WASHINGTON, DC—Patients undergoing head and neck radiation who routinely used NeutraSal®, a new supersaturated calcium phosphate oral rinse, significantly mitigated the severity of acute mucosal toxicity, a study presented at the Oncology Nursing Society (ONS) 38th Annual Congress has found.
In addition, the results compare favorably to historical outcomes with salt and soda rinses, noted Jean Hamker, RN, of Cleveland Clinic, Cleveland, OH. Mucositis, thickened sticky saliva, xerostomia, loss of taste, and pain commonly result from head and neck radiotherapy. Oral mucositis in particular can affect up to 100% of patients with head and neck cancer undergoing radiation and/or chemotherapy treatment.
Noting that “nurses can influence head and neck cancer treatment through emphasis on symptom management, patient and family education, and care coordination,” Hamker and colleagues evaluated preference among 35 patients for NeutraSal to standard of care salt and soda rinses. All 35 patients were receiving radiation therapy—12 patients, chemotherapy and radiation therapy concurrently—for squamous cell or adenocarcinoma.
End points were patient performance status: pain and dysphagia—defined as ability to eat orally, weight loss control, and degree of mucosity (both on a scale of 0-10)—and return of taste within 0-2 months after completing treatment. Patients were evaluated weekly during treatment and at approximately 4 to 6 weeks for acute toxicities, then scheduled for follow up every 4 to 8 weeks for 9 months posttreatment.
Among the 35 patients evaluated, oral toxicities associated with radiation therapy were found to be significantly lower with the use of NeutraSal than with historical averages. Compared with a historical rate of 100% for xerostomia for patients receiving either radiation therapy alone or chemoradiotherapy, the patients who used NeutraSal had a rate of 15% for radiation therapy and 35% for those receiving both radiation therapy and chemotherapy. Historical rates for limited dysphagia at 4 to 6 weeks was a mean of 76% compared with 20% for NeutraSal; oral pain 3 months posttreatment was 35% historical, 5% with NeutraSal.
Patients reported less opioid use: an average of 21 days of oxycodone 5/325 vs 35+ days historically. Within 42 to 50 days after treatment, patients returned to a normal diet and weight was being maintained. Overall, patients reported an 85% satisfaction rate for NeutraSal.
“Routine use of NeutraSal oral rinse by patients undergoing head and neck radiation significantly mitigates the severity of acute mucosal toxicity and compares favorably to historical outcomes with salt and soda rinses,” the researchers concluded.