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Table 6 Common clinical practices for management of mucositis in Asian countries.

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

Grade 1 Grade 2 Grade 3 Grade 4
• Maintain oral hygiene • Maintain oral hygiene • Maintain oral hygiene • Maintain oral hygiene
• Frequent mouthwash use with agents like betadine, sodium bicarbonate • Frequent mouthwash use with agents like betadine, sodium bicarbonate • Frequent mouthwash use with agents like betadine, sodium bicarbonate • Frequent mouthwash use with agents like betadine, sodium bicarbonate
• Thymol and aspirin gargles/NSAIDs/local anesthetics for pain relief
• NSAIDs/opioids/local anesthetics for pain relief
• Thymol and aspirin gargles/ NSAIDs/local anesthetics for pain relief • NSAIDs/opioids/local anesthetics for pain relief • Systemic continuous use of steroidal therapy for mucositis prevention/therapy not recommended
  • Parenteral nutrition used only if the bowel is not working or there are serious contra-indications to the placement of a device for enteral nutrition
• Parenteral nutrition used only if the bowel is not working or there are serious contra-indications to the placement of a device for enteral nutrition
• Stop radiation and cetuximab till the condition is resolved
• Cetuximab dosing may be interrupted for a week or two, till the reaction has resolved to grade 2