Management of mucositis in oral irradiation.
Mucositis significantly affects quality of life and tolerance of treatment in oral irradiation. Effective management of this complication is therefore very important. However, there is a scarcity of up-to-date oral care protocols, with most centres using ritualized regimens. The literature on oral rinses in radiation mucositis is at best inconclusive and at worst confusing. In this study, patients undergoing radical radiotherapy treatment (55-60 Gy in 4 weeks) to more than 50% of the oral cavity and oropharynx were randomized to a research based oral care protocol with either saline 0.9% or hydrogen peroxide 3.5 volumes (HP) as rinses. The results of this study show that, on average, the group receiving saline rinses appeared to do better on some outcomes than the group receiving HP. This suggests that frequent mechanical cleansing of the mouth may be more important than the antiseptic properties of a mouthwash. Antiseptic mouthwashes may be contra-indicated in radiation mucositis. In order to determine best practice in mucositis management, multi-centre, multidisciplinary trials should be conducted.
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Yorkshire Regional Centre for Cancer Treatment, Cookridge Hospital, Leeds, UK.
D000704:Analysis of Variance; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use; D002985:Clinical Protocols; D000075202:Contraindications; D006801:Humans; D006861:Hydrogen Peroxide / Q000008:administration & dosage / Q000627:therapeutic use; D016015:Logistic Models; D009061:Mouth Mucosa / Q000528:radiation effects; D009062:Mouth Neoplasms / Q000532:radiotherapy*; D009067:Mouthwashes / Q000627:therapeutic use; D015337:Multicenter Studies as Topic; D015999:Multivariate Analysis; D009910:Oral Hygiene; D009959:Oropharyngeal Neoplasms / Q000532:radiotherapy; D011788:Quality of Life; D011832:Radiation Injuries / Q000209:etiology / Q000628:therapy*; D011878:Radiotherapy / Q000009:adverse effects; D012965:Sodium Chloride / Q000008:administration & dosage / Q000627:therapeutic use; D013280:Stomatitis / Q000209:etiology / Q000628:therapy*; D016896:Treatment Outcome
D000891:Anti-Infective Agents, Local; D009067:Mouthwashes; D012965:Sodium Chloride; D006861:Hydrogen Peroxide