title: Multicenter randomized trial of chewing gum for preventing oral mucositis in children receiving chemotherapy.
abstract: The properties of saliva led us to hypothesize that the salivary flow increase induced by gum chewing might protect the oral mucosa from lesions due to cancer chemotherapy. We conducted a multicenter randomized trial to evaluate the efficacy of chewing gum in preventing oral mucositis in 145 children receiving chemotherapy regimens expected to induce WHO grade 3-4 oral mucositis in at least 30% of patients. Patients were allocated at random to standard oral care with or without 5 gum pieces per day. No overall reduction in severe oral mucositis occurred in the gum arm (51%) compared with the standard arm (44%). VIDE, COPADM, and multidrug intensive chemotherapy caused severe oral mucositis in 75% of patients in both arms. In patients receiving less toxic regimens, a decrease in WHO grade 1-4 oral mucositis was noted in the gum arm compared with the standard arm (49% vs. 72%, P=0.03). In the multivariate analysis, the risk of oral mucositis was related only to the type of chemotherapy regimen, suggesting that further strategies for preventing oral mucositis could be mainly based on these criteria.
authors.affiliation: Department of Paediatrics, Teaching Hospitals 35203 Rennes Cedex, France. virginie.gandemer@chu-rennes.fr
authors.forename: Virginie
authors.initials: V
authors.lastname: Gandemer
authors.forename: Marie-Cécile
authors.initials: MC
authors.lastname: Le Deley
authors.forename: Catherine
authors.initials: C
authors.lastname: Dollfus
authors.forename: Anne
authors.initials: A
authors.lastname: Auvrignon
authors.forename: Martine
authors.initials: M
authors.lastname: Bonnaure-Mallet
authors.forename: Michel
authors.initials: M
authors.lastname: Duval
authors.forename: Lionel
authors.initials: L
authors.lastname: De Lumley
authors.forename: Olivier
authors.initials: O
authors.lastname: Hartmann
authors.forename: Françoise
authors.initials: F
authors.lastname: Mechinaud
authors.forename: Nicolas
authors.initials: N
authors.lastname: Sirvent
authors.forename: Daniel
authors.initials: D
authors.lastname: Orbach
authors.forename: Valérie
authors.initials: V
authors.lastname: Doireau
authors.forename: Patrick
authors.initials: P
authors.lastname: Boutard
authors.forename: Jean-Hugues
authors.initials: JH
authors.lastname: Dalle
authors.forename: Yves
authors.initials: Y
authors.lastname: Reguerre
authors.forename: Brigitte
authors.initials: B
authors.lastname: Pautard
authors.forename: Françoise
authors.initials: F
authors.lastname: Aubier
authors.forename: Pascale
authors.initials: P
authors.lastname: Schneider
authors.forename: Agnès
authors.initials: A
authors.lastname: Suc
authors.forename: Gérard
authors.initials: G
authors.lastname: Couillaut
authors.forename: Claudine
authors.initials: C
authors.lastname: Schmitt
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D002638:Chewing Gum; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000188:drug therapy; D012307:Risk Factors; D013280:Stomatitis / Q000139:chemically induced / Q000517:prevention & control*
chemical_list: D002638:Chewing Gum