Prevention of oral mucositis in paediatric patients treated with chemotherapy: a randomised crossover trial comparing two protocols of oral care

• Published in: European journal of cancer (1990) Vol. 40; no. 8; pp. 1208 - 1216
• Main Authors: Cheng, K.K.F, Chang, A.M, Yuen, M.P
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01.05.2004; Elsevier
• Subjects: Adolescent; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Benzydamine; Benzydamine - therapeutic use; Biological and medical sciences; Chemotherapy; Child; Chlorhexidine; Chlorhexidine - therapeutic use; Cross-Over Studies; Facial bones, jaws, teeth, parodontium: diseases, semeiology; Female; Humans; Male; Medical sciences; Mouth Mucosa; Mouthwashes - therapeutic use; Neoplasms - drug therapy; Non tumoral diseases; Oral Hygiene; Oral mucositis; Oral Ulcer - chemically induced; Oral Ulcer - prevention & control; Otorhinolaryngology. Stomatology; Paediatrics; Pharmacology. Drug treatments; Prospective Studies; Stomatitis - chemically induced; Stomatitis - prevention & control; Tumors; Chemotherapy; Oral mucositis; Chlorhexidine; Benzydamine; Paediatrics; Antineoplastic agent; Human; Stomatology; Guanidines; Pharmacology; Care; Prevention; Stomatitis; Biguanides; Cancerology; Treatment; Clinical trial; Oral cavity disease
• ISSN: 0959-8049; 1879-0852
• DOI: 10.1016/j.ejca.2003.10.023

This study compared the efficacy of two protocols for oral care using either chlorhexidine or benzydamine as oral rinses to alleviate mucositis in children undergoing chemotherapy. Eligible participants were randomised to receive either protocol for 3 weeks in a two-period crossover design. The occurrence of ulcerative lesions and severity of mucositis were measured at baseline and twice weekly, using the modified Oral Assessment Guide (OAG). Data were continuously analysed by plotting them directly on predefined sequential charts. According to this sequential analysis, the study could be terminated at the 34th within subject comparison, with a statistically significant reduction in ulcerative lesions (P<0.05) and severity of mucositis (P<0.05) in children on the chlorhexidine protocol. These findings suggest that chlorhexidine together with oral care might be helpful in alleviating mucositis when given prophylactically to children on chemotherapy, but the therapeutic benefit needs to be confirmed in a larger trial.