Article Abstract

Chemotherapy induced oral mucositis: prevention is possible

Authors: E. Una Cidon


Background: Oral mucositis (OM) is an inflammation of the oral mucosa which occurs in 20–40% of patients receiving conventional chemotherapy (CM). Many different substances have been used separately to treat or prevent OM but no standard procedure has been settled as definitive. We conducted a prospective study to examine whether rinses with a mixture of soluble prednisolone, nystatin and salt water applied before the expected OM appears, would reduce the incidence of grade 2–3 OM in subsequent cycles of CM.
Methods: Prospective study of breast cancer patients undergoing neoadjuvant or adjuvant treatment with FEC (5 fluorouracil, epirubicin, cyclophosphamide) or docetaxel who developed OM grade 2 or 2–3 with the previous cycle. The specific mouthwash consisted of a combination of 100 mL of water, 5 mg of soluble prednisolone, 2 drops of nystatin and 2.300 mg of salt (1 teaspoon). Patients received clear instructions on how to use it. The primary end-point was the incidence of OM grade 2–3 with the following cycle of CM. Secondary end-points were the rate of CM dose reduction (DR) and the incidence of OM grade 0, 1 and 2 with the following treatment.
Results: Sixty-eight patients were included. Twenty-three developed OM grade 2–3 after first cycle. After using this mouthwash, only two cases developed grade 2–3 OM. Only four cases needed a CM DR.
Conclusions: Our study showed a significant reduction in the rate of OM grade 2–3 in patients using the especial mouthwash. This mouthwash is currently used as standard in our institution. Further evaluation in other centres to confirm these results is needed.