The use of MuGard™, Caphosol^®and Episil^®in patients undergoing chemoradiotherapy for squamous cell carcinoma of the head and neck

Abstract

Introduction: Oral mucositis is common for patients undergoing chemoradiotherapy for squamous cell carcinoma of the head and neck (SCCHN). Despite the significant detrimental sequelae associated, there is no consensus on the optimum mouth care regimen. This prospective audit aims to record mucositis and dysphagia toxicity and the level of analgesia prescribed when recent products: MuGard TM , Caphosol R and Episil R are compared with our standard departmental mouth care regimen.Methods: Patients undergoing concurrent chemoradiotherapy for locally advanced SCCHN at University Hospital Birmingham, UK were prospectively audited weekly for 8 consecutive weeks starting from week 1 of chemoradiotherapy from June 2009 until January 2011. Patients received either standard oral care regimen of aspirin, glycerin and sucralfate, or, MuGard TM , Caphosol R or Episil R . Grade of mucositis, dysphagia and analgesia score were prospectively recorded using the common toxicity criteria v3?0.Results: One hundred and four patients were included. There was no difference in the grade and duration of mucositis (p 5 0?82), dysphagia (p 5 0?99) or analgesia score (p 5 0?61) for either MuGard TM , Caphosol R or Episil R compared with standard oral care.Conclusion: There is no evidence from this audit that Mugard TM , Caphosol R or Episil R improves mucositis and dysphagia toxicity or the level of analgesia prescribed compared with our standard departmental mouth care regimen. Randomised trials comparing these approaches are required to detect any meaningful clinical benefit.

Low-Dose vs. High-Dose Cisplatin: Lessons Learned From 59 Chemoradiotherapy Trials in Head and Neck Cancer

“…In the definitive setting, the difference was indisputable (88 vs. 71%, p = 0.0017), being backed up by a higher number of enrolled trials. In contrast, in the meta-analysis of altered fractionation it was the high-dose protocol reaching better adherence ( p = 0.0353), which might be a consequence of the specific kinetic pattern of severe acute adverse events usually peaking at 4–5 weeks after chemoradiotherapy initiation, that is when two cycles of three-weekly cisplatin have already be delivered (31, 32).…”

Elimination of unplanned treatment breaks and dose reductions caused by mucositis: Positive implications for survival outcomes and cost reductions using high potency polymerized cross-linked sucralfate in 55 patients undergoing radiation for head and neck cancer with and without chemotherapy

“…FDA approved oral rinses with similar effects in lessening the discomfort of mucositis but do not address the process of mucositis directly [57]. Glycerin carbomer homopolymer A (MuGard) was FDA approved for oral mucositis in the US in 2006, followed by market approval in Korea in 2015.…”

The use of MuGard™, Caphosol®, and episil® in patients undergoing chemoradiotherapy for squamous cell carcinoma of the head and neck

“…Interestingly, the authors concluded by emphasising the importance of rigorous clinical and financial evaluations before introduction into clinical practice. 1 It is assumed that this statement also pertained to the standard departmental care regimen.…”

“…In addition, it is unclear from the article if standard departmental care used in the study also included second line GelClair ® , which would raise additional questions to the comparison and the effect of the standard departmental care regimen. Interestingly, the authors concluded by emphasising the importance of rigorous clinical and financial evaluations before introduction into clinical practice 1 . It is assumed that this statement also pertained to the standard departmental care regimen.…”

“…Dear Professor Duxbury, We have read with interest the prospective audit trial of episil R , Caphosol R and Mugard TM by Pettit and colleagues that was published as a FirstView article in the Journal of Radiotherapy in Practice 1 and have the following comments.…”