Interventions effective for preventing oral mucositis in patients with cancer

January 01, 0001

Interventions effective for preventing oral mucositis in patients with cancer

Clinical Question:How effective are interventions for preventing oral mucositis in patients with cancer receiving treatment?

Bottom line: Compared with either a placebo or no treatment, 9 interventions were found to have some benefit with regard to preventing or reducing the severity of mucositis associated with cancer treatment. For patients with head and neck cancer undergoing radiotherapy, oral mucositis may be prevented by aloe vera, honey or with polymixin/tobramycin/amphotericin (PTA) antibiotic pastilles/ paste. For patients with blood cancers undergoing chemotherapy or stem cell transplant, cryotherapy (ice chips) may be effective. Another 5 interventions were found to be effective in groups of patients with a range of different types of cancer undergoing a range of different treatments. These interventions were allopurinol, amifostine, intravenous glutamine, keratinocyte growth factor and laser treatment.

Caveat:The patient groups studied were diverse, the associated treatment modalities were varied and the strength of the evidence of effectiveness was variable. As some interventions were studied exclusively in certain patient groups receiving specific treatment modalities, generalisation of the results to other tumour types and treatment modalities must be done with caution Ð some benefits may be specific to certain cancer types and treatments.

Context:Treatment for cancer (including bone marrow transplant) can cause oral mucositis. This painful condition can cause difficulties in eating, drinking and swallowing, and may also be associated with infections which may require the patient to stay longer in hospital.

Cochrane Systematic Review:Alfirevic Z, Gyte GML, Dou L et. Different classes of antibiotics given to women routinely for preventing infection at caesarean section. Cochrane Reviews, 2010, Issue 10. Article No. CD008726. DOI: 10.1002/14651858.CD008726. This review contains 25 studies involving 6367 participants.

Cochrane PEARLS Practical Evidence About Real Life Situations. No. 303, March 2011.
Written by Brian R McAvoy. Published by the Cochrane Primary Care Group

Category: D. Digestive. Keywords: mucositis, cancer, aloe vera, honey, allopurinol, amifostine, intravenous glutamine, keratinocyte growth factor, laser treatment
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 7 June 2011

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Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.