Therapeutic aspects of gallbladder cancer

Abstract

Prospective study of pancreatic cancer patients undergoing neoadjuvant or palliative therapy with FOLFIRINOX (5 fluorouracil, oxaliplatin, irinotecan) and colorectal cancer patients under FOLFOX (5 fluorouracil, oxaliplatin) or FOLFIRI (5 fluorouracil, irinotecan) who developed OM grade 2 or 2-3 with the previous cycle. We used the same combination with a higher dose of Prednisolone and Nystatin before considering any CM dose reduction (DR). It consisted of 100 mL of water combined with 30 mg of soluble prednisolone, 6 drops of nystatin and 2.300 mg of salt (1 teaspoon). Patients were educated clearly on how to use it. Primary end-point was the incidence of OM grade 2-3 with the following cycle and secondary end-points were rate of CM DR and the incidence of OM grade 0, 1 and 2 with the next cycle. Results: Thirty-five patients were included. 21 had developed OM grade 2-3 with prior cycle and 14 grade 2. After using this mouthwash, no cases developed grade 2-3 OM and none needed a DR due to OM. Ten patients developed OM grade 2 which recovered quickly to grade 1. Sixteen patients grade 1 OM and the rest no OM (grade 0). Conclusion:This study shows a significant reduction in the rate of OM grade 2-3 in patients using this mixture as mouthwash. Although further evaluation is needed to confirm its final benefits we use this as standard in our institution.