Abstract Purpose: This study was intended to evaluate the efficacy in alleviating mucositis, safety and tolerability of sandalwood album oil (SAO) in patients treated with (chemo-) radiation therapy for head and neck cancer. Methods: Patients to be treated with (chemo-) radiation therapy for cancers of oral cavity/ oropharynx were asked to swish and gargle for 30 seconds, and spit, with SAO mouth rinse thrice a day throughout radiation therapy. Pain in the oral cavity/ oropharynx was measured using the numerical rating pain scale (NRPS) and mucositis using the RTOG scale every week. Our data were compared with two of the largest historical data bases. Results: Fourteen subjects were enrolled but six withdrew (4 due to taste/ smell, one due to fatigue, one due to perceived ineffectiveness). Among the eight who completed the course of SAO, 6 were treated with chemo-radiation and two with radiation only. IMRT was used for everyone. The median dose was 6,996 cGy in 33 fractions. There were no serious adverse events from the mouth rinse. The mean RTOG mucositis grades from weeks 3, 6 and 9 were 1.125, 2.125 and 1.875. Two patients experienced mucositis ≥3. The corresponding mean NRPS were 3.700, 4.988 and 3.875. Conclusions: The incidence of mucositis ≥3 from the historical data bases ranged from 22% to 70%. Distribution of our mean NRPS and RTOG mucositis data compared favorably against the historical data. Though SAO was difficult to use due to poor taste/smell, it was otherwise well tolerated and appears to exhibit enough signal to warrant further development.
Keywords: mucositis; sandalwood oil; radiation; chemotherapy; head and neck cancer