***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Purpose This multicenter phase II trial assessed the clinical benefit of a multidisciplinary oral care program in reducing the incidence of severe chemoradiotherapy-induced oral mucositis ( OM ) . Methods Patients with head and neck cancer ( HNC ) who were scheduled to receive definitive or postoperative chemoradiotherapy were enrolled .  The oral care program included routine oral screening by dentists and a leaflet containing instructions regarding oral care , nutrition , and lifestyle . Oral hygiene and oral care were evaluated continuously during and after the course of chemoradiotherapy . The primary endpoint was the incidence of grade ≥3 OM assessed by certified medical staff according to the Common Terminology Criteria of Adverse Events version 3.0 . Results From April 2012 to December 2013 , 120 patients with HNC were enrolled . Sixty-four patients ( 53.3 % ) developed grade ≥3 OM ( i.e. , functional/symptomatic ) . The incidence of grade ≤1 OM at 2 and 4 weeks after radiotherapy completion was 34.2 and 67.6 % , respectively . Clinical examination revealed that 51 patients ( 42.5 % ) developed grade ≥3 OM during chemoradiotherapy . The incidence of grade ≤1 OM at 2 and 4 weeks after radiotherapy completion was 54.7 and 89.2 % , respectively . The incidences of grade 3 infection and pneumonitis throughout chemoradiotherapy were < 5 % . Only 6.7 % of patients had unplanned breaks in radiotherapy , and 99.2 % completed treatment . Conclusions A systematic oral care program alone is insufficient to decrease the incidence of severe OM in patients with HNC being treated with chemoradiotherapy .  However , systematic oral care programs may indirectly improve treatment compliance by decreasing infection risk . Trial registration number : Purpose Benzydamine is recommended for prophylaxis of oral mucositis ( OM ) in head and neck cancer ( HNC ) patients for radiation doses ( < 50 Gy ) . This study evaluates role of benzydamine for higher radiation doses ( > 50 Gy ) with or without chemotherapy . Methods One hundred twenty patients of HNC with planned radiation doses of ≥60 Gy were r and omized to group A ( control radiotherapy alone ) , group B ( study radiotherapy alone ) , group C ( control chemoradiotherapy ) , or to group D ( study chemoradiotherapy ) . Groups A and C were advised saline mouth rinses , and in groups B and D , additional benzydamine rinses ( 0.15 % ) were advised . Mucositis grading was done with both WHO ( WHO-M ) and CTCAE ( CTC-M ) version 4.0 ( common terminology criteria for adverse events ) weekly . Results Patient characteristics are presented in the table . Patients in group B had lesser grade 3 WHO-M and CTC-M as compared to group A , 62.1 vs. 36.4 % ( p = 0.038 ) and 51.7 vs. 27.3 % ( p = 0.043 ) , respectively . The rates of Ryle ’s tube feeding ( RTF ) , intravenous fluid supplementation ( IVF ) , and hospitalization were also lesser in group B as compared to A , 34.5 vs. 21.2 % ( p = 0.18 ) , 27.6 vs. 9.1 % ( p = 0.06 ) , and 6.9 vs. 0 % ( p = 0.21 ) , respectively . WHO-M and CTC-M in groups C and D were not statistically different , 64.3 vs. 43.3 % ( p = 0.091 ) and 53.6 % vs. 43.3 % ( p = 0.30 ) , respectively . The rates of RTF , IVF , and hospitalization were all lesser but p > 0.05 . Conclusion Benzydamine significantly reduces OM even at doses > 50 Gy in HNC patients . Its role in patients receiving concurrent chemotherapy further needs to be evaluated BACKGROUND AND PURPOSE Oral mucositis ( OM ) is most cumbersome acute side effect of concurrent chemoradiotherapy ( CCRT ) for head and neck cancer ( HNC ) . OM associated pain affects oral functions and nutrition of the patient that may result in discontinuity of treatment . Several modalities have been tried to prevent and treat OM , but none proved completely successful until date . We used prophylactic low level laser therapy ( LLLT ) for the prevention and treatment of CCRT induced OM . MATERIAL S AND METHODS In this triple blinded study , 221 HNC patients scheduled to undergo CCRT ( Cisplatin ( 1 , 22 , 43 day)+RT=66 Grays ( 2 Gy/fraction ) , 33 fractions , 5 fractions/week , for 45 days ) were block r and omized into laser ( n=111 ) and placebo ( n=110 ) group . Laser group received LLLT ( HeNe , λ=632.8 nm , power-density=24 mW , dosage=3.0 J/point , total dosage/session=36 - 40 J , spot-size=1cm(2 ) , 5 sessions/week ) while placebo received sham treatment daily prior to radiation . OM ( RTOG/EORTC Scale ) , oral pain ( VAS ) , dysphagia ( FIS ) , weight loss and CCRT break were assessed . Data were analyzed using frequencies and percentage , generalized estimating equations ( GEE ) and odds ratio . RESULTS There was significant reduction in incidence of severe OM ( F=16.64 , df=8876 , p<0.0001 ) and its associated pain ( F=25.06 , df=8876 , p<0.0001 ) , dysphagia ( F=20.17 , df=8876 , p<0.0001 ) and opioid analgesics use ( p<0.0001 ) in laser than placebo group patients . CONCLUSIONS LLLT decreased the incidence of CCRT induced severe OM and its associated pain , dysphagia and opioid analgesics use This r and omized-controlled trial studied the efficacy of palifermin in a chemotherapy-only , high-dose Melphalan ( HDM ) transplant setting , to reduce oral mucositis ( OM ) and its sequelae measured by patient-reported outcomes ( PRO ) and medical re source use . Palifermin , relative to placebo was given either pre-/post-HDM or pre-HDM in patients with multiple myeloma ( MM ) undergoing auto-SCT at 39 European centers . Oral cavity assessment ( WHO ) and PRO question naires ( oral mucositis daily question naire ( OMDQ ) and EQ 5D ) were used in 281 patients ( mean age 56 , ±s.d.=8 years ) . 57 patients received placebo . One hundred and fifteen subjects were r and omized to pre-/post-HDM receiving palifermin on 3 consecutive days before HDM and after auto-SCT and 109 patients were r and omized to pre-HDM , receiving palifermin ( 60 μg/kg/day ) i.v . for 3 consecutive days before HDM . There was no statistically significant difference in maximum OM severity . Severe OM occurred in 37 % ( placebo ) , 38 % ( pre-/post-HDM ) and 24 % ( pre-HDM ) of patients . No significant difference was observed with respect to PRO assessment s or medical re source use , but more infections and fever during neutropenia were reported in pre-/post-HDM vs placebo ( for example , 51 and 26 % ) . To conclude , palifermin was unable to reduce OM or OM-related patient ’s burden in MM transplant patients Objective . To evaluate the efficacy and safety of Kangfuxin Solution , a pure Chinese herbal medicine , on mucositis induced by chemoradiotherapy in nasopharyngeal carcinoma patients . Methods . A r and omized , parallel-group , multicenter clinical study was performed . A total of 240 patients were r and omized to receive either Kangfuxin Solution ( test group ) or compound borax gargle ( control group ) during chemoradiotherapy .  Oral mucositis , upper gastrointestinal mucositis , and oral pain were evaluated by Common Terminology Criteria for Adverse Events ( CTCAE ) v3.0 and the Verbal Rating Scale ( VRS ) . Results . Of 240 patients enrolled , 215 were eligible for efficacy analysis . Compared with the control group , the incidence and severity of oral mucositis in the test group were significantly reduced ( P = 0.01 ) . The time to different grade of oral mucositis occurrence ( grade 1 , 2 , or 3 ) was longer in test group ( P < 0.01 ) , and the accumulated radiation dose was also higher in test group comparing to the control group ( P < 0.05 ) . The test group showed lower incidence of oral pain and gastrointestinal mucositis than the control group ( P < 0.01 ) . No significant adverse events were observed . Conclusion . Kangfuxin Solution demonstrated its superiority to compound borax gargle on mucositis induced by chemoradiotherapy . Its safety is acceptable for clinical application The aim of this study was to evaluate the efficacy and safety of recombinant human epidermal growth factor ( rhEGF ) oral spray for oral mucositis ( OM ) induced by intensive chemotherapy with hematopoietic stem cell transplantation . In this phase 2 study , patients were r and omized to  either rhEGF ( 50 microg/mL ) or placebo in a 1:1 ratio . The primary endpoint was incidence of National Cancer Institute ( NCI ) grade ≥2 OM . A total of 138 patients were enrolled in this study . In the intention-to-treat analysis , rhEGF did not reduce the incidence of NCI grade ≥2 OM ( p = 0.717 ) nor reduce its duration ( p = 0.725 ) . Secondary endpoints including the day of onset and duration of NCI grade ≥2 OM , the incidence of NCI grade ≥3 OM and its duration , and patient-reported quality of life were also similar between the two groups . In the per- protocol analysis , however , the duration of opioid analgesic use was shorter in the rhEGF group ( p = 0.036 ) , and recipients in the rhEGF group required a lower cumulative dose of opioid analgesics than those in the placebo group ( p = 0.046 ) , among patients with NCI grade ≥2 OM . Adverse events were mild and transient . This study found no evidence to suggest that rhEGF oral spray reduces the incidence of OM . However , further studies are needed to investigate the effect of rhEGF on OM-induced pain reduction after intensive chemotherapy The purpose of this study was to determine the effect of zinc supplementation on radiation-induced mucositis in patients with nasopharyngeal carcinoma ( NPC ) and those with oral cancers ( OC ) . A total of 100 patients with head and neck cancers engaged in a r and omized double blind study . All participants were placed into two r and omized groups ( experimental and control ) . The experimental group received a st and ard dose of zinc supplements , and the control group was given a placebo . Subgroup analyses were performed between 40 NPC and 43 OC patients . It was found that patients with OC in the control group developed Grade 2 and Grade 3 mucositis sooner than those in the experimental group . However , the benefits were not found to extend to patients with NPC . The results indicated that zinc supplementation prescribed in conjunction with radiotherapy postponed the development of severe mucositis solely for patients with OC . The pretreatment oral mucosa condition and areca chewing habit might account for such discrepancy PURPOSE Oral mucositis ( OM ) is a debilitating toxicity of chemoradiotherapy for head and neck cancer ( HNC ) . This r and omized , placebo-controlled , double-blind study evaluated the efficacy and safety of palifermin to reduce OM associated with definitive chemoradiotherapy for locally advanced HNC . PATIENTS AND METHODS Patients receiving conventionally fractionated radiotherapy ( 2.0 Gy/d , 5 days/wk to 70 Gy ) with cisplatin ( 100 mg/m(2 ) on days 1 , 22 , and 43 ) received palifermin ( 180 μg/kg ) or placebo before starting chemoradiotherapy and then once weekly for 7 weeks . The primary end point was the incidence of severe , observable , and functional OM ( WHO grade 3 to 4 ) . RESULTS The palifermin ( n = 94 ) and placebo ( n = 94 ) arms were well balanced . The incidence of severe OM was significantly lower for palifermin than for placebo ( 54 % v 69 % ; P = .041 ) . In the palifermin  arm , median time to severe OM was delayed ( 47 v 35 days ) , median duration of severe OM was shortened ( 5 v 26 days ) , and the incidence of xerostomia grade ≥ 2 was lower ( 67 % v 80 % ) , favoring palifermin ; however , the differences were not significant after multiplicity adjustment . Opioid analgesic use , average mouth and throat soreness scores , and chemoradiotherapy compliance were not significantly different between treatment arms . Adverse events were similar between arms ( 98 % , palifermin ; 93 % , 
    Output:
    
Results : Results of the studies used in this systematic review of literature showed that laser therapy , cryotherapy , professional oral hygiene , antimicrobial agents , Royal jelly , L. brevis lozenges , Zync supplementation and Benzydamine are the best treatment or/ and prevention methods for oral mucositis .
Conclusions : Palifermin , Chlorhexidine , Smecta , Actovegin , Kangfuxin , L. brevis lozenges , Royal jelly , Zync supplement , Benzydamine , cryotherapy , laser therapy and professional oral hygiene may be used in oral mucositis treatment and prevention