Triamcinolone acetonide is a synthetic corticosteroid. The drug is available over the counter as a nasal spray to treat allergic rhinitis. In addition, triamcinolone acetonide can be used to relieve itching, redness, dryness, crusting, scaling, or inflammation. It has been investigated as a topical intervention for oral mucositis.
Ghalayani, P., Emami, H., Pakravan, F., & Nasr Isfahani, M. (2014). Comparison of triamcinolone acetonide mucoadhesive film with licorice mucoadhesive film on radiotherapy-induced oral mucositis: A randomized double-blinded clinical trial. Asia-Pacific Journal of Clinical Oncology. Advance online publication.
To determine whether improved pain control and/or ulcer management of oral mucositis in patients with head and neck cancer receiving postoperative radiation therapy can be achieved with licorice mucoadhesive film or triamcinolone acetonide mucoadhesive film
When patients reached a World Health Organization (WHO) grade 2 or 3 mucositis rating, they were randomized according to a balanced block randomization to receive either triamcinolone (T) (.5 mg triamcinolone acetonide in film) or licorice (L) (.18 mg polyphenols as pyrogallol extracted from licorice root) in addition to the standard of care. The standard of care included frequent mouth rinses using boiled water, regular brushing and flossing, scaling, and the removal of plaque and tartar during radiation therapy. The films were applied to the upper lip four times per day. The intervention continued for four weeks or until the cessation of mucositis. The use of analgesics was not permitted before or during the study. Two investigators rated the severity of the mucositis, and data were collected on a weekly basis. Compliance was measured by counting unused films.
Double-blinded, prospective, randomized, controlled trial
There was a significant difference in the mean value of the mucositis scores for the T and L interventions when compared to the control group (p < .05) although there was no difference between the two intervention groups. No statistically significant difference was achieved (p > .05) between interventions in reducing pain during radiation therapy. However, each was statistically significant (p < .05) in reducing pain during radiation therapy when compared to the standard of care alone. A slight additional reduction in pain was noted in the L group, but it was not significant.
Both triamcinolone acetonide mucoadhesive film and licorice mucoadhesive film reduced the mean mucositis score and the pain associated with mucositis during radiation therapy when compared to the group that only received standard of care. However, there was no significant difference between the two interventions for mucositis scores or pain scores when compared to each other.
Although there is not enough evidence to recommended the use of this intervention, this study is a good starting point for nurse research to continue working toward finding additional, better ways to treat and prevent oral mucositis and its complications in patients undergoing cancer treatment.