An observational, single-center study that compared MuGard, Caphosol, and Episil in patients with OM after chemoradiotherapy for HNC found no evidence that any of the mucosal coating agents had clinical benefit.35 Mucotrol is an oral gel wafer. In the only published randomized, double-blind study of Mucotrol, which included 30 patients with chemoradiation-induced mucositis, the gel significantly reduced mean mucositis scores versus placebo after 7 to 10 days of treatment.36

Because of the lack of randomized controlled trials of mucosal coating agents, guidelines on OM from MASCC/ISOO and ESMO do not include these agents in their recommendations. More data are needed to determine whether these agents are effective at reducing OM symptoms.11


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Many clinics use “magic mouthwashes” that contain a vehicle, a topical anesthetic, and possibly antifungals or steroids.11 Evaluation of these preparations in clinical trials show they are generally no more effective than saline at improving OM.11

Conclusion

Oral mucositis is a potentially life-threatening complication of radiotherapy or chemotherapy. In addition to severe pain and a negative effect on quality of life, OM increases the risk of infection, hospitalizations, and therapy discontinuation. Treatment options consist primarily of oral rinses, which are relatively safe but have limited evidence for their effectiveness. A better understanding of the pathogenesis and risk factors for OM may lead to the development of novel agents that are more effective at preventing or treating the condition.

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