• Janina Christoforou, Jumana Karasneh, Maddalena Manfredi, Bella Dave, Jennifer S Walker, Dios Pedro Diz PD https://orcid.org/0000-0002-1483-401X Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de C, Joel Epstein, Navdeep Kumar, Michael Glick, Peter B Lockhart, and Lauren L Patton.
• University of Western Australia, Crawley, Western Australia, Australia.
• Oral Dis. 2019 Jun 1; 25 Suppl 1: 182-192.

ObjectiveTo evaluate the current evidence regarding the effectiveness of non-opioid interventions for the therapeutic management of pain in head and neck cancer patients with oral mucositis resulting from radiotherapy only or chemoradiotherapy.Materials And MethodsA literature search was conducted which included randomised controlled trials that assessed patient-related outcome of pain in patients with oral mucositis associated with radiation therapy only or chemoradiotherapy. Literature searches were conducted in MEDLINE via Pubmed, Embase, Scopus and CINAHL.ResultsThe electronic searches identified 846 articles. Screening revealed that six articles met all eligibility inclusion criteria. Interventions showing statistically significant benefits to reduce oral mucositis associated pain compared to placebo included doxepin (p < 0.001, 95% CI -6.7 to -2.1), amitriptyline (p = 0.04), diclofenac (p < 0.01) and benzydamine (p = 0.014).ConclusionsNon-opioid interventions, including topical doxepin, amitriptyline, diclofenac and benzydamine, were found to provide relief of pain due to mucositis, and when effective may allow for reduction in the use of opioids in pain management.© 2019 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. All rights reserved.

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