Abstract
Objective:to evaluate the effect of oral cryotherapy compared to physiological serum on the development of oral mucositis in outpatient cancer patients using the 5-fluorouracil antineoplastic agent.Method:this is a controlled, randomized, double-blind, and multi-center clinical trial, conducted with 60 patients undergoing chemotherapy. The experimental group (n=30) used oral cryotherapy during the infusion of the 5-FU antineoplastic agent, while the control group (n=30) performed mouthwash with physiological serum at their homes. The oral cavity of the participants was assessed at three times: before randomization, and on the 7th and 14th days after using 5-FU. For data analysis, descriptive analyses and the ANOVA, paired t, and McNemar tests were used.Results:there was no statistically significant difference between the experimental and control groups in the assessments regarding the grade of mucositis. However, cryotherapy presented the chance to reduce the presence of intragroup mucositis, between the first and second assessments (p=0.000126).Conclusion:cryotherapy did not obtain statistical significance in relation to oral hygiene with serum, but it proved to be effective intragroup. Record number: RBR-4k7zh3
Highlights
Oral Mucositis (OM) is a complex biological process
Patients undergoing treatment with 5-FU who had any of the following criteria were excluded from the study: radiotherapy treatment in the head and neck region, smoking and alcoholism habits, history of tooth sensitivity, use of oxaliplatin chemotherapy concomitant with the use of 5-FU, since cryotherapy tends to aggravate the neurotoxicity caused by this chemotherapy
Both the patients in the control group (CG) and in the experimental group” (EG) did not have a regular habit of using mouthwash, the same occurring with respect to regular visit to the dentist in the vast majority of the sample of patients in the CG (76.6%) and in the EG (70.0%) (Table 1)
Summary
Oral Mucositis (OM) is a complex biological process. The pathogenesis of OM comprises a sequence of biological events possibly influenced by the oral microbiome and by the environment, leading to the positive regulation of pro-inflammatory cytokines, resulting in the thinning of the epithelium through tissue damage and cell death[1].People receiving chemotherapy for cancer are at risk of developing mucositis as a side effect[2], which can occur in 20% to 40% of the patients undergoing conventional chemotherapy regimens[3].Among the antineoplastic agents that cause these changes in the oral mucosa is 5-fluorouracil (5-FU)(4). 5-FU is a drug used in the treatment of solid cancers, such as those of the gastrointestinal tract and breast, and has a short half-life[5].OM is a side effect that causes several changes in the patient, such as pain, difficulty in eating, risk of infection and bleeding, and distress, in addition to causing an increase in the treatment cost, both for the patient and for the health system, since it needs medications to control pain and infections and often requires hospitalization for enteral support[1,2,3,4,5,6].Oral cryotherapy is characterized by the application of ice in the oral cavity or by mouth rinsing with iced water before, during, and after the administration of the chemotherapy drugs[7]. People receiving chemotherapy for cancer are at risk of developing mucositis as a side effect[2], which can occur in 20% to 40% of the patients undergoing conventional chemotherapy regimens[3]. OM is a side effect that causes several changes in the patient, such as pain, difficulty in eating, risk of infection and bleeding, and distress, in addition to causing an increase in the treatment cost, both for the patient and for the health system, since it needs medications to control pain and infections and often requires hospitalization for enteral support[1,2,3,4,5,6]. The use of cryotherapy is based on the assumption that ice-induced vasoconstriction will reduce blood flow in the oral mucosa, resulting in lower local concentrations of the chemotherapeutic agents, reducing the chance of OM[1]
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