M Elvira P Correa1, Karis Kin Fong Cheng2, Karen Chiang3,4, Abhishek Kandwal5, Charles L Loprinzi6, Takehiko Mori7, Carin Potting8, Tanya Rouleau9, Juan J Toro10, Vinisha Ranna11, Anusha Vaddi12,13, Douglas E Peterson13, Paolo Bossi14, Rajesh V Lalla13, Sharon Elad12. 1. Oral Medicine, Post-Graduation Program, Oncology Department, School of Medical Science, University of Campinas, Cidade, Universitária Zeferino Vaz - Barão Geraldo, Campinas, São Paulo, 13083-970, Brazil. elvira@unicamp.br. 2. Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, 21 Lower Kent Ridge Rd, Singapore, 119077, Singapore. 3. Pharmacy Department, St Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia. 4. Electronic Medical Records, Department, Melbourne Health, Parkville, Victoria, Australia. 5. Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India. 6. Division of Medical Oncology, Mayo Clinic, Rochester, MN, USA. 7. Division of Hematology, Department of Medicine, Keio University School of Medicine, Tokyo, Japan. 8. Department of Hematology, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525, Nijmegen, GA, Netherlands. 9. Dental Oncology Program, Health Sciences North, North East Cancer Center, Sudbury, Ontario, Canada. 10. Department of Medicine, South Texas Veterans Health Care System, San Antonio, TX, USA. 11. Department of Oral and Maxillofacial Surgery, The Mount Sinai Hospital, New York, NY, USA. 12. Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA. 13. Division of Oral and Maxillofacial Diagnostic Sciences, UConn School of Dental Medicine, UConn Health, Farmington, CT, USA. 14. Department of Medical and Surgical Specialties, Radiological Sciences and Public Health - Medical Oncology, University of Brescia, ASST Spedali Civili, Brescia, Italy.
Abstract
PURPOSE: To update the 2013 Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) clinical practice guidelines on oral cryotherapy for the management of oral mucositis (OM) caused by cancer therapies. METHODS: A systematic review was conducted by the Mucositis Study Group of MASCC/ISOO. The evidence for each intervention for specific cancer treatment modalities was assigned a level of evidence (LoE). The findings were added to the database used to develop the 2013 MASCC/ISOO clinical practice guidelines. Based on the LoE, the guidelines were set as: recommendation, suggestion, or no guideline possible. RESULTS: A total of 114 papers were identified: 44 from PubMed and 70 from Web of Science. After abstract triage and merging with the 2013 database, 36 papers were reviewed. The LoE for prevention of OM with oral cryotherapy in patients undergoing autologous hematopoietic stem cell transplant using high-dose melphalan conditioning protocols was upgraded, and the guideline changed to recommendation. Additionally, the recommendation for prevention of OM with oral cryotherapy in patients receiving bolus 5-fluorouracil for the treatment of solid tumors was confirmed. No guidelines were possible for other clinical settings. CONCLUSIONS: The evidence supports recommendations for the use of oral cryotherapy for the prevention of OM for either (i) patients undergoing autologous hematopoietic stem cell transplant with high-dose melphalan conditioning protocols or (ii) patients receiving bolus 5-fluorouracil chemotherapy.
PURPOSE: To update the 2013 Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) clinical practice guidelines on oral cryotherapy for the management of oral mucositis (OM) caused by cancer therapies. METHODS: A systematic review was conducted by the Mucositis Study Group of MASCC/ISOO. The evidence for each intervention for specific cancer treatment modalities was assigned a level of evidence (LoE). The findings were added to the database used to develop the 2013 MASCC/ISOO clinical practice guidelines. Based on the LoE, the guidelines were set as: recommendation, suggestion, or no guideline possible. RESULTS: A total of 114 papers were identified: 44 from PubMed and 70 from Web of Science. After abstract triage and merging with the 2013 database, 36 papers were reviewed. The LoE for prevention of OM with oral cryotherapy in patients undergoing autologous hematopoietic stem cell transplant using high-dose melphalan conditioning protocols was upgraded, and the guideline changed to recommendation. Additionally, the recommendation for prevention of OM with oral cryotherapy in patients receiving bolus 5-fluorouracil for the treatment of solid tumors was confirmed. No guidelines were possible for other clinical settings. CONCLUSIONS: The evidence supports recommendations for the use of oral cryotherapy for the prevention of OM for either (i) patients undergoing autologous hematopoietic stem cell transplant with high-dose melphalan conditioning protocols or (ii) patients receiving bolus 5-fluorouracil chemotherapy.
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