Randomized control trial of benzydamine HCl versus sodium bicarbonate for prophylaxis of concurrent chemoradiation-induced oral mucositis

Chitapanarux, Imjai; Tungkasamit, Tharatorn; Petsuksiri, Janjira; Kannarunimit, Danita; Katanyoo, Kanyarat; Chakkabat, Chakkapong; Setakornnukul, Jiraporn; Wongsrita, Somying; Jirawatwarakul, Naruemon; Lertbusayanukul, Chawalit; Sripan, Patumrat; Traisathit, Patrinee

doi:10.1007/s00520-017-3904-4

Cited by 41 publications

(30 citation statements)

References 25 publications

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“…They found no statistically significant difference between the groups receiving CRT. The second study [12] did not find a statistically significant difference between the groups. Only one study [12] recorded adverse events (AEs) and found that 6.75% of participants in the BHM group were unable to tolerate the full strength of BHM due to a burning sensation in the mouth.…”

Section: Synthesis Of Resultsmentioning

confidence: 78%

“…Secondary outcome measures Three studies measured treatment interruptions; one study [10] found statistically significantly fewer treatment interruptions in the BHM group receiving RT alone but not in the group receiving chemoradiotherapy (CRT). One study [11] found fewer treatment interruptions but did not calculate statistical significance, and one study [12] found no statistically significant difference between the groups. Two studies measured the number of participants who required feeding tubes fitted.…”

Section: Synthesis Of Resultsmentioning

confidence: 99%

“…One study [11] measured the mean OM grade and found a statistically significant reduction in the BHM group in weeks 4 to 7 of RT. One study [12] measured the median OM and found a statistically significant reduction in the BHM group. The same study measured the mean maximum OM grade and found a lower OM grade in the BHM group; the statistical significance was not calculated.…”

Section: Synthesis Of Resultsmentioning

confidence: 99%

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A systematic review of interventions to mitigate radiotherapy-induced oral mucositis in head and neck cancer patients

Davy¹,

Heathcote²

2020

Support Care Cancer

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Background Oral mucositis is a debilitating consequence of radiotherapy in patients with head and neck cancers. Radiationinduced oral mucositis (RIOM) can cause pain and weight loss, reduce quality of life and affect treatment outcomes. Methods A systematic review was undertaken to identify and examine the efficacy of low-cost interventions to mitigate RIOM and to develop clinical guidelines based on the evidence. Results The author identified three interventions: benzydamine hydrochloride mouth rinse (BHM), honey and oral glutamine (OG). The search identified twenty-four studies in total. Four studies examined BHM; all findings were favourable, although only one had moderate methodological quality, and the rest were low. The product was poorly tolerated by some participants in one study. Twelve studies examined honey. Eleven of these had favourable results; two studies had moderate methodological quality, and the rest were low. Eight studies examined OG. Six of these had favourable results; two studies had moderate methodological quality, and the rest were low. Conclusion The author cannot recommend BHM to mitigate RIOM due to the overall low quality of the studies and poor tolerance to the product. The author cannot recommend honey to mitigate RIOM due to weak evidence supporting the intervention. The author can recommend OG to mitigate RIOM. There is a need for high-quality studies with a consensus of the methodology to reduce heterogeneity and examination of the cost-effectiveness of the interventions.

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Section: Synthesis Of Resultsmentioning

confidence: 78%

Section: Synthesis Of Resultsmentioning

confidence: 99%

Section: Synthesis Of Resultsmentioning

confidence: 99%

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A systematic review of interventions to mitigate radiotherapy-induced oral mucositis in head and neck cancer patients

Davy¹,

Heathcote²

2020

Support Care Cancer

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“…242 The NSAID benzydamine also has some data supporting its use in an oral rinse for the prevention and treatment of mucositis. 249,250 Local anesthetics (eg, lidocaine) may be used to treat mucositis either as component of a mouth rinse or separately, in a liquid or gel formulation.…”

Section: Management Of Bone Pain Without An Oncologic Emergencymentioning

confidence: 99%

Adult Cancer Pain, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology

Swarm

Paice

Anghelescu

et al. 2019

Journal of the National Comprehensive Cancer Network

410

282

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In recent years, the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Adult Cancer Pain have undergone substantial revisions focusing on the appropriate and safe prescription of opioid analgesics, optimization of nonopioid analgesics and adjuvant medications, and integration of nonpharmacologic methods of cancer pain management. This selection highlights some of these changes, covering topics on management of adult cancer pain including pharmacologic interventions, nonpharmacologic interventions, and treatment of specific cancer pain syndromes. The complete version of the NCCN Guidelines for Adult Cancer Pain addresses additional aspects of this topic, including pathophysiologic classification of cancer pain syndromes, comprehensive pain assessment, management of pain crisis, ongoing care for cancer pain, pain in cancer survivors, and specialty consultations.

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“…It is capable of local anaesthetic effects by inhibiting the release of inflammatory mediators like substance P and calcitonic generelated peptide (CGRP) from sensory nerve endings. Benzydamine mouthrinse has been trialed in multiple studies assessing its effectiveness in OM, although many studies have focused on prevention of OM rather than its effectiveness on pain control (Apaydin, Karadeniz, Ayisigi, & Bilge, 1996;Chitapanarux et al, 2018;Epstein & Stevenson-Moore, 1986;Epstein et al, 2001;Jayachandran & Balaji, 2012;Samaranayake et al, 1988). Benzydamine reduced pain severity in radiotherapy patients during the early stages of cancer treatment (Kim et al, 1986).…”

Section: Discussionmentioning

confidence: 99%

World Workshop on Oral Medicine VII: Non‐opioid pain management of head and neck chemo/radiation‐induced mucositis: A systematic review

et al. 2019

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Objective To evaluate the current evidence regarding the effectiveness of non‐opioid interventions for the therapeutic management of pain in head and neck cancer patients with oral mucositis resulting from radiotherapy only or chemoradiotherapy. Materials and Methods A literature search was conducted which included randomised controlled trials that assessed patient‐related outcome of pain in patients with oral mucositis associated with radiation therapy only or chemoradiotherapy. Literature searches were conducted in MEDLINE via Pubmed, Embase, Scopus and CINAHL. Results The electronic searches identified 846 articles. Screening revealed that six articles met all eligibility inclusion criteria. Interventions showing statistically significant benefits to reduce oral mucositis associated pain compared to placebo included doxepin (p < 0.001, 95% CI −6.7 to −2.1), amitriptyline (p = 0.04), diclofenac (p < 0.01) and benzydamine (p = 0.014). Conclusions Non‐opioid interventions, including topical doxepin, amitriptyline, diclofenac and benzydamine, were found to provide relief of pain due to mucositis, and when effective may allow for reduction in the use of opioids in pain management.

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Randomized control trial of benzydamine HCl versus sodium bicarbonate for prophylaxis of concurrent chemoradiation-induced oral mucositis

Cited by 41 publications

References 25 publications

A systematic review of interventions to mitigate radiotherapy-induced oral mucositis in head and neck cancer patients

A systematic review of interventions to mitigate radiotherapy-induced oral mucositis in head and neck cancer patients

Adult Cancer Pain, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology

World Workshop on Oral Medicine VII: Non‐opioid pain management of head and neck chemo/radiation‐induced mucositis: A systematic review

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