Hostname: page-component-cd9895bd7-7cvxr Total loading time: 0 Render date: 2024-12-25T05:03:42.242Z Has data issue: false hasContentIssue false
  • English
  • Français

Colchicine mouth washings to improve oral mucositis in patients with hematological malignancies: A clinical trial

Published online by Cambridge University Press:  13 November 2008

Andrés Ávila Garavito ,
Andrés Felipe Cardona ,
Ludovic Reveiz ,
Edgar Ospina ,
Andrés Yepes  and
Vannesa Ospina
Andrés Ávila Garavito
Affiliation:
Clinical Oncology and Hematology Department, Clínica de Oncología Astorga and Unidad de Trasplante de Médula Ósea Clínica SOMA, Medellín, Colombia
Andrés Felipe Cardona*
Affiliation:
Clinical Oncology Department, Instituto Nacional de Cancerología, Bogotá D.C., Colombia Cochrane Colombian Group, Bogotá, D.C., Colombia
Ludovic Reveiz
Affiliation:
Cochrane Colombian Group, Bogotá, D.C., Colombia
Edgar Ospina
Affiliation:
Cochrane Colombian Group, Bogotá, D.C., Colombia
Andrés Yepes
Affiliation:
Clinical Oncology Department, Instituto Nacional de Cancerología, Bogotá D.C., Colombia
Vannesa Ospina
Affiliation:
Clinical Oncology Department, Instituto Nacional de Cancerología, Bogotá D.C., Colombia
*
Address correspondence and reprint requests to: Andrés Felipe Cardona, Clinical Oncology Department, Instituto Nacional de Cancerología, Bogotá, D.C., Colombia. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

Oral mucositis (OM) is a frequently encountered problem as a complication of cancer treatment. We investigated whether daily washings with colchicine solution improved mucositis in patients with hematological malignancies undergoing chemotherapy.

Methods:

This study was a one-arm, nonrandomized clinical trial that used a historical control group. Patients were included in the study from the first day of mucositis and followed up until discharge. Patients received 2 mg colchicine mouthwashes daily for 5 days or saline solution. OM was assessed once daily until symptom resolution, using the WHO grading scale of 0–4 and a visual analogue scale. We determined that at least 40 patients in the colchicine group would be needed to detect a 20% difference in the duration of OM between Groups A and B, with a 95% confidence level and a power of 80%.

Results:

82 patients were included in the final analysis, 40 in the colchicine group and 42 in the control group. Median duration of OM was significantly different among groups; 9days (range 1–17days) for the control group versus 6days (range 3–13days) for those exposed to colchicine mouthwash (p = .028). The median days of regression of mucosal lesions were significantly different (p = .047) among the control group (7 days [range 3–20]) compared to the colchicine group (4 days [range 2–14]).

Significance of results:

Although our findings suggest that colchicine mouthwash is helpful in reducing the severity and duration of chemotherapy-induced OM, randomized trials are needed to confirm these results.

Keywords

Oral mucositisStomatitisOral ulcersMouthwashChemotherapyLymphomaLeukemia
Type
Original Articles
Information
Palliative & Supportive Care , Volume 6 , Issue 4 , December 2008 , pp. 371 - 376
Copyright
Copyright © Cambridge University Press 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Altinor, S., Ozturkcan, S. & Hah, M.M. (2003). The effects of colchicine on neutrophil function in subjects with recurrent aphthous stomatitis. Journal of the European Academy of Dermatology and Venereology, 17, 469–470.CrossRefGoogle ScholarPubMed
Al-Waiz, M.M., Sharquie, K.E., A-Qaissi, M.H., et al. (2005). Colchicine and benzathine penicillin in the treatment of Behcet disease: A case comparative study. Dermatology Online Journal, 11, 3.CrossRefGoogle ScholarPubMed
Anthony, L., Bowen, J., Garden, A., et al. (2006). New thoughts on the pathobiology of regimen-related mucosal injury. Supportive Care in Cancer, 14, 516–518.CrossRefGoogle ScholarPubMed
Ávila, A., Cardona, A.F. & Perez, A. (2000). Prevención y tratamiento de la mucositis oral inducida por quimio y radioterapia (Prevention and treatment of oral mucositis induced by chemotherapy and radiotherapy). Revue Colombiana Cancerologia (Colombian Cancer Review), 41, 36–56.Google Scholar
Chang, M.N., Shuster, J.J. & Kepner, J.L. (2004). Sample sizes based on exact unconditional tests for phase II clinical trials with historical controls. Journal of Biopharmaceutical Statistics, 14, 189–200.CrossRefGoogle ScholarPubMed
Chiappelli, F. (2005). The molecular immunology of mucositis: Implications for evidence-based research in alternative and complementary palliative treatments. Evidence-based Complementary and Alternative Medicine, 2, 489–494.CrossRefGoogle ScholarPubMed
Elting, L.S., Cooksley, C. & Chambers, M., et al. (2003). The burdens of cancer therapy. Clinical and economic outcomes of chemotherapy-induced mucositis. Cancer, 98, 1531–1539.CrossRefGoogle ScholarPubMed
Epstein, J.B., Silverman, S. Jr. & Paggiarino, D.A., et al. (2001). Benzydamine HCl for prophylaxis of radiation-induced oral mucositis: Results from a multicenter, randomized, double-blind, placebo controlled clinical trial. Cancer, 92, 875–885.3.0.CO;2-1>CrossRefGoogle ScholarPubMed
Fontes, V., Machet, L., Huttenberger, B., et al. (2002). Recurrent aphthous stomatitis: Treatment with colchicine. An open trial of 54 cases. Annales de Dermatologie et de Venereologie, 129, 1365–1369.Google ScholarPubMed
Gatot, A. & Tovi, F. (1984). Colchicine therapy in recurrent oral ulcers. Archives of Dermatology, 120, 994.CrossRefGoogle ScholarPubMed
Katz, J., Langevitz, P., Shemer, J., et al. (1994). Prevention of recurrent aphthous stomatitis with colchicine: An open trial. Journal of the American Academy of Dermatology, 31, 459–461.CrossRefGoogle ScholarPubMed
Lalla, R.V., Schubert, M.M., Bensadoun, R.J., et al. (2006). Anti-inflammatory agents in the management of alimentary mucositis. Supportive Care in Cancer, 14, 558–565.CrossRefGoogle ScholarPubMed
Momo, K., Shiratsuchi, T., Taguchi, H., et al. (2005). Preparation and clinical application of indomethacin gel for medical treatment of stomatitis. Yakugaku Zasshi, 125, 433–440.CrossRefGoogle ScholarPubMed
Nakamura, T., Aoyama, T., Yanagihara, Y., et al. (2003). The effects of indomethacin spray on the pain of stomatitis in the patients for hematopoietic stem cell transplantation. Yakugaku Zasshi, 123, 1023–1029.CrossRefGoogle Scholar
Nicolopoulos, N., Mantidis, A., Stathopoulos, E., et al. (1985). Prophylactic administration of indomethacin for irradiation esophagitis. Radiotherapy and Oncology, 3, 23–25.CrossRefGoogle ScholarPubMed
Northway, M.G., Libshitz, H.I., Osborne, B.M., et al. (1980). Radiation esophagitis in the opossum: Radioprotection with indomethacin. Gastroenterology, 78, 883–892.CrossRefGoogle ScholarPubMed
Pico, J.L., Avila-Garavito, A. & Naccache, P. (1998). Mucositis: Its occurrence, consequences, and treatment in the oncology setting. Oncologist, 3, 446–451.CrossRefGoogle ScholarPubMed
Plevova, P. (1999). Prevention and treatment of chemotherapy and radiotherapy induced oral mucositis: A review. Oral Oncology, 35, 453–470.CrossRefGoogle ScholarPubMed
Porta, C., Moroni, M. & Nastasi, G. (1994). Allopurinol mouthwashes in the treatment of 5-fluorouracil-induced stomatitis. American Journal of Clinical Oncology, 17, 246–247.CrossRefGoogle ScholarPubMed
Ruah, C.B., Stram, J.R. & Chasin, W.D. (1988). Treatment of severe recurrent aphthous stomatitis with colchicine. Archives of Otolaryngology—Head & Neck Surgery, 114, 671–675.CrossRefGoogle ScholarPubMed
Shaw, M.J., Kumar, N.D., Duggal, M., et al. (2000). Oral management of patients following oncology treatment: Literature review. British Journal of Oral & Maxillofacial Surgery, 38, 519–524.CrossRefGoogle ScholarPubMed
Sonis, S.T. (2004). The pathobiology of mucositis. Nature Reviews Cancer, 4, 277–284.CrossRefGoogle ScholarPubMed
Stokman, M.A., Spijkervet, F.K., Boezen, H.M., et al. (2006). Preventive intervention possibilities in radiotherapy- and chemotherapy-induced oral mucositis: Results of meta-analyses. Journal of Dental Research, 85, 690–700.CrossRefGoogle ScholarPubMed
Stokman, M.A., Spijkervet, F.K., Burlage, F.R., et al. (2005). Clinical effects of flurbiprofen tooth patch on radiation-induced oral mucositis. A pilot study. Supportive Care in Cancer, 13, 42–48.CrossRefGoogle ScholarPubMed
Symonds, R.P. (1998). Treatment-induced mucositis: An old problem with new remedies. British Journal of Cancer, 77, 1689–95.Google ScholarPubMed
Trotti, A. (2000). Toxicity in head and neck cancer: A review of trends and issues. International Journal of Radiation Oncology, Biology, Physics, 47, 1–12.CrossRefGoogle ScholarPubMed
Worthington, H.V., Clarkson, J.E. & Eden, O.B. (2004). Interventions for treating oral mucositis for patients with cancer receiving treatment. Cochrane Database of Systematic Reviews, Issue 2. Art. No. CD001973.Google ScholarPubMed
Worthington, H.V., Clarkson, J.E. & Eden, O.B. (2006). Interventions for preventing oral mucositis for patients with cancer receiving treatment. Cochrane Database of Systematic Reviews, Issue 2, Art. No. CD000978.CrossRefGoogle ScholarPubMed