The Clinical Usefulness of Gargling with Hangeshashinto for Treatment of Oral Mucositis Caused by Sunitinib in Patients with Metastatic Renal Cancer / 日本東洋医学雑誌

ABSTRACT

Objective: To evaluate the clinical usefulness of gargling with hangeshashinto (HST) for treatment of oral mucositis (OM) caused by sunitinib in patients with metastatic renal cancer. Patients and methods: The study included 22 patients with sunitinib-induced OM. Among them, 12 patients were instructed to gargle with 2.5 g of HST for 30 seconds after each meal, 3 times a day, and to refrain from eating and drinking afterward (gargling group). The remaining 10 patients were treated without gargling (non-gargling group). The changes in the following outcome measures after treatment were analyzed and compared between the two groups the Karnofsky Performance Status (KPS), OM grade, body weight, albumin (Alb) levels, hemoglobin (Hb) levels, and eating status. Results: In the non-gargling group, the OM grade and eating status were not well improved, and KPS, body weight, Alb and Hb levels decreased. In the gargling group, despite a decrease in KPS, both OM grade and eating status improved from the day after the start of gargling, while no significant decreases were observed in body weight, Alb levels, or Hb levels after treatment. The gargling group showed better responses in all measures than the non-gargling group. Discussion: OM associated with cancer chemotherapy interferes with treatment completion. HST is a typical Kampo medicine belonging to the shashinto group, gargling with HST is also effective for treating OM. It appears that gargling with HST improves earlier stage of OM and eating status, thereby suppressing a decrease in KPS, body weight, Alb, and Hb levels.