Sumac-rose water mouthwash versus benzydamine to prevent radiation-induced oral mucositis in head and neck cancers: a phase II randomized trial.

Abstract

BACKGROUND:

Radiation-induced oral mucositis (OM) largely impairs the quality of life (QoL) of patients with head and neck cancer (HNC). Few choices with limited efficacy are available to prevent this adverse effect. This randomized trial was conducted to compare the efficacy of benzydamine (standard) and a new combination (sumac and rose water) in preventing radiation-induced OM.

METHODS:

This was a phase II, triple-blind, active-controlled, randomized trial. The primary endpoint was OM, and the secondary endpoints were oral pain and QoL. Besides, the possible variables defining the outcomes were analyzed using the chi-squared test (univariate analysis) and binomial regression model (multivariate analysis).

RESULTS:

Sumac-rose group had fewer high-grade OM (33% vs. 63%, odds ratio [OR] 0.28, 95% confidence interval [CI 95%] 0.08-0.93, P = 0.03) and better QoL (P < 0.05). Multivariate analysis confirmed these findings. Sumac-rose rinsing could also postpone the start of oral pain (hazard ratio [HR] 0.02, CI 95% 0.001-0.32, P = 0.001) and high-grade OM (HR 0.28, P = 0.03) compared with benzydamine.

CONCLUSIONS:

The sumac-rose group had a lower OM rate and grade and higher QoL than the benzydamine group. In addition, the experimental group developed high-grade OM and oral pain later during the radiotherapy course. Further studies need to be conducted to assess the role of sumac and rose water in reducing grade 3-4 mucositis in patients who undergo chemoradiation for head and neck cancer.

• Authors: Ahmad Ameri, Ghazaleh Heydarirad, Rasoul Choopani, Sanaz Poshtmahi, Pooya Ameri, Fereshteh Talebi, Anahid Bagheri Pour, Farzad Taghizadeh-Hesary
• Journal: Journal of cancer research and clinical oncology (J Cancer Res Clin Oncol) Vol. 149 Issue 10 Pg. 7427-7439 (Aug 2023) ISSN: 1432-1335 [Electronic] Germany
• PMID: 36947237 (Publication Type: Randomized Controlled Trial, Clinical Trial, Phase II, Journal Article)
• Copyright: © 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

Chemical References

• Benzydamine
• Mouthwashes
• Water

Topics

• Humans
• Benzydamine (therapeutic use)
• Mouthwashes (therapeutic use)
• Quality of Life
• Rhus
• Stomatitis (etiology, prevention & control)
• Head and Neck Neoplasms (radiotherapy)
• Pain
• Radiation Injuries
• Water
• Double-Blind Method