Supportive Care in Cancer

, Volume 24, Issue 10, pp 4393–4398 | Cite as

Chamomile infusion cryotherapy to prevent oral mucositis induced by chemotherapy: a pilot study

  • Paula Elaine Diniz dos ReisEmail author
  • Marcia A. Ciol
  • Nilce Santos de Melo
  • Paulo Tadeu de Souza Figueiredo
  • André Ferreira Leite
  • Natália de Melo Manzi
Original Article



The aim of this study is to compare cryotherapy made only with water and cryotherapy made with chamomile infusion for prevention and reduction of intensity of oral mucositis in patients with cancer receiving 5-fluorouracil and leucovorin.


This is a randomized pilot study with two groups: cryotherapy made only with water (control group, n = 18) and cryotherapy made with chamomile infusion (chamomile group, n = 20). Both groups were instructed to swish the ice around in their oral cavity for at least 30 min during chemotherapy. Assessment of oral mucosa occurred on days 8, 15, and 22 after the first day of chemotherapy.


Fifty percent of the patients in the control and 30 % in the chamomile group developed oral mucositis. Mouth pain score was higher in patients in the control group on all evaluations (p = 0.02 for day 8, p = 0.09 for day 15, and p = 0.14 for day 22). Patients in the chamomile group never developed mucositis with grade 2 or higher. Presence of ulceration was statistically significant on day 8 (16 % in the control vs. 0 % in the chamomile group, p = 0.10), but not in days 15 and 22, although 11 % still had ulcerations in the control group and none in the chamomile group.


The occurrence of oral mucositis was lower in patients in the chamomile group than in the control group. When compared to the controls, the chamomile group presented less mouth pain and had no ulcerations. Cryotherapy was well tolerated by both groups, and no toxicity related to chamomile was identified.


Oral care Cryotherapy Chemotherapy Cancer Oral mucositis 



We acknowledge the dentist Fábio Fernandes Alves for clinical evaluation of oral mucositis and the nurses Nayara Narley Pires Vieira, Karine Raphaela Missias da Silva, and Carlos de Jesus Sacramento for the intervention applied. We also acknowledge the National Committee for Research and Scientific Development (CNPQ), Brazil, for funding this study.

Compliance with ethical standards

Ethical considerations

Each patient provided written consent prior to starting the procedures. The study was approved by the Committee on Ethics Research of the School of Health Sciences of the University of Brasília.

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Paula Elaine Diniz dos Reis
    • 1
    Email author
  • Marcia A. Ciol
    • 2
  • Nilce Santos de Melo
    • 3
  • Paulo Tadeu de Souza Figueiredo
    • 3
  • André Ferreira Leite
    • 3
  • Natália de Melo Manzi
    • 4
  1. 1.Nursing Department, School of Health SciencesUniversity of BrasíliaBrasiliaBrazil
  2. 2.Department of Rehabilitation Medicine, School of MedicineUniversity of WashingtonSeattleUSA
  3. 3.Dentistry Department, School of Health SciencesUniversity of BrasíliaBrasíliaBrazil
  4. 4.Medical DepartmentSenado FederalBrasíliaBrazil

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