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Supportive Care in Cancer

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01-10-2013 | Original Article

The effect of a supersaturated calcium phosphate mouth rinse on the development of oral mucositis in head and neck cancer patients treated with (chemo)radiation

A single-center, randomized, prospective study of a calcium phosphate mouth rinse + standard of care versus standard of care

Authors: Maarten Lambrecht, Carole Mercier, Yasmyne Geussens, Sandra Nuyts

Published in: Supportive Care in Cancer | Issue 10/2013

Abstract

Objectives

Mucosal damage is an important and debilitating side effect when treating head and neck cancer patients with (chemo-)radiation. The aim of this randomized clinical trial was to investigate whether the addition of a neutral, supersaturated, calcium phosphate (CP) mouth rinse benefits the severity and duration of acute mucositis in head and neck cancer patients treated with (chemo)radiation.

Materials and methods

A total of 60 patients with malignant neoplasms of the head and neck receiving (chemo)radiation were included in this study. Fifty-eight patients were randomized into two treatment arms: a control group receiving standard of care (n = 31) and a study group receiving standard of care + daily CP mouth rinses (n = 27) starting on the first day of (chemo-)radiation. Oral mucositis and dysphagia were assessed twice a week using the National Cancer Institute common toxicity criteria scale version 3, oral pain was scored with a visual analogue scale.

Results

No significant difference in grade III mucositis (59 vs. 71 %; p = 0.25) and dysphagia (33 vs. 42 %, p = 0.39) was observed between the study group compared to the control group. Also no significant difference in time until development of peak mucositis (28.6 vs. 28.7 days; p = 0.48), duration of peak mucositis (22.7 vs. 24.6 days; p = 0.31), recuperation of peak dysphagia (20.5 vs 24.2 days; p = 0.13) and occurrence of severe pain (56 vs. 52 %, p = 0.5).

Conclusion

In this randomized study, the addition of CP mouth rinse to standard of care did not improve the frequency, duration or severity of the most common acute toxicities during and early after (chemo)radiation. There is currently no evidence supporting its standard use in daily practice.

Elting LS, Cooksley CD, Chambers MS et al (2007) Risk, outcomes, and costs of radiation-induced oral mucositis among patients with head-and-neck malignancies. Int J Radiat Oncol Biol Phys 68:1110–1120CrossRefPubMed

Barasch A, Peterson DE (2003) Risk factors for ulcerative oral mucositis in cancer patients: unanswered questions. Oral Oncol 39:91–100CrossRefPubMed

Russo G, Haddad R, Posner M et al (2008) Radiation treatment breaks and ulcerative mucositis in head and neck cancer. Oncologist 13:886–898CrossRefPubMed

Peterson DE, Bensadoun RJ, Roila F (2011) Management of oral and gastrointestinal mucositis: ESMO Clinical Practice Guidelines. Ann Oncol 22(Suppl 6):vi78–vi84CrossRefPubMed

Keefe DM, Schubert MM, Elting LS et al (2007) Updated clinical practice guidelines for the prevention and treatment of mucositis. Cancer 109:820–831CrossRefPubMed

Rosenthal DI, Trotti A (2009) Strategies for managing radiation-induced mucositis in head and neck cancer. Semin Radiat Oncol 19:29–34CrossRefPubMed

Clarkson JE, Worthington HV, Furness S et al. (2010) Interventions for treating oral mucositis for patients with cancer receiving treatment. Cochrane Database Syst Rev 2010; CD001973-

Hensley ML, Hagerty KL, Kewalramani T et al (2009) American Society of Clinical Oncology 2008 clinical practice guideline update: use of chemotherapy and radiation therapy protectants. J Clin Oncol 27:127–145CrossRefPubMed

Papas AS, Clark RE, Martuscelli G et al (2003) A prospective, randomized trial for the prevention of mucositis in patients undergoing hematopoietic stem cell transplantation. Bone Marrow Transplant 31:705–712CrossRefPubMed

10.

Wasko-Grabowska A, Rzepecki P, Oborska S et al (2011) Efficiency of supersaturated calcium phosphate mouth rinse treatment in patients receiving high-dose melphalan or BEAM prior to autologous blood stem cell transplantation: a single-center experience. Transplant Proc 43:3111–3113CrossRefPubMed

11.

Stokman MA, Burlage FR, Spijkervet FK (2012) The effect of a calcium phosphate mouth rinse on (chemo) radiation induced oral mucositis in head and neck cancer patients: a prospective study. Int J Dent Hyg 10:175–180PubMed

12.

Sonis ST, Elting LS, Keefe D et al (2004) Perspectives on cancer therapy-induced mucosal injury: pathogenesis, measurement, epidemiology, and consequences for patients. Cancer 100:1995–2025CrossRefPubMed

13.

Vagliano L, Feraut C, Gobetto G et al (2011) Incidence and severity of oral mucositis in patients undergoing haematopoietic SCT—results of a multicentre study. Bone Marrow Transplant 46:727–732CrossRefPubMed

14.

Sanguineti G, Sormani MP, Marur S et al (2012) Effect of radiotherapy and chemotherapy on the risk of mucositis during intensity-modulated radiation therapy for oropharyngeal cancer. Int J Radiat Oncol Biol Phys 83:235–242CrossRefPubMed

15.

Narayan S, Lehmann J, Coleman MA et al (2008) Prospective evaluation to establish a dose response for clinical oral mucositis in patients undergoing head-and-neck conformal radiotherapy. Int J Radiat Oncol Biol Phys 72:756–762CrossRefPubMed

16.

Vera-Llonch M, Oster G, Hagiwara M et al (2006) Oral mucositis in patients undergoing radiation treatment for head and neck carcinoma. Cancer 106:329–336CrossRefPubMed

Title: The effect of a supersaturated calcium phosphate mouth rinse on the development of oral mucositis in head and neck cancer patients treated with (chemo)radiation
A single-center, randomized, prospective study of a calcium phosphate mouth rinse + standard of care versus standard of care
Authors: Maarten Lambrecht
Carole Mercier
Yasmyne Geussens
Sandra Nuyts
Publication date: 01-10-2013
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 10/2013
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-013-1829-0

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