The use of MuGard (TM), Caphosol (R) and Episil (R) in patients undergoing chemoradiotherapy for squamous cell carcinoma of the head and neck

Introduction: Oral mucositis is common for patients undergoing chemoradiotherapy for squamous cell carcinoma of the head and neck (SCCHN). Despite the significant detrimental sequelae associated, there is no consensus on the optimum mouth care regimen. This prospective audit aims to record mucositis and dysphagia toxicity and the level of analgesia prescribed when recent products: MuGard (TM) , Caphosol (R) and Episil (R) are compared with our standard departmental mouth care regimen. Methods: Patients undergoing concurrent chemoradiotherapy for locally advanced SCCHN at University Hospital Birmingham, UK were prospectively audited weekly for 8 consecutive weeks starting from week 1 of chemoradiotherapy from June 2009 until January 2011. Patients received either standard oral care regimen of aspirin, glycerin and sucralfate, or, MuGard (TM), Caphosol (R) or Episil (R). Grade of mucositis, dysphagia and analgesia score were prospectively recorded using the common toxicity criteria v3.0. Results: One hundred and four patients were included. There was no difference in the grade and duration of mucositis (p = 0.82), dysphagia (p = 0.99) or analgesia score (p = 0.61) for either MuGard (TM), Caphosol (R) or Episil (R) compared with standard oral care. Conclusion: There is no evidence from this audit that Mugard (TM), Caphosol (R) or Episil (R) improves mucositis and dysphagia toxicity or the level of analgesia prescribed compared with our standard departmental mouth care regimen. Randomised trials comparing these approaches are required to detect any meaningful clinical benefit.