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Chlorhexidine prophylaxis for chemotherapy- and radiotherapy-induced stomatitis: a randomized double-blind trial
G A Ferretti1, T P Raybould, A T Brown
1Department of Oral Health Practice, University of Kentucky, Lexington.
Oral Surgery, Oral Medicine, and Oral Pathology
|March 1, 1990
Summary
This study found that chlorhexidine digluconate mouthwash effectively reduced oral mucositis in chemotherapy patients. It also decreased microbial burden, though it showed no significant effect on radiation therapy patients.
Area of Science:
- Oncology
- Oral Medicine
- Microbiology
Background:
- Cancer therapies like chemotherapy and radiotherapy frequently cause painful oral mucositis.
- Oral mucositis can lead to infection, treatment delays, and reduced quality of life.
Purpose of the Study:
- To evaluate the efficacy of 0.12% chlorhexidine digluconate mouthrinse as a preventive measure against oral mucositis in cancer patients undergoing intensive treatment.
- To assess the impact of chlorhexidine mouthrinse on oral microflora composition.
Main Methods:
- A prospective, double-blind, randomized trial involving 70 patients (40 chemotherapy, 30 radiotherapy).
- Participants used 15 ml of 0.12% chlorhexidine digluconate mouthrinse or placebo three times daily.
- Oral mucositis incidence and severity were monitored, alongside oral microbial counts.
Main Results:
- Chlorhexidine significantly reduced oral mucositis incidence and severity in the chemotherapy group at multiple time points.
- Mucositis resolved faster in chemotherapy patients using chlorhexidine.
- A trend towards reduced oral streptococci and yeast was observed in the chemotherapy group.
- No significant difference in mucositis was found in the radiotherapy group, but similar microbial reductions occurred.
- A slight, non-significant increase in gram-negative bacilli was noted in chlorhexidine users without increased systemic infection.
Conclusions:
- Prophylactic chlorhexidine digluconate mouthrinse is effective in reducing oral mucositis and microbial burden in cancer patients undergoing intensive chemotherapy.
- While beneficial for chemotherapy-induced mucositis, its effect on radiotherapy-induced mucositis requires further investigation.
- Chlorhexidine mouthrinse represents a valuable tool for managing side effects in oncology supportive care.