• 10/5/2006
  • Instanbul, Turkey
  • Jill Stein
  • Doctor’s Guide (www.docguide.com)

The use of either an antiseptic mouthwash containing chlorhexidine or cryotherapy can reduce the duration of oral mucositis secondary to chemotherapy, researchers reported here at the 31st European Society for Medical Oncology (ESMO) Congress.

The mouthwash may be superior because cryotherapy cannot be used with infusional 5-fluorouracil or with chemotherapy that has a substantially longer half-live than 5-FU, researchers said in a presentation on October 2nd.

Jens B. Sorensen, MD, chief of oncology, Finsen Centre, National University Hospital, Copenhagen, Denmark, presented results in 206 patients who had been randomized to 1 of 3 treatment arms: 1) mouth rinse containing 15 mL of chlorhexidine 0.1% for 1 minute thrice daily for 3 weeks; 2) saline mouth rinse with the same taste additive as in the chlorhexidine rinse for 1 minute thrice daily for 3 weeks; 3) cryotherapy with crushed ice for 10 minutes before to 35 minutes after chemotherapy.

The trial included previously untreated patients with gastrointestinal cancer receiving bolus 5-FU 425 mg/m2 with leucovorin 20 mg/m2 daily over 5 days.

Patient completed questionnaires that measured the severity and duration of mucositis after treatment. Mucositis grade III/IV was defined as impaired oral nutrition and the need for artificial nutrition.

Mucositis grade 3/4 occurred in 13% of the chlorhexidine group, 33% of the placebo group, and 11% of the cryotherapy group.

Median duration of mucositis was 3 days in the chlorhexidine group, 5 days in the placebo group, and 1 day in the cryotherapy group.

Overall, the data suggest a role for chlorhexidine for prevention of mucositis in adults with solid tumors treated with chemotherapy in standard doses, Dr. Sorensen noted.

“The limitation of cryotherapy is that its use is confined to chemotherapy agents with a short half-life,” he said.

Finally, he pointed out that the study is the first double-blind, randomized assessment of chlorhexidine in a large patient population treated identically with a single chemotherapy regimen with strong “mucositis- inducing” potential.

Presentation title:
Prophylaxis of Chemotherapy-Induced Oral Mucositis: Double Blind Placebo-Controlled Randomized Study of Chlorhexidine Versus Placebo and With Nonblinded Randomized Comparison to Oral Cooling (Cryotherapy). Abstract 988O