Traditional Chinese Medicine for the Prevention of Radiotherapy-Induced Oral Mucositis (RTOM)

NCT07543978 | Not Yet Recruiting Phase 3

• 1 other identifier: RTOM-1
• Study Type: interventional
• Target: 156
• Locations: 0 countries
• Sites: N/A

Brief Summary

This is a multicenter, randomized, controlled, prospective clinical trial designed to observe and evaluate the safety and efficacy of Modified Dahuang Huanglian Xiexin Mouthwash for the prevention of radiotherapy-induced oral mucositis (RTOM). Participants will be randomly assigned to receive either the Modified Dahuang Huanglian Xiexin Mouthwash or Placebo Mouthwash. The study aims to assess the preventative effect on RTOM in patients undergoing radiotherapy.

Conditions

Radiotherapy-Induced Oral Mucositis; Stomatitis; Oral Mucositis; Radiotherapy Side Effects

Keywords

Radiotherapy-Induced Oral Mucositis; RTOM; Stomatitis; Oral Mucositis; Radiation Injury

Outcome Measures

Primary Outcomes (1)

• Incidence of Radiation-Induced Oral Mucositis Within 2 Weeks of Radiotherapy Initiation

  Proportion of participants who develop radiation-induced oral mucositis (RTOM) of any grade within 2 weeks after the start of radiotherapy, assessed using the WHO Oral Toxicity Scale or RTOG Acute Radiation Morbidity Scoring Criteria. Participants who develop grade ≥3 RTOM prior to the 2-week assessment point are also counted as having reached the primary endpoint.

  From start of radiotherapy to the 2-week assessment point (day 14 ± 3 days)

Secondary Outcomes (4)

• Time to Onset of Radiation-Induced Oral Mucositis

  From start of radiotherapy until 7 days after completion of radiotherapy, assessed up to 8 weeks (56 days) from start of radiotherapy.

• Weekly Oropharyngeal Pain Score Measured by OMWQ

  weekly from start of radiotherapy to 7 days post-radiotherapy, assessed up to 56 days, or until occurrence of grade ≥3 RTOM, whichever comes first.

• Weekly Body Weight Change During Radiotherapy

  weekly from start of radiotherapy to 7 days post-radiotherapy, assessed up to 56 days, or until occurrence of grade ≥3 RTOM, whichever comes first.

• Quality of Life (EORTC QLQ-H&N35)

  weekly from start of radiotherapy to 7 days post-radiotherapy, assessed up to 56 days, or until occurrence of grade ≥3 RTOM, whichever comes first.

Other Outcomes (2)

• Incidence of Intervention-Related Adverse Events

  From start of radiotherapy to 7 days post-radiotherapy, assessed up to 56 days, or until occurrence of grade ≥3 RTOM, whichever comes first.

• Biomarker Discovery for RTOM Prediction

  Baseline (prior to radiotherapy initiation), week 2 (± 2 days), and completion of radiotherapy (± 3 days).

Study Arms (2)

Control arm

PLACEBO COMPARATOR

Placebo mouthwash matching the active intervention in appearance, color, taste, and packaging, containing no active pharmaceutical ingredients. It consists of purified water, pharmaceutical-grade coloring and flavoring agents to mimic the characteristics of the Modified Dahuang Huanglian Xiexin Mouthwash. Patients in this arm are instructed to rinse with 10 mL of the placebo solution for 2-3 minutes, six times daily, starting from the first day of radiotherapy and continuing throughout the radiotherapy course. All participants receive the same radiotherapy regimen and standard oral care. This arm serves as a control to evaluate the efficacy of the active intervention under double-blind conditions.

Drug: Placebo Mouthwash

Experimental arm

EXPERIMENTAL

Modified Dahuang Huanglian Xiexin Mouthwash (Jiawei Dahuang Huanglian Xiexin Koufuye), an active Chinese herbal formulation. Patients in this arm are instructed to rinse with 10 mL of the active solution for 2-3 minutes, six times daily, starting from the first day of radiotherapy and continuing throughout the radiotherapy course. All participants receive the same radiotherapy regimen and standard oral care. This arm serves as the experimental intervention to evaluate its efficacy in reducing radiation-induced oral mucositis compared with a matched placebo under double-blind conditions.

Drug: Modified Dahuang Huanglian Xiexin Mouthwash

Interventions

Modified Dahuang Huanglian Xiexin Mouthwash DRUG

A Chinese herbal mouthwash formulation derived from the classic formula Dahuang Huanglian Xiexin Decoction, with additional ingredients to enhance its properties for radiation-induced oral mucositis. The active ingredients include Rhei Radix et Rhizoma, Coptidis Rhizoma, Scutellariae Radix, and other botanical components. It is prepared as a ready-to-use aqueous solution with standardized extraction and quality control procedures. The mouthwash is administered as 10 mL per use, held in the oral cavity for 2-3 minutes, six times daily, starting from the first day of radiotherapy and continuing until the development of grade 3 or higher oral mucositis, as defined by the WHO or RTOG criteria. This intervention is distinguished from the placebo comparator by the presence of active herbal ingredients, and its appearance, color, taste, and packaging are matched by the placebo to enable double-blind conditions.

Experimental arm

Placebo Mouthwash DRUG

A placebo mouthwash formulated to match the active intervention (Modified Dahuang Huanglian Xiexin Mouthwash) in appearance, color, taste, and packaging. It contains no active pharmaceutical ingredients and is composed of purified water with pharmaceutical-grade coloring and flavoring agents to mimic the characteristics of the herbal formulation. The mouthwash is supplied as a ready-to-use aqueous solution. It is administered as 10 mL per use, held in the oral cavity for 2-3 minutes, six times daily, starting from the first day of radiotherapy and continuing throughout the radiotherapy course. This intervention is distinguished from the active comparator by the absence of active herbal ingredients and serves as a control to enable double-blind evaluation.

Control arm

Eligibility Criteria

• Age: 18 Years - 70 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Aged 18 to 70 years (inclusive) at the time of screening.
• Histologically confirmed squamous cell carcinoma of the nasopharynx, oral cavity, or oropharynx.
• Planned to receive radiotherapy.
• No prior history of radiotherapy to the head and neck region.
• Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1.
• Adequate major organ function as defined by the following criteria (within 14 days prior to enrollment, without transfusion support):
• Hemoglobin (Hb) ≥90 g/L Absolute neutrophil count (ANC)≥1.5×10⁹/L Platelet count (PLT) ≥80×10⁹/L Total bilirubin (BIL) \< 1.25×upper limit of normal (ULN) Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) \< 2.5×ULN Serum creatinine (Cr)≤ULN, or calculated creatinine clearance (Cockcroft-Gault formula) \> 50 mL/min
• Signed written informed consent prior to any study-related procedures.
• Judged by the investigator to be able to comply with the study protocol.
• Negative pregnancy test (for women of childbearing potential) at screening.
• Willing and able to adhere to scheduled visits, treatment plans, laboratory tests, and other study procedures.

You may not qualify if:

• Pre-existing oral mucositis prior to the start of radiotherapy.
• Prior radiotherapy to the head and neck region.
• Major surgery within 3 weeks prior to enrollment.
• Uncontrolled cardiac conditions or symptoms, including but not limited to:
• New York Heart Association (NYHA) class II or higher heart failure Unstable angina pectoris Myocardial infarction within 1 year prior to enrollment Clinically significant supraventricular or ventricular arrhythmia requiring intervention
• Use of topical (oral) or systemic corticosteroids within 1 week prior to enrollment.
• Active infection requiring systemic therapy.
• Known history of substance abuse, alcohol abuse, or drug addiction.
• Pregnancy or breastfeeding.
• Any other condition that, in the investigator's judgment, may interfere with the participant's ability to complete the study or compromise the collection of study data, including but not limited to serious concurrent illness (including psychiatric disorders) requiring concomitant treatment, severely abnormal laboratory values, or unfavorable family or social circumstances.

Sponsors & Collaborators

• Union Hospital, Tongji Medical College, Huazhong University of Science and Technology: lead

MeSH Terms

Conditions

Stomatitis; Radiation Injuries

Condition Hierarchy (Ancestors)

Mouth Diseases; Stomatognathic Diseases; Wounds and Injuries

Central Study Contacts

Chao Wan

CONTACT

+86-18062775069; wanc@hust.edu.cn

Study Design

• Study Type: interventional
• Phase: phase 3
• Allocation: RANDOMIZED
• Masking: QUADRUPLE
• Who Masked: PARTICIPANT, CARE PROVIDER, INVESTIGATOR, OUTCOMES ASSESSOR
• Masking Details: This is a quadruple-blind study. Participants, care providers, investigators, and outcome assessors are all blinded to group assignment. The placebo mouthwash is identical in appearance, taste, smell, and packaging to the active Modified Dahuang Huanglian Xiexin Mouthwash to ensure successful blinding.
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: April 2, 2026
• First Posted: April 22, 2026
• Study Start: April 30, 2026
• Primary Completion (Estimated): April 30, 2027
• Study Completion (Estimated): December 31, 2027
• Last Updated: April 22, 2026

Record last verified: 2026-04

Data Sharing

• IPD Sharing: Will not share