Efficacy and Safety of Topical Steroid Therapy for Oral Mucositis During Cancer Chemotherapy: A Scoping Review

Abstract

Oral mucositis (OM) is a common and debilitating complication of cancer chemotherapy and targeted therapies, significantly affecting patients' quality of life and potentially leading to treatment delays or dose reductions. Although topical corticosteroids have demonstrated anti-inflammatory effects, their clinical use for OM remains limited, particularly in countries such as Japan, due to regulatory and safety concerns. This scoping review examined existing evidence on the efficacy and safety of topical corticosteroid therapy-administered via mouthwash or ointment, for the prevention and management of OM in patients undergoing cancer pharmacotherapy. A comprehensive literature search was conducted using PubMed and Scopus to identify English-language studies published up to June 2025, and six eligible studies were included in the qualitative synthesis. The reviewed studies demonstrated that topical corticosteroid therapy, particularly dexamethasone-based mouthwashes and ointments, was associated with significant reductions in OM incidence and severity, with no adverse events such as oral candidiasis reported. Randomized controlled trials by Niikura et al. and Kuba et al. provided the most robust evidence, supporting both efficacy and safety. Moreover, combined use with professional oral care may further enhance therapeutic outcomes. Overall, topical corticosteroids appear to be a safe and effective intervention for managing chemotherapy- and targeted therapy-induced OM. However, the evidence remains limited by small sample sizes and heterogeneous study designs, underscoring the need for large-scale clinical trials to standardize treatment protocols, evaluate long-term safety, and inform future guidelines and policy development.