mouth washing in the prevention of radiation-induced mucositis: a placebo-controlled double-blind randomized study.
OBJECTIVE
To evaluate the value of sucralfate mouth washings in prevention of radiation-induced mucositis.


METHODS
Forty patients with head and neck cancer were randomized to use either sucralfate mouth washing 1 g six times daily during irradiation (n = 20) or to placebo washing (n = 20). Mouth washing was started at the beginning of radiation therapy and continued to the end of the therapy (7-10 weeks). Assessment of the degree of radiation mucositis and collection of stimulated saliva samples were done weekly during the therapy. Salivary lactoferrin and albumin, suggested markers for the degree of mucositis, were analyzed from stimulated whole saliva samples.


RESULTS
All patients developed radiation-induced mucositis of varying degree after irradiation of about 30 Gy. No difference in the visually assessed degree of mucositis or oral pain reported by the patients was found between the study and the control groups. However, the patients treated with sucralfate used less anesthetic mouth washing and their salivary lactoferrin and albumin levels were lower.


CONCLUSIONS
Although the trial produced no direct clinical evidence indicating that sucralfate mouth rinses prevent radiation-induced mucositis, the decrease in the salivary lactoferrin and albumin levels suggests that sucralfate has a slight protective effect on the oral mucosa.
Makkonen
T A
TA
University of Turku, Department of Oral Surgery, Finland.
Boström
P
P
Vilja
P
P
Joensuu
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000418:Albumins / Q000378:metabolism; D003131:Combined Modality Therapy; D004311:Double-Blind Method; D005260:Female; D006258:Head and Neck Neoplasms / Q000532:radiotherapy*; D006801:Humans; D007781:Lactoferrin / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009061:Mouth Mucosa / Q000187:drug effects* / Q000528:radiation effects*; D009067:Mouthwashes / Q000627:therapeutic use; D010919:Placebos; D011446:Prospective Studies; D011832:Radiation Injuries / Q000209:etiology* / Q000517:prevention & control*; D012469:Salivary Glands / Q000378:metabolism; D013280:Stomatitis / Q000209:etiology* / Q000517:prevention & control*; D013392:Sucralfate / Q000627:therapeutic use*
D000418:Albumins; D009067:Mouthwashes; D010919:Placebos; D013392:Sucralfate; D007781:Lactoferrin