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 |