{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,25]],"date-time":"2026-03-25T11:41:03Z","timestamp":1774438863969,"version":"3.50.1"},"reference-count":10,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,3,10]],"date-time":"2020-03-10T00:00:00Z","timestamp":1583798400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Oral Pathology Medicine"],"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>Oral and\/or oropharyngeal acute mucositis during and after chemo\u2010radiotherapy (chemo\u2010RT) for head and neck squamous cell carcinoma (HNSCC) can be extremely painful, sometimes requiring nasogastric feeding to enable adequate nutrition. The MASCC\/ISOO evidence\u2010based guidelines recommend benzydamine mouthwash for mucositis prevention in RT (recently updated to include chemo\u2010RT), and a Cochrane systematic review found other agents to be effective in prophylaxis. Diclofenac mouthwash is licensed for painful oral mucosal inflammatory conditions but to our knowledge has not been assessed in chemo\u2010RT\u2013associated oral mucositis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Method<\/jats:title><jats:p>A clinical observation and service evaluation study in 10 patients undergoing chemo\u2010RT for HNSCC to assess the potential value of diclofenac mouthwash (0.74\u00a0mg\/mL) in reducing symptoms. Patients used 20ml of mouthwash up to 4 times a day starting in week 3 (of a 6\u2010week course of treatment), recording pain and discomfort scores using a visual analogue scale on days 0, 1,7 and 14 (until the end of week 4). As per our current clinical practice, oral mucositis was not clinically scored as an outcome. Statistical analysis was performed using a one\u2010way ANOVA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Using diclofenac mouthwash, 9\/10 patients experienced pain score reduction from day 0 (mean score 6.75\u00a0\u00b1\u00a0SD 1.83) to day 2 (5.05\u00a0\u00b1\u00a0SD 1.62) and day 14 (4.09\u00a0\u00b1\u00a0SD 1.96).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Diclofenac mouthwash may be beneficial for managing chemo\u2010RT\u2013induced oral mucositis. While a prospective randomised clinical trial is needed, it can be prescribed for this condition within its current licence.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jop.13001","type":"journal-article","created":{"date-parts":[[2020,2,4]],"date-time":"2020-02-04T05:52:04Z","timestamp":1580795524000},"page":"956-959","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Diclofenac Mouthwash as a potential therapy for reducing pain and discomfort in chemo\u2010radiotherapy\u2013induced oral mucositis"],"prefix":"10.1111","volume":"49","author":[{"given":"Peter A.","family":"Brennan","sequence":"first","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Queen Alexandra Hospital Portsmouth UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rowena","family":"Lewthwaite","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Queen Alexandra Hospital Portsmouth UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Poornima","family":"Sakthithasan","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Queen Alexandra Hospital Portsmouth UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"McGuigan","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Queen Alexandra Hospital Portsmouth UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Oliver","family":"Donnelly","sequence":"additional","affiliation":[{"name":"Clinical Oncology Queen Alexandra Hospital Portsmouth UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peyman","family":"Alam","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery Queen Alexandra Hospital Portsmouth UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo S.","family":"Gomez","sequence":"additional","affiliation":[{"name":"Department of Oral Surgery and Pathology School of Dentistry Universidade Federal de Minas Gerais Belo Horizonte Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Fedele","sequence":"additional","affiliation":[{"name":"Eastman Dental Institute University College London London UK"},{"name":"NIHR University College London Hospital Biomedical Research Centre London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,3,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.oraloncology.2019.05.013"},{"issue":"53","key":"e_1_2_7_3_1","article-title":"Oral mucositis due to high\u2010dose chemotherapy and\/or head and neck radiation therapy","author":"Lalla RV","year":"2019","journal-title":"J Natl Cancer Inst Monogr"},{"key":"e_1_2_7_4_1","unstructured":"MASCC\/ISOO 2014 guidelines.https:\/\/www.mascc.org\/assets\/Guidelines-Tools\/mascc%20isoo%20mucositis%20guidelines%20summary%207nov2014.pdf. 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