The role of benzydamine in prevention and treatment of chemoradiotherapy-induced mucositis.

Abstract

PURPOSE:

To discuss the role of benzydamine in the prevention and treatment of radiation-induced oral mucositis (OM) in head and neck (H&N) cancer patients. This document represents an expert opinion paper on indications and key-role aspects in OM pathogenesis, prevention and treatment.

ORAL MUCOSITIS:

OM represents a common side effect of chemotherapy (CHT) and radiotherapy (RT). It consists in a painful erythema involving the oral cavity mucosa, which may progress to ulceration. Five biologically dynamic phases are considered crucial in mucositis: "initiation, signalling, amplification, ulceration and healing". Oral environment and microbiota are fundamental in mucositis development being involved in susceptibility to infections and in ulceration consequences. Different agents against mucositis have been studied and the use of benzydamine is strongly supported in literature. The Multinational Association of Supportive Care in Cancer and International Society for Oral Oncology (MASCC/ISOO) guidelines recommend its use for the prevention of OM in H&N patients undergoing RT and RT/CHT.

BENZYDAMINE:

Benzydamine is a local anti-inflammatory drug with analgesic properties. It can decrease TNF-α, IL-1β and prostaglandin synthesis, also inhibiting leukocyte-endothelial interactions, neutrophil degranulation, vasodilation and vascular permeability. Literature agrees on the beneficial effects of benzydamine in preventing and reducing oral mucositis severity in H&N cancer patients undergoing RT/CHT.

CONCLUSIONS:

Mucositis represents a major concern in H&N cancer patients and a clinical and economical issue. A multimodal and multidisciplinary approach is needed for its management. International guidelines recommend benzydamine for OM prevention and treatment in H&N cancer patients, but further "real world" trials should be designed.

• Authors: Ourania Nicolatou-Galitis, Paolo Bossi, Ester Orlandi, René-Jean Bensadoun
• Journal: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (Support Care Cancer) Vol. 29 Issue 10 Pg. 5701-5709 (Oct 2021) ISSN: 1433-7339 [Electronic] Germany
• PMID: 33649918 (Publication Type: Journal Article)
• Copyright: © 2021. The Author(s).

Chemical References

• Benzydamine

Topics

• Benzydamine (therapeutic use)
• Chemoradiotherapy
• Head and Neck Neoplasms
• Humans
• Mucositis (chemically induced, prevention & control)
• Stomatitis (chemically induced, prevention & control)