Prospective Evaluation of a Chamomile Mouthwash for Prevention of 5-FU-Induced Oral Mucositis

Stomatitis is one of the dose-limiting toxicities of 5-fluorouracil (5- S FU). While rarely life threatening, the oral discomfort of ulcerations produced by 5-FU can be very painful and may influence patient compliance with future cytotoxic therapy. Severe ulceration of the mouth and gastrointestinal tract can significantly interfere with nutrition and may result in oral or systemic infection. Currently, no successful intervention exists to prevent stomatitis completely. Any measure to alleviate or decrease the frequency andlor severity of stomatitis would be of obvious benefit. It may also allow a greater opportunity for tumor response if higher doses of chemotherapy could be safely given. 

A previously-reported randomized trial of oral cryotherapy for 30 minutes versus control in patients receiving 5-FU plus leucovorin demonstrated impressively less stomatitis in patients randomized to cryotherapy.’ A subsequent trial failed to demonstrate additional benefit by increasing the oral cryotherapy duration to 60 minutes? Despite the use of cryotherapy, stomatitis continues to be a prominent clinical problem affecting approximately 40% of patients receiving 5-FU-based chemotherapy. Thus further efforts are warranted to attempt to decrease 5-FUrelated stomatitis.