A comparison of dioctahedral smectite and iodine glycerin cream with topical mouth rinse in treatment of chemotherapy induced oral mucositis: a pilot study

Eur J Oncol Nurs. 2015 Apr;19(2):136-41. doi: 10.1016/j.ejon.2014.10.006. Epub 2014 Nov 18.

Abstract

Purpose of the research: To compare the efficacy of dioctahedral smectite and iodine glycerin (DSIG) cream with topical mouth rinse (composed of saline, gentamicin and Vitamin B12) in treatment of chemotherapy induced oral mucositis (OM).

Methods and sample: A total of 130 intensive chemotherapy or stem cells transplantation induced OM patients were recruited. Among these patients, 67 patients received topical mouth rinse and 63 patients received DSIG cream treatment. The OM would be treated on the OM appearance and sustained for 5 days. OM severity was measured daily using The American Oncology Nursing Society recommended Oral Assessment Guideline (OAG) score system.

Key results: Compared with topical mouth rinse treatment, a significant lower OAG score was observed in DSIG cream treated patients. Specifically, the OAG scores were respectively 12.1 ± 1.1, 12.0 ± 1.2, 11.3 ± 1.3 and 10.4 ± 1.3 from day 2 to day 5 in topical mouth rinse treatment subgroup. Correspondingly, the OAG scores were respectively 10.2 ± 1.0, 9.3 ± 0.9, 8.5 ± 0.6 and 8.0 ± 0.2 for DSIG cream treatment subset (all P < 0.05). Importantly, compared with topical mouth rinse treatment, the DSIG cream significantly shortened OM repair time (4.68 ± 0.98 vs. 8.76 ± 1.80 days, P < 0.001). After 5 days treatment, 54 patients (85.7%) obtained complete regression with an OAG score ≤8, and 7 patients (11.1%) had partial regression with an OAG score of 9-10 in DSIG cream treatment subgroup. However, only 2 patients (3.0%) obtained completed regression and 32 patients (47.8%) had partial regression in topical mouth rinse treatment cohort. Moreover, no serious side-effect was observed in both cohorts.

Conclusions: Compared with topical mouth rinse, DSIG cream significantly lowered the OAG score and shortened OM duration.

Keywords: Chemotherapy; Dioctahedral smectite and iodine glycerin mixture; Mucositis repair; Oral mucositis; Topical mouth rinse.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Administration, Topical
  • Adult
  • Aged
  • Anti-Infective Agents, Local / therapeutic use*
  • Antineoplastic Agents / adverse effects*
  • Female
  • Glycerol / therapeutic use
  • Humans
  • Iodine Compounds / therapeutic use*
  • Male
  • Middle Aged
  • Mouthwashes / therapeutic use
  • Neoplasms / drug therapy
  • Neoplasms / pathology
  • Pilot Projects
  • Silicates / therapeutic use*
  • Skin Cream
  • Solvents / therapeutic use
  • Stomatitis / chemically induced*
  • Stomatitis / drug therapy*
  • Stomatitis / pathology
  • Young Adult

Substances

  • Anti-Infective Agents, Local
  • Antineoplastic Agents
  • Iodine Compounds
  • Mouthwashes
  • Silicates
  • Solvents
  • Smectite
  • Glycerol