Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Randomized Controlled Trial
. 2023 Jul 1;24(7):2445-2454.
doi: 10.31557/APJCP.2023.24.7.2445.

Prophylaxis of Oral Mucositis with Iodine Solution during Concurrent Chemoradiation of Head and Neck Cancer: Preliminary Results of a Double-Blind, Randomized Controlled Trial

Yotdanai Namuangchan  1 , Ornpapa Chailertwanich  2 , Sirinun Susinsamphan  1 , Narudom Supakalin  1 , Chunsri Supaadirek  1 , Srichai Krusun  1 , Montien Pesee  1 , Komsan Thamronganantasakul  1
Affiliations
Randomized Controlled Trial

Prophylaxis of Oral Mucositis with Iodine Solution during Concurrent Chemoradiation of Head and Neck Cancer: Preliminary Results of a Double-Blind, Randomized Controlled Trial

Yotdanai Namuangchan et al. Asian Pac J Cancer Prev. .

Abstract

Objective: This study aims to evaluate the clinical efficacy of an in-house iodine solution (IS) mouthwash for the prophylaxis of concurrent chemoradiation (CCRT) induced oral mucositis (OM) in head & neck cancer (HNC) patients.

Methods: This prospective, double-blind, randomized controlled trial was conducted on 20 HNC patients, being treated with definite or postoperative CCRT, at the Division of Radiation Oncology, Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. The patients were randomly assigned (1:1) to the treatment group or the control group. Patients in the treatment group gargled IS three times daily after meals, while patients in the control group gargled normal saline solutions (NSS). Assessment of OM was performed before starting CCRT, once a week during CCRT, and 4 weeks after CCRT was completed. The primary outcome was Oral Mucositis Assessment Scale (OMAS).

Results: The mean weekly OMAS, pain score, and impact on swallowing score were not statistically significant in patients who rinsed with IS mouthwash compared to those who received NSS (p > 0.999 in every week). There was no difference in the mean onset to OM (all grades) (p = 0.704), and the mean duration of OM (all grades) (p = 0.365). Severe OM (WHO grade 3-4) occurred in three patients [IS=2, NSS=1] with the median onset of 45.50 & 33.00 days (p = NA), and the duration of 8.00 & 57.00 days (p = NA) in the IS and NSS groups, respectively. Oral candidiasis occurred in one patient from the NSS group while no secondary infection of oral mucosa was observed in the patients receiving IS mouthwash.

Conclusion: The study could not reach statistically significance to show that IS mouthwash was effective in of prevention CCRT-induced OM. Further study with a larger number of participants is encouraged.

Keywords: Oral Mucositis; Prophylaxis; chemoradiotherapy; head and neck cancer; povidone-iodine.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest in this study.

Figures

Figure 1
Figure 1
CONSORT Flow Chart of Participants in This Study
Figure 2
Figure 2
Mean Weekly OMAS Score
Figure 3
Figure 3
Mean Weekly Pain Score
Figure 4
Figure 4
Mean Weekly Impact on Swallowing Score
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Antunes HS, Herchenhorn D, Small IA, et al. Phase III trial of low-level laser therapy to prevent oral mucositis in head and neck cancer patients treated with concurrent chemoradiation. Radiother Oncol. 2013;109:297–302. - PubMed
    1. Ariyawardana A, Cheng KKF, Kandwal A, et al. Systematic review of anti-inflammatory agents for the management of oral mucositis in cancer patients and clinical practice guidelines. Support Care Cancer. 2019;27:3985–95. - PubMed
    1. Bahl A, Oinam AS, Kaur S, et al. Evaluation of Acute Toxicity and Early Clinical Outcome in Head and Neck Cancers Treated With Conventional Radiotherapy and Simultaneous Integrated Boost Arc Radiotherapy. World J Oncol. 2017;8:117–21. - PMC - PubMed
    1. Beukelman CJ, van den Berg AJ, Hoekstra MJ, et al. Anti-inflammatory properties of a liposomal hydrogel with povidone-iodine (Repithel) for wound healing in vitro. Burns. 2008;34:845–55. - PubMed
    1. Beumer J, Curtis T, Harrison RE. Radiation therapy of the oral cavity: sequelae and management, part 1. Head Neck Surg. 1979a;1:301–12. - PubMed

Publication types