Ia. Adamietz et al., PROPHYLAXIS WITH POVIDONE-IODINE AGAINST INDUCTION OF ORAL MUCOSITIS BY RADIOCHEMOTHERAPY, Supportive care in cancer, 6(4), 1998, pp. 373-377
Citations number
46
Categorie Soggetti
Oncology,Rehabilitation,"Health Care Sciences & Services
Oral mucositis is a frequent complication of radiochemotherapy. The or
igin of radiation-induced mucosal lesions is iatrogenic in nature, alt
hough further development of mucositis is essentially influenced by in
fection. It can be assumed that disinfection measures should decrease
the severity of mucositis induced by radiochemotherapy, Therefore, in
a prospective randomised study the efficacy of prophylactic oral rinsi
ng with a disinfection agent was investigated. A randomised, prospecti
ve comparative trial was conducted with 40 patients undergoing radioch
emotherapy of the head and neck region because of malignant disease. T
he treatment scheme consisted of irradiation to the tumour region and
adjacent lymph nodes, with a total dose of 71.3 Gy, and simultaneous c
hemotherapy with carboplatin (60 mg/m(2)) on days 1-5 and 29-34. In al
l patients mucositis prophylaxis with nystatin, rutosides, panthenol a
nd immunoglobulin was undertaken. In addition, 20 patients rinsed the
oral cavity 4 times daily with povidone-iodine solution, while the gro
up for comparison rinsed with sterile water, Clinical examination of t
he oral mucosa was performed weekly, Onset, grading and duration of mu
cositis were used as the main variables. Clinically manifest oral muco
sitis was observed in 14 patients in the iodine group (mean grading: 1
.0) and in all 20 patients in the control group (mean grading: 3,0), T
he total duration (mean) of clinically observed mucositis was 2.75 wee
ks in treatment patients and 9.25 weeks in control patients. Median AU
C (area under curve for grade vs duration) was 2.5 in the iodine rinsi
ng patients and 15.75 in control patients. All differences found betwe
en the two groups were statistically significant, Increased iodine inc
orporation was not observed. A pathologic rise in thyroid hormone leve
ls was not found in the iodine group. The results obtained indicate th
at in and duration of radiochemotherapy-induced mucositis can be signi
ficantly reduced by oral rinsing with povidone-iodine in addition to t
he standard prophylaxis scheme, It can be concluded that rinsing with
povidone-iodine is an easy, cheap and safe prophylactic method and can
be recommended as a supportive treatment during antineoplastic treatm
ent of the head and neck region.