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Table 5 Management of oral mucositis

From: Asian expert recommendation on management of skin and mucosal effects of radiation, with or without the addition of cetuximab or chemotherapy, in treatment of head and neck squamous cell carcinoma

Systemic Topical
1. Pain management Diluting agentsb: Saline, bicarbonate rinses, frequent water rinses, dilute hydrogen peroxide rinses
 • Analgesics: WHO ladder Topical anaestheticsb: Dyclonine HCl, xylocaine HCl, benzocaine HCl, diphenhydramine HCl
 • Adjuncts: Relaxation, imagery, biofeedback, hypnosis and transcutaneous electrical nerve stimulation
Analgesic agentsb: Benzydamine HCl
 • Beta-carotene
Coating agentsc: Kaolin-pectin, aluminium chloride, aluminium hydroxide, magnesium hydroxide, hydroxypropyl cellulose, sucralfate
2. Radioprotectorsa
Lip Lubricantsc: Water-based lubricants, lanolin
 • Amifostine: Scavenge free radicals
3. Biologic Response Modifiersa
 • G-CSF, GM-CSF, Keratinocyte Growth Factor
  1. aMore relevant in Bone Marrow Transplant cases and not crucial in radiotherapy patients
  2. bMost practiced and accepted form of topical therapy
  3. cThough mentioned in-frequently in literature and case discussions, they have failed to generate sufficient impact in routine practice