Effect of Oral Cooling on Bolus 5-FUFA Induced Mucositis in Cancer Patients

Chemotherapy-induced mucositis affects over one third of patients receiving standard dose chemotherapy which may result in pain, dysphagia and risk of infection.

To evaluate the effect of oral cooling using ice-rolls on chemotherapy-induced mucositis in patients administered bolus 5-FUFA.

Study was conducted in BRAIRCH, AIIMS, New Delhi with Randomized controlled trial design.

Fifty three cancer patients receiving 5-FUFA, weekly (31) and daily (22) were randomized into control and experimental groups. Twenty seven patients in experimental group were given icerolls for sucking during the chemotherapy-administration. Assessment of mucositis was done using WHO Oral Toxicity Scale and Patient-judged Mucositis Grading.

Descriptive statistics, independent sample t-test, chi-square and Fisher's exact tests were used.

Incidence of mucositis significantly reduced in experimental group at week one (p= 0.001*), week two (p=0.014*) and week three (p=0.050*). In experimental group, none of patient developed moderate to high grade mucositis whereas in control group 5, 4 and 4 patients developed it at week one, two and three respectively. Patients receiving oral cooling had significantly (p= 0.018*) delayed onset (10.28±3.8 days) in comparison to control group (6.1±3.5 days). Duration of mucositis also reduced significantly (p=0.014*) in oral cooling group (6.1± 4.1 days) as compared to control group (12.5± 5.9 days).

Oral cooling reduced the incidence and duration whereas increased the day of onset of chemotherapy-induced mucositis. These findings strongly recommend the need for routine oral cooling during bolus 5-FUFA administration.