Huang, B.S., Wu, S.C., Lin, C.Y., Fan, K.H., Chang, J.T., & Chen, S.C. (2018). The effectiveness of a saline mouth rinse regimen and education programme on radiation-induced oral mucositis and quality of life in oral cavity cancer patients: A randomised controlled trial. European Journal of Cancer Care, 27, e12819.

To assess the impact of saline mouth rinse regimen and education program on radiation-induced OM symptoms and QOL in patients with oral cavity cancer receiving RT or CCRT.

Ninety‐one OCC patients were randomly divided into a group that received saline mouth rinses and an education program and a control group that received standard care. OM symptoms and QOL were assessed with the WHO Oral Toxicity Scale, MSS‐moo, and UW‐QOL. Data were collected at the first postoperative visit to the radiation department (T0) and at 4 weeks and 8 weeks after beginning RT or CCRT.

• N: 91   
• AGE: 20 years or older
• MALES: 93.8%  
• FEMALES: 6.2%
• CURRENT TREATMENT: Radiation, combination radiation and chemotherapy  
• KEY DISEASE CHARACTERISTICS: Diagnosed with oral cavity cancer
• OTHER KEY SAMPLE CHARACTERISTICS: Undergoing postoperative adjuvant RT or CCRT

• SITE: Single site   
• SETTING TYPE: Outpatient    
• LOCATION: Cancer center in northern Taiwan

• PHASE OF CARE: Active anti-tumor treatment
• APPLICATIONS: Elder care

Double-blind RCT one control and two intervention groups.

OM symptoms and QOL were assessed with the WHO Oral Toxicity Scale, MSS‐moo, and UW‐QOL. Data were collected at the first postoperative visit to the radiation department (T0) and at 4 weeks and 8 weeks after beginning RT or CCRT.

Patients in both groups had significantly higher levels of physical and social‐emotional QOL at 8 weeks after beginning RT or CCRT compared to the first visit. Patients in the saline rinse group had significantly better physical and social‐emotional QOL as compared to the standard care group at 8 weeks. Radiation‐induced OM symptoms and overall QOL were not different between the groups.

The authors concluded that the saline rinse and education program promote better physical and social‐emotional QOL in OCC patients receiving RT/CCRT. The results of this study indicated that saline mouth rinses with an education program were effective in increasing physical and social‐emotional QOL by improving the radiation‐induced OM symptoms and promoting oral comfort in patients receiving RT/CCRT for HNC, as compared to standard care. However, no improvement in radiation‐induced OM symptoms and overall QOL was found.

• Small sample (< 100)
• Other limitations/explanation: Small study with limitations in descriptive measurement.

It might be helpful to provide and teach saline mouth rinses to patients