Comparison of Chlorhexidine and Benzydamine Mouth Rinses in the Management of Radiotherapy or Chemotherapy-Induced Oral Mucositis: A Systematic Review and Meta-Analysis

Mucositis rates rise with concurrent chemotherapy and changed fractionation regimens for head and neck cancer. This causes poor disease control and therapy cessation. This study aimed to compare the efficacy and safety of chlorhexidine and benzydamine in treating oral mucositis (OM) induced by radiotherapy or chemotherapy. A comprehensive search of PubMed, Embase, Cochrane Library, and ClinicalTrials.gov from 1980 to August 2021 was performed. Four studies with a pooled sample size of 107 and two randomized controlled trials (RCTs) with a pooled sample size of 48 were included in qualitative and quantitative synthesis, respectively. A meta-analysis was performed for a percentage of OM. The Risk of Bias 2 (ROB 2) tool was used for the assessment of the risk of bias. The pooled odds ratio of OM was 0.39 (95% CI: 0.12-1.35) for chlorhexidine as compared to benzydamine (I2 = 0%, P-value = 0.75). A meta-analysis could not be conducted for safety outcomes such as pain and dysphagia. Our study results indicate that chlorhexidine has superior efficacy in managing OM over benzydamine.