Prevention of radiotherapy-related oral mucositis with zinc and polyherbal mouthwash: a double-blind, randomized clinical trial

A significant percentage of head and neck cancer (HNCs) patients receiving RT experience oral mucositis (OM). This study aimed to evaluate the effect of the polyherbal (containing chamomile, peppermint oil, Aloe vera, and honey) and zinc mouthwashes in comparison to the control (chlorhexidine) and p...

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Bibliographic Details
Published in:	European journal of medical research Vol. 28; no. 1; p. 109
Main Authors:	Sahebnasagh, Marzieh, Aksi, Vahideh, Eslami, Fatemeh, Lashkardoost, Hossein, Kasaian, Jamal, Golmohammadzadeh, Shiva, Parkam, Bahareh, Negarandeh, Reza, Saghafi, Fatemeh, Sahebnasagh, Adeleh
Format:	Journal Article
Language:	English
Published:	England BioMed Central Ltd 02-03-2023 BioMed Central BMC
Subjects:	Acids Analgesics Cancer therapies Chemotherapy Chlorhexidine Clinical trials Double-blind studies Drug dosages Free radicals Head & neck cancer Head and neck cancer Health aspects Herbal medicine Humans Hygiene Ingredients Mouthwash Mouthwashes - therapeutic use Mucositis Oral hygiene Oral mucositis (stomatitis) Patients Polyherbal Potassium Prevention Product development Radiation Radiation therapy Radiotherapy RNA polymerase Stomatitis Stomatitis - drug therapy Stomatitis - etiology Stomatitis - prevention & control Sulfates Toiletries industry Tumor necrosis factor-TNF Wound healing Zinc - therapeutic use Zinc sulfate Zinc Sulfate - therapeutic use Prevention Mouthwash Oral mucositis (stomatitis) Polyherbal Head and neck cancer Zinc sulfate Radiotherapy
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Summary:	A significant percentage of head and neck cancer (HNCs) patients receiving RT experience oral mucositis (OM). This study aimed to evaluate the effect of the polyherbal (containing chamomile, peppermint oil, Aloe vera, and honey) and zinc mouthwashes in comparison to the control (chlorhexidine) and placebo groups for prevention of radiation-induced OM. This study was a double-blinded randomized clinical trial, conducted on 67 patients with HNCs undergoing radiotherapy. The eligible participants were randomized to receive either one of the following; zinc sulfate, polyherbal, chlorhexidine (Vi-one 0.2% CHX), or placebo mouthwash for 6 weeks. Follow-up evaluation of oral hygiene and the checklists of OM and the intensity of pain were filled out according to WHO assessment tool, Oral Mucositis Assessment Scale (OMAS), and Visual Analog Scale (VAS) in all the participants weekly for seven consecutive weeks. The results of present clinical trial demonstrated that the use of either zinc sulfate or polyherbal mouthwash significantly reduced the scores of OM and the severity of pain during weeks 2 to 7 after consumption compared with the CHX or placebo mouthwashes (P < 0.05). According to the post hoc analysis and compared with the placebo, a significantly better result was reported for zinc sulfate and polyherbal mouthwashes at weeks 2 to 7, but not for the CHX mouthwash. This study showed that the use of zinc sulfate or polyherbal mouthwashes is effective in prevention of both OM severity scores and pain related to OM intensity at weeks 2 to 7 following consumption in HNCs patients. Trial registration IRCT20190123042475N1 and IRCT20190123042475N2. Registration date: 2019-06-09, 2019-07-26.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	2047-783X 0949-2321 2047-783X
DOI:	10.1186/s40001-023-01015-8