Efficacy of oral and topical antioxidants in the prevention and management of oral mucositis in head and neck cancer patients: a systematic review and meta-analyses

Raza, Afsheen; Karimyan, Nelli; Watters, Amber L.; Emperumal, Chitra Priya; Al‐Eryani, Kamal; Enciso, Reyes

doi:10.1007/s00520-022-07190-4

Cited by 12 publications

(11 citation statements)

References 62 publications

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“…Previous reports of Episil ® and OM have focused on pain, feeding function, and nutritional status. Even in several systematic reviews of OM, there is no literature discussing speech function [21][22][23].…”

Section: Discussion Of the Effects Of Episil ® And Oral Functionmentioning

confidence: 99%

Comparative study before and after the use of Episil ® oral liquid in patients with hematological malignancies

Fukutani,

Yoshioka,

Imori

et al. 2023

Preprint

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Background. Episil® is a non-absorbable liquid medical material used to cover and protect oral lesions, particularly those caused by mucositis associated with chemotherapy and radiation therapy. While there are some scattered reports on its use in head and neck cancer, there have been few studies in other malignancies. Methods. In this study, 38 patients with hematologic malignancies treated for oral mucositis (OM) with Episil® at the Hiroshima Red Cross & Atomic-bomb Survivors Hospital were included; the degree of OM before and after use was examined. Of these 23 patients were interviewed about the effects of OM on pain, conversation, and eating, using our original evaluation protocol, and the results were compared. Results. The severity of mucositis decreased after the use of Episil® in eight patients (21%), particularly in those with mucositis at multiple sites. Patient evaluations showed significant pain relief and improvements in speech and feeding functions. Patients with Grade 3 mucositis had higher ratings for improvement in pain relief, speech, and eating functions than those with Grade 2. Conclusions. Episil® performed well in patients with hematologic malignancies and was particularly effective in multiple mucositis. In addition to pain relief, Episil has been suggested to improve speech and feeding functions effectively.

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Section: Discussion Of the Effects Of Episil ® And Oral Functionmentioning

confidence: 99%

Comparative study before and after the use of Episil ® oral liquid in patients with hematological malignancies

Fukutani,

Yoshioka,

Imori

et al. 2023

Preprint

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“…Improved treatment outcomes are discussed, including the use of dietary changes, 11 hyperbaric oxygen therapy 12 and antioxidative drugs. 13 According to these findings, reducing the harmful effects of oxidative stress on facial neurons may be an effective treatment of chronic orofacial pain.…”

Section: Introductionmentioning

confidence: 99%

“…19 Rats' pain thresholds were upregulated along with a substantial increase in bilirubin in both their cerebrospinal fluid and serum. 20 In dental clinics, zinc is consistently and frequently used as an analgesic, 11 and anecdotal placebo-controlled studies using tocopherol revealed short-term pain alleviation, 21 the results listed above imply that enzymatic antioxidants and non-enzymatic antioxidants are involved in the mechanism of chronic pain and can be exploited as possible therapeutic targets; however, further clinical validation is required because the majority of research is done using animal models.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, antioxidant treatment has recently been shown to have new applications in the prevention and management of chronic orofacial pain patients. Improved treatment outcomes are discussed, including the use of dietary changes, 11 hyperbaric oxygen therapy 12 and antioxidative drugs 13 . According to these findings, reducing the harmful effects of oxidative stress on facial neurons may be an effective treatment of chronic orofacial pain.…”

Section: Introductionmentioning

confidence: 99%

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Association between oxidative stress and chronic orofacial pain and potential druggable targets: Evidence from a Mendelian randomization study

Zhang,

Feng,

Zhong

et al. 2024

J of Oral Rehabilitation

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BackgroundOxidative stress indicators affect chronic orofacial pain (COFP), but how to reduce these effects is uncertain.Objectives11 oxidative stress biomarkers were collected as exposures, while four forms of COFP were chosen as outcomes for Mendelian randomization (MR) study.MethodsThe effect estimates between oxidative stress and COFP were calculated using inverse variance‐weighted MR (IVW‐MR). Then, functional mapping and annotation (FUMA) was utilized in order to carry out SNP‐based functional enrichment analyses. In addition, the IVW‐MR method was applied to combine effect estimates when using genetic variants associated with oxidative stress biomarkers as an instrument for exploring potential druggable targets.ResultsThe results indicated that oxidative stress biomarkers (causal OR of uric acid (UA), 0.998 for myofascial pain, 95% CI 0.996–1.000, p < .05; and OR of glutathione transferase (GST), 1.002 for dentoalveolar pain, 95% CI 1.000–1.003, p < .05) were significantly linked with the probability of COFP. Functional analysis also demonstrated that UA and myofascial pain genes were prominent in nitrogen and uracil metabolism, while GST and dentoalveolar pain genes were enriched in glutathione metabolism. Also, the study provided evidence that solute carrier family 2 member 9 (SLC2A9) and glutathione S‐transferase alpha 2 (GSTA2) cause discomfort in the myofascial pain (OR = 1.003, 95% CI 1.000–1.006; p < .05) and dentoalveolar region (OR = 1.001, 95% CI 1.000–1.002; p < .05), respectively.ConclusionsIn conclusion, this MR study indicates that genetically predicted myofascial pain was significantly associated with decreased UA and dentoalveolar pain was significantly associated with increased GST level. SLC2A9 inhibitor and GSTA2 inhibitor were novel chronic orofacial pain therapies and biomarkers, but clinical trials are called to examine if these oxidative biomarkers have the protective effect against orofacial pain, and further research are needed to explore the underlying mechanisms.

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“…The benefit for supportive treatment of OM is e.g. proven for natural products [ 9 ] such as honey [ 10 , 11 ], curcumin [ 12 ], aloe vera [ 13 ], propolis [ 14 , 15 ] and chamomile [ 16 ]. In contrast, the use of highly effective but cytotoxic antiseptics such as chlorhexidine digluconate (CHG), which is considered the gold standard for mouth antisepsis, proved to be contraindicated.…”

Section: Introductionmentioning

confidence: 99%

Antiseptic efficacy of two mouth rinses in the oral cavity to identify a suitable rinsing solution in radiation- or chemotherapy induced mucositis

et al. 2023

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Objectives Oral mucositis caused by intensive cancer chemotherapy or radiotherapy frequently results in pronounced damage of the oral mucosa leading to painful oral hygiene. To support oral care, antimicrobial effective mouth rinses may be used. Thus, the efficacy of a hypochlorite-based mouth rinse (Granudacyn®), assumed to be highly biocompatible because of the compounds being part of the natural pathogen defense, as possible antiseptic agent in case of oral mucositis was compared to that of an octenidine based antiseptic mouth rinse (Octenidol® md). Materials and methods The study was conducted as monocentric, controlled, randomized, blind cross over comparative study on 20 volunteers. As a proof of principle, we performed the study on orally healthy subjects and not cancer patients. The efficacy was determined as reduction of colony forming units (cfu) on buccal mucosa as well as in saliva. After mouth rinsing for 30 s, samples were taken after 1 min, 15 min, 30 and 60 min. The lg-reduction was calculated as difference between lg-values of cfu pre- and post-treatment. Results Both antiseptic mouth rinses induced a significant reduction of cfu on buccal mucosa and in saliva 1 min after mouth rinsing. The effect persisted up to 60 min. The octenidine based rinse was significantly superior to the hypochlorite-based rinse up to the last sample 60 min after rinsing. However, the known cytotoxicity of octenidine argues against its application. Conclusion Within the limits of this study, due to its antiseptic efficacy, the hypochlorite-based rinse Granudacyn® can be regarded appropriate to support the oral hygiene in patients with a sensitive oral mucosa during an aggressive cancer chemotherapy and radiation treatment in case of oral mucositis.

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Efficacy of oral and topical antioxidants in the prevention and management of oral mucositis in head and neck cancer patients: a systematic review and meta-analyses

Cited by 12 publications

References 62 publications

Comparative study before and after the use of Episil ® oral liquid in patients with hematological malignancies

Comparative study before and after the use of Episil ® oral liquid in patients with hematological malignancies

Association between oxidative stress and chronic orofacial pain and potential druggable targets: Evidence from a Mendelian randomization study

Antiseptic efficacy of two mouth rinses in the oral cavity to identify a suitable rinsing solution in radiation- or chemotherapy induced mucositis

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