SUCRALFATE MOUTH WASHING IN THE PREVENTION OF RADIATION-INDUCED MUCOSITIS - A PLACEBO-CONTROLLED DOUBLE-BLIND RANDOMIZED STUDY

Purpose: To evaluate the value of sucralfate mouth washings in prevent ion of radiation-induced mucositis. Methods and Materials: Forty patie nts with head and neck cancer were randomized to use either sucralfate mouth washing 1 g six times daily during irradiation (n = 20) or to p lacebo washing (n = 20). Mouth washing was started at the beginning of radiation therapy and continued to the end of the therapy (7-10 weeks ). Assessment of the degree of radiation mucositis and collection of s timulated saliva samples were done weekly during the therapy. Salivary lactoferrin and albumin, suggested markers for the degree of mucositi s, were analyzed from stimulated whole saliva samples. Results: All pa tients developed radiation-induced mucositis of varying degree after i rradiation of about 30 Gy. No difference in the visually assessed degr ee of mucositis or oral pain reported by the patients was found betwee n the study and the control groups. However, the patients treated with sucralfate used less anesthetic mouth washing and their salivary lact oferrin and albumin levels were lower. Conclusion: Although the trial produced no direct clinical evidence indicating that sucralfate mouth rinses prevent radiation-induced mucositis, the decrease in the saliva ry lactoferrin and albumin levels suggests that sucralfate has a sligh t protective effect on the oral mucosa.