Topical oral cavity chemoprophylaxis using isotretinoin rinse: A 15-year experience

Laryngoscope. 2017 Jul;127(7):1595-1599. doi: 10.1002/lary.26463. Epub 2016 Dec 21.


Objectives/hypothesis: To determine the utility of isotretinoin oral rinses as a method of chemoprevention for recurrent oral cavity squamous cell carcinoma (SCC), carcinoma in situ, and dysplasia.

Study design: Retrospective cohort study.

Methods: One hundred forty-three patients were initially enrolled in the study; however, 18 were excluded due to inability to tolerate therapy. The included patients were classified into four groups. Group 1 included patients with multiple early stage oral cavity lesions following initial resection. Group 2 included patients with SCC in situ after excision. Group 3 included patients with multifocal dysplasia following initial CO2 laser ablation. Group 4 included patients with a history of treated oral cavity SCC with new leukoplakia lesions proven to be dysplastic. Fifty-three patients in the control group did not use post-treatment isotretinoin rinses due to various reasons, whereas 72 patients completed therapy. Minimum use of isotretinoin rinses was 12 months, and minimum follow-up was 24 months. During the follow-up period, all recurrences of carcinoma, in situ disease, and dysplasia were noted and compared with a Fisher test of fit. A Bonferroni correction was applied to increase accuracy and strength of comparison.

Results: Using a Bonferroni correction, the significance threshold was 0.0125. By that cutoff, isotretinoin rinses were found to be associated with lower recurrence in groups 1 and 3 (P = .00014, P = .00002, respectively) but not in groups 2 and 4 (P = .4, P = .3846, respectively).

Conclusions: Oral isotretinoin as chemoprophylaxis for patients treated for oral cavity squamous cell carcinoma, in situ disease, or dysplasia may be beneficial in decreasing recurrence rate.

Level of evidence: 4. Laryngoscope, 127:1595-1599, 2017.

Keywords: Isotretinoin; chemoprophylaxis; oral cavity cancer.

Publication types

  • Comparative Study
  • Controlled Clinical Trial

MeSH terms

  • Carcinoma in Situ / drug therapy*
  • Carcinoma in Situ / pathology
  • Carcinoma, Squamous Cell / drug therapy*
  • Carcinoma, Squamous Cell / pathology
  • Cohort Studies
  • Combined Modality Therapy
  • Female
  • Humans
  • Isotretinoin / administration & dosage*
  • Laser Therapy
  • Leukoplakia, Oral / drug therapy*
  • Leukoplakia, Oral / pathology
  • Male
  • Middle Aged
  • Mouth Neoplasms / drug therapy*
  • Mouth Neoplasms / pathology
  • Mouthwashes*
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / prevention & control*
  • Neoplasm Staging
  • Precancerous Conditions / drug therapy*
  • Precancerous Conditions / pathology
  • Retrospective Studies
  • Secondary Prevention


  • Mouthwashes
  • Isotretinoin