Effects of Hydrogen Water Gargling on Oral Mucositis and Pain in Head and Neck Cancer Patients: A Randomized Controlled Pilot Study.

Abstract

BackgroundTraditional, complementary, and integrative medicine (TCIM) is an evolving field in oncology focused on managing cancer symptoms. Hydrogen water (HW) has gained attention for its antioxidant and anti-inflammatory properties, yet its clinical effectiveness needs further exploration. This randomized controlled trial aimed to assess the impact of gargling with HW on oral mucositis severity, pain levels, oral frailty, and quality of life in head and neck cancer patients undergoing radiotherapy or concurrent chemo-radiotherapy.MethodsIn this single-center, single-blind, parallel-group randomized controlled trial, patients were randomly assigned to receive either HW or distilled water (DW) for gargling. Oral mucositis (OM) severity, pain, oral frailty, and quality of life (QoL) were assessed using the World Health Organization Oral Mucositis Grading Criteria (WHO-OMGC), the Brief Pain Inventory-Taiwan (BPI-T), the Oral Frailty Checklist (OFC), and the EORTC QLQ-H&N35 questionnaire. Assessments were conducted at baseline (T0) and on Days 1 (T1), 3 (T2), 7 (T3), and 14 (T4) post-treatment.ResultsThe HW group showed significant OM improvement at Day 7 (p = 0.04) and Day 14 (p = 0.002). Pain decreased significantly in the HW group at Day 14 (p = 0.02). QoL improved in the HW group (p = 0.03), while OFC scores showed no significant difference between groups (p = 0.74).ConclusionHW gargling significantly alleviated OM severity and pain and improved QoL in head and neck cancer (HNC) patients undergoing radiotherapy or CCRT. HW gargling may serve as a simple, well-tolerated, and effective complementary and integrative therapy during cancer treatment.