Abstract 5683
Background
Oral mucositis (OM) is the most common adverse event in patients with head and neck cancer (HNC) who are treated with chemoradiotherapy (CRT). Normal saline/ or benzydamine hydrochloride oral rinse might reduce OM incidence and severity. However, the need for interruption of CRT may occurred. A phase II study of steroid solution for stomatitis prophylaxis has been reported in patients with advanced stage breast cancer who was treated with mTOR inhibitor. We aimed to assess the efficacy of dexamethasone-based mouthwash for prevention of oral mucositis (OM) in HNC patients who were receiving with CRT.
Methods
In this phase II, double-blind, placebo-controlled study, we enrolled 27 patients with HNC who were treated with CRT. Those patients were randomized (1:1) to received dexamethasone-based mouthwash (0.5 mg in 10 ml of normal saline solution) (n = 14) versus placebo plus normal saline solution (n = 13) at a day before starting in CRT schedule (rinse for 2 min and spit, four time daily for 10 weeks). The primary endpoint was incidence- and severity of OM, which focused on pain score by 10 weeks evaluated in the full analysis.
Results
There was statistically significant difference in the incidence of WHO grade 2 OM at 3 weeks after randomization (23.1% placebo group vs 0% in dexamethasone-based solution group, p-value=0.003). At 6 weeks, 84.6% of patients in placebo group developed grade 2 or higher OM, and only 7.1% in dexamethasone-based solution group (p-value <0.001). Furthermore, pain score in patient with dexamethasone-based solution group was lower than placebo group significantly at 3 weeks until complete treatment.
Conclusions
Dexamethasone-based solution mouthwash significantly reduced the incidence and severity of oral mucositis in head and neck cancer patients receiving chemoradiotherapy, and could be a new standard of care for prevention of oral mucositis from chemoradiation treatment.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Phramongkutklao College of Medicine/ Department of Medicine, Phramongkutklao Hospital.
Disclosure
All authors have declared no conflicts of interest.
Resources from the same session
3317 - Circulating tumor DNA (ctDNA) analysis in patients (pts) with non-small cell lung cancer (NSCLC) treated with telisotuzumab vedotin (teliso-v), an antibody-drug conjugate targeting c-Met
Presenter: Rebecca Heist
Session: Poster Display session 1
Resources:
Abstract
3887 - First Real Life Data on Durvalumab after definitive concomitant ChemoRadiotherapy (cCRT) in unresectable Stage (St) III Non-Small Cell Lung Cancer (NSCLC) in France: Analysis of 591 patients (pts) enrolled in the French cohort (c) Temporary Authorization of Use (ATU)
Presenter: Virginie Avrillon
Session: Poster Display session 1
Resources:
Abstract
682 - EGFR Inhibitor Versus Chemotherapy as Adjuvant Treatment for Locally-advanced EGFR-mutant Non-Small Cell Lung Cancer
Presenter: Peng Xie
Session: Poster Display session 1
Resources:
Abstract
2509 - Afatinib in EGFR TKI-naïve patients with EGFR mutation-positive (EGFRm+) NSCLC: interim analysis of a Phase IIIb, multi-national, open-label study
Presenter: Filippo de Marinis
Session: Poster Display session 1
Resources:
Abstract
3300 - First-line ceritinib versus chemotherapy in patients (pts) with advanced ALK rearranged (ALK+) non-small cell lung cancer (NSCLC): ASCEND-4 Asian subgroup analysis
Presenter: Daniel SW Tan
Session: Poster Display session 1
Resources:
Abstract
2653 - A combined analysis of two Phase IIIb studies of afatinib in EGFR TKI-naïve patients (pts) with EGFR mutation-positive (EGFRm+) NSCLC
Presenter: Filippo de Marinis
Session: Poster Display session 1
Resources:
Abstract
3663 - Impact of plasma EGFR mutation fractions on response to first generation tyrosine-kinase inhibitor in treatment of naïve non-small cell lung cancer patients
Presenter: Xiaohong Wang
Session: Poster Display session 1
Resources:
Abstract
5921 - Definition of an afatinib trough concentration threshold in the treatment of NSCLC
Presenter: Stephane Bouchet
Session: Poster Display session 1
Resources:
Abstract
2852 - A Phase Ib Trial of Neoadjuvant Chemoradiotherapy and Durvalumab(MEDI4736) for Potentially Resectable stage III Non-Small Cell Lung Cancer (NSCLC)
Presenter: Beung chul AHN
Session: Poster Display session 1
Resources:
Abstract
3273 - Low expression of Notch1 and combined Notch1/HES1 are associated with adverse survival factor for limited stage small cell lung cancer
Presenter: Jinsoo Lee
Session: Poster Display session 1
Resources:
Abstract