Background: Oral mucositis (OM) is the most common and inevitable sequela of anti-cancer therapies. OM associated oral pain (OMOP) is reported to be the most burdensome symptom, compromising the patient’s functional capabilities, adherence to anti-cancer treatment and psychosocial status; which in turn reduces their overall quality of life (QOL). OM is unavoidable, as such, it is necessary to manage it based on patient symptoms; most notably, oral pain. Topical agents are most preferred in the management of OMOP, compared to their systemic counterparts. At current, there is still limited evidence to support the use of a standard therapy for OM management alone.
Objective: The present narrative review aims to compile the most effective, emerging topical therapies for management of OMOP.
Methods: Databases consisting of Cochrane Database of Systematic Reviews Database, Medline and Embase via Ovid were used to investigate key search terms. Articles retrieved were screened for duplicates, and any articles published prior to 1999 were excluded. A total of 28 articles were included within the final narrative review; 23 of which were Randomised Controlled Trials.
Results: Of the 21 pilot compounds investigated, 8 were found to have a statistically significant role in the management of OMOP. These included topical therapies containing doxepin, ketamine, morphine, indomethacin, diclofenac, benzydamine, rhEGF and phenylbutyrate. Each compound differs in evidence supporting its efficacy according to the malignancy type and location, nature of the treatment received and the initial severity of OM.
Discussion: Heterogeneity across the studies amplifies the need to develop a standardised validated assessment tool, which would allow for accurate comparison regarding the efficacy of therapies in reducing OMOP. Further research is warranted into the pathophysiology of oral pain specifically, as well as to fully elucidate the role of topical therapies in the management of OMOP.