Clinical Evaluation of Universal Efficacy of Mouthwashes in Alleviating Pain and Xerostomia Among Nasopharyngeal Carcinoma Patients: A Prospective Cohort

Abstract

Abstract Purpose This Prospective study was designed to evaluate the overall efficacy of Mouthwashes in Oral mucositis (OM) related pain and xerostomia in nasopharyngeal carcinoma (NPC) patients undergoing concurrent chemoradiotherapy (CCRT) throughout the course of treatment. Methods A prospective longitudinal cohort study enrolled 79 NPC patients receiving CCRT. Patients were interviewed prospectively three times over for pain and xerostomia scores based on the various mouthwashes being used. The highest cumulative score difference was utilised to determine mouthwash superiority. Results Fifty-nine participants completed three interviews, during which a total of 490 instances of mouthwash use were observed throughout the treatment period. The median total pain score reduction for Lignocaine mouthwash (112 observations) was 2 (IQR, 3), with a cumulative pain score reduction of 206. For Magic Mouthwash (12 observations), the median total pain score reduction was 1.5 (IQR, 1), with a cumulative pain score reduction of 18. The pain score reduction of these 2 mouthwashes was significantly higher than Benzydamine, Aspirin, Sodium bicarbonate (NaHCO3), and Oral7®. There was no significant difference between the studied mouthwashes in their treatment of xerostomia. Conclusions The preferred universal choice for managing OM related pain throughout the entire chemoradiotherapy treatment process for NPC is Lignocaine mouthwash. Magic Mouthwash can be considered as a secondary option or as an additional choice to address OM pain. Combinations of mixed medications, including a local anesthetic, anti-inflammatory, or antihistamine, are suggestive of being effective. There is insufficient evidence to determine the preferred mouthwash for treating OM related xerostomia.