Journal of Clinical Oncology, Vol 12, 2630-2633, Copyright © 1994 by American Society of Clinical Oncology

ARTICLES

Randomized trial of a chlorhexidine mouthwash for alleviation of radiation-induced mucositis

RL Foote, CL Loprinzi, AR Frank, JR O'Fallon, S Gulavita, HH Tewfik, MA Ryan, JM Earle and P Novotny
Mayo Clinic, Rochester, MN 55905.

PURPOSE: To determine whether a chlorhexidine mouthwash could alleviate radiation-induced oral mucositis. PATIENTS AND METHODS: Patients scheduled to receive radiation therapy to include greater than one third of the oral cavity mucosa were selected for study. Following stratification, they were randomized in a double-blind manner to receive a chlorhexidine mouthwash or a placebo mouthwash. Both groups were then similarly evaluated for mucositis and mouthwash toxicity. RESULTS: Twenty-five patients were randomized to receive the chlorhexidine mouthwash, while 27 received the placebo mouthwash. Treatment arms were well balanced. There was a trend for more mucositis and there was substantially more toxicity (eg, mouthwash-induced discomfort, taste alteration, and teeth staining) on the chlorhexidine arm. CONCLUSION: In contrast to the prestudy hypothesis that a chlorhexidine mouthwash might provide benefit for patients receiving radiation therapy to the oral mucosa, this study provides strong evidence suggesting that a chlorhexidine mouthwash is detrimental in this clinical situation.
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