The effectiveness of rebamipide mouthwash therapy for radiotherapy and chemoradiotherapy-induced oral mucositis in patients with head and neck cancer: a systematic review and meta-analysis
Abstract Background Oral mucositis is a frequent and severe adverse event in patients undergoing chemoradiotherapy for head and neck cancers, especially grade 3 or 4 mucositis. Occurrence may result in drop-out from treatment, thereby reducing survival. We aimed to clarify the effectiveness and safe...
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| Format: | Article |
| Language: | English |
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BMC
2019-07-01
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| Series: | Journal of Pharmaceutical Health Care and Sciences |
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| Online Access: | http://link.springer.com/article/10.1186/s40780-019-0146-2 |
| _version_ | 1818155023217983488 |
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| author | Shinsuke Akagi Takashi Fujiwara Mai Nishida Akiko Okuda Yuka Nagao Toshikatsu Okuda Hidenori Tokuda Kazunobu Takayanagi |
| author_facet | Shinsuke Akagi Takashi Fujiwara Mai Nishida Akiko Okuda Yuka Nagao Toshikatsu Okuda Hidenori Tokuda Kazunobu Takayanagi |
| author_sort | Shinsuke Akagi |
| collection | DOAJ |
| description | Abstract Background Oral mucositis is a frequent and severe adverse event in patients undergoing chemoradiotherapy for head and neck cancers, especially grade 3 or 4 mucositis. Occurrence may result in drop-out from treatment, thereby reducing survival. We aimed to clarify the effectiveness and safety of rebamipide mouthwash for oral mucositis in patients with head and neck cancer receiving treatment. Methods We carried out a systematic review and meta-analysis of patients with head and neck cancer who were treated with rebamipide mouthwash. We searched PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL), and the World Health Organization (WHO) International Clinical Trial Registry Platform. The primary outcome was the incidence of severe oral mucositis, and secondary outcomes were time from treatment start to onset of oral mucositis, the response rate of radiotherapy, and any adverse events. Results We included three studies comparing rebamipide versus placebo, all of which evaluating chemoradiotherapy induced oral mucositis. The chemotherapeutic agent was docetaxel in one study and cisplatin in the remaining two. Radiotherapy in each study consisted of 3D-conformal radiation therapy, intensity modulated radiation therapy and conventional radiation therapy, respectively. The calculated odds ratio was 0.29 [95% confidence interval (CI): 0.15 to 0.55], showing a positive association in the three studies between the incidence of grade 3–4 oral mucositis and chemotherapy for head and neck cancer. One study reported an onset of oral mucositis and the time to onset was 14.6 ± 6.4 days for the rebamipide group and 11.2 ± 4.4 days for placebo. One study reported a complete response of 8.3% for placebo and 16.7% for the rebamipide the group, and the partial response was 91.7 and 75.0%, respectively. Adverse events were reported in two studies to be 6.1 and 11.6% for placebo, and 19.4 and 26.0% in the rebamipide group, respectively. Conclusions Rebamipide mouthwash is effective in the prevention of severe mucositis and stomatitis. However, evaluation of adverse events in observational studies are needed. |
| first_indexed | 2024-12-11T14:35:48Z |
| format | Article |
| id | doaj.art-9150284d6e7140709c4144b571068afd |
| institution | Directory Open Access Journal |
| issn | 2055-0294 |
| language | English |
| last_indexed | 2024-12-11T14:35:48Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Pharmaceutical Health Care and Sciences |
| spelling | doaj.art-9150284d6e7140709c4144b571068afd2022-12-22T01:02:12ZengBMCJournal of Pharmaceutical Health Care and Sciences2055-02942019-07-01511710.1186/s40780-019-0146-2The effectiveness of rebamipide mouthwash therapy for radiotherapy and chemoradiotherapy-induced oral mucositis in patients with head and neck cancer: a systematic review and meta-analysisShinsuke Akagi0Takashi Fujiwara1Mai Nishida2Akiko Okuda3Yuka Nagao4Toshikatsu Okuda5Hidenori Tokuda6Kazunobu Takayanagi7Department of Pharmacy, Ohara Healthcare Foundation Kurashiki Central HospitalDepartment of Otolaryngology/Head and Neck Surgery, Ohara Healthcare Foundation Kurashiki Central HospitalDepartment of Pharmacy, Ohara Healthcare Foundation Kurashiki Central HospitalDepartment of Pharmacy, Ohara Healthcare Foundation Kurashiki Central HospitalDepartment of Pharmacy, Ohara Healthcare Foundation Kurashiki Central HospitalDepartment of Pharmacy, Ohara Healthcare Foundation Kurashiki Central HospitalDepartment of Pharmacy, Ohara Healthcare Foundation Kurashiki Central HospitalDepartment of Pharmacy, Ohara Healthcare Foundation Kurashiki Central HospitalAbstract Background Oral mucositis is a frequent and severe adverse event in patients undergoing chemoradiotherapy for head and neck cancers, especially grade 3 or 4 mucositis. Occurrence may result in drop-out from treatment, thereby reducing survival. We aimed to clarify the effectiveness and safety of rebamipide mouthwash for oral mucositis in patients with head and neck cancer receiving treatment. Methods We carried out a systematic review and meta-analysis of patients with head and neck cancer who were treated with rebamipide mouthwash. We searched PubMed, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL), and the World Health Organization (WHO) International Clinical Trial Registry Platform. The primary outcome was the incidence of severe oral mucositis, and secondary outcomes were time from treatment start to onset of oral mucositis, the response rate of radiotherapy, and any adverse events. Results We included three studies comparing rebamipide versus placebo, all of which evaluating chemoradiotherapy induced oral mucositis. The chemotherapeutic agent was docetaxel in one study and cisplatin in the remaining two. Radiotherapy in each study consisted of 3D-conformal radiation therapy, intensity modulated radiation therapy and conventional radiation therapy, respectively. The calculated odds ratio was 0.29 [95% confidence interval (CI): 0.15 to 0.55], showing a positive association in the three studies between the incidence of grade 3–4 oral mucositis and chemotherapy for head and neck cancer. One study reported an onset of oral mucositis and the time to onset was 14.6 ± 6.4 days for the rebamipide group and 11.2 ± 4.4 days for placebo. One study reported a complete response of 8.3% for placebo and 16.7% for the rebamipide the group, and the partial response was 91.7 and 75.0%, respectively. Adverse events were reported in two studies to be 6.1 and 11.6% for placebo, and 19.4 and 26.0% in the rebamipide group, respectively. Conclusions Rebamipide mouthwash is effective in the prevention of severe mucositis and stomatitis. However, evaluation of adverse events in observational studies are needed.http://link.springer.com/article/10.1186/s40780-019-0146-2Meta-analysisRebamipideMouthwashMucositisChemoradiotherapyChemotherapy |
| spellingShingle | Shinsuke Akagi Takashi Fujiwara Mai Nishida Akiko Okuda Yuka Nagao Toshikatsu Okuda Hidenori Tokuda Kazunobu Takayanagi The effectiveness of rebamipide mouthwash therapy for radiotherapy and chemoradiotherapy-induced oral mucositis in patients with head and neck cancer: a systematic review and meta-analysis Journal of Pharmaceutical Health Care and Sciences Meta-analysis Rebamipide Mouthwash Mucositis Chemoradiotherapy Chemotherapy |
| title | The effectiveness of rebamipide mouthwash therapy for radiotherapy and chemoradiotherapy-induced oral mucositis in patients with head and neck cancer: a systematic review and meta-analysis |
| title_full | The effectiveness of rebamipide mouthwash therapy for radiotherapy and chemoradiotherapy-induced oral mucositis in patients with head and neck cancer: a systematic review and meta-analysis |
| title_fullStr | The effectiveness of rebamipide mouthwash therapy for radiotherapy and chemoradiotherapy-induced oral mucositis in patients with head and neck cancer: a systematic review and meta-analysis |
| title_full_unstemmed | The effectiveness of rebamipide mouthwash therapy for radiotherapy and chemoradiotherapy-induced oral mucositis in patients with head and neck cancer: a systematic review and meta-analysis |
| title_short | The effectiveness of rebamipide mouthwash therapy for radiotherapy and chemoradiotherapy-induced oral mucositis in patients with head and neck cancer: a systematic review and meta-analysis |
| title_sort | effectiveness of rebamipide mouthwash therapy for radiotherapy and chemoradiotherapy induced oral mucositis in patients with head and neck cancer a systematic review and meta analysis |
| topic | Meta-analysis Rebamipide Mouthwash Mucositis Chemoradiotherapy Chemotherapy |
| url | http://link.springer.com/article/10.1186/s40780-019-0146-2 |
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