Topical pain therapy in oral mucositis. A systematic review

The pain provoked by mucositis is often described as the most excruciating symptom of cancer treatment. It often causes reduced ingestion, malnutrition, and sometimes postponement or withdrawal of the therapy. For health care providers, adequate pain treatment is a major challenge. The aim of this article is to present an overview of studies on the topical treatment of mucositis pain. A systematic search was performed in PubMed with the keywords "mucositis" "pain" and "topical" or "local". In addition, reference lists and relevant websites were scanned for appropriate literature. A total of 47 articles were included. There is only scarce evidence for the topical treatment of mucositis pain. The most convincing studies tested opioids, corticoids and benzydamine. For the other substances, too few studies were performed, the results were contradictory, or the study quality was low. Based on the information gathered in this systematic search of the literature, topical treatment of mucositis pain today is based on empiricism and not on scientific evidence.