Multicenter randomized trial of chewing gum for preventing oral mucositis in children receiving chemotherapy.
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.
Gandemer
Virginie
V
Department of Paediatrics, Teaching Hospitals 35203 Rennes Cedex, France. virginie.gandemer@chu-rennes.fr
Le Deley
Marie-Cécile
MC
Dollfus
Catherine
C
Auvrignon
Anne
A
Bonnaure-Mallet
Martine
M
Duval
Michel
M
De Lumley
Lionel
L
Hartmann
Olivier
O
Mechinaud
Françoise
F
Sirvent
Nicolas
N
Orbach
Daniel
D
Doireau
Valérie
V
Boutard
Patrick
P
Dalle
Jean-Hugues
JH
Reguerre
Yves
Y
Pautard
Brigitte
B
Aubier
Françoise
F
Schneider
Pascale
P
Suc
Agnès
A
Couillaut
Gérard
G
Schmitt
Claudine
C
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*
D002638:Chewing Gum