Noam Yarom1,2, Allan Hovan3, Paolo Bossi4, Anura Ariyawardana5,6, Siri Beier Jensen7, Margherita Gobbo8, Hanan Saca-Hazboun9, Abhishek Kandwal10, Alessandra Majorana11, Giulia Ottaviani8, Monica Pentenero12, Narmin Mohammed Nasr13, Tanya Rouleau14, Anna Skripnik Lucas15, Nathaniel Simon Treister16,17, Eyal Zur18, Vinisha Ranna19, Anusha Vaddi20,21, Andrei Barasch22, Rajesh V Lalla21, Karis Kin Fong Cheng23, Sharon Elad20. 1. Oral Medicine Unit, Sheba Medical Center, Tel Hashomer, Israel. Noam.yarom@sheba.health.gov.il. 2. School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel. Noam.yarom@sheba.health.gov.il. 3. British Columbia Cancer-Vancouver Centre, Vancouver, Canada. 4. Department of Medical and Surgical Specialties, Radiological Sciences and Public Health - Medical Oncology, University of Brescia, Spedali Civili, Brescia, Italy. 5. College of Medicine and Dentistry, James Cook University, Cairns, QLD, Australia. 6. Metro South Oral Health, Queensland Health, Brisbane, Australia. 7. Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Aarhus, Denmark. 8. Division of Oral Medicine and Pathology, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy. 9. Al-Maha Cancer Foundation, Bethlehem, Palestine. 10. Swami Rama Himayalan University Cancer research institute, Himalayan Institute of Medical Sciences, Dehradun, Uttarakhand, India. 11. Dental School University of Brescia Radiological, Department of Medical and Surgical Specialties, Science and Public Health, Brescia, Italy. 12. Department of Oncology, Oral Medicine and Oral Oncology Unit, University of Turin, Turin, Italy. 13. Special Needs Dentistry, Dental Services, Ministry of Health, Muscat, Oman. 14. Dental Oncology Program, Health Sciences North, North East Cancer Center, Sudbury, ON, Canada. 15. Medical Oncology Service, Department of Medicine, NYU Langone Perlmutter Cancer Center, New York, NY, USA. 16. Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA. 17. Harvard School of Dental Medicine Department of Oral Medicine, Infection and Immunity, Boston, MA, USA. 18. Compounding Solutions, Tel-Mond, Israel. 19. The Mount Sinai Hospital Department of Oral and Maxillofacial Surgery New York 10029, NY, USA. 20. University of Rochester Medical Center Oral Medicine, Eastman Institute for Oral Health Rochester, New York, USA. 21. Division of Oral and Maxillofacial Diagnostic Sciences, UConn School of Dental Medicine, UConn Health, Farmington, CT, USA. 22. Dental Clinics, Cambridge Health Alliance, Cambridge, MA, USA. 23. National University of Singapore Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine , Singapore, Singapore.
Abstract
OBJECTIVE: To update the clinical practice guidelines for the management of oral mucositis (OM) that were developed by the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). This part focuses on honey, herbal compounds, saliva stimulants, probiotics, and miscellaneous agents. METHODS: A systematic review was conducted by the Mucositis Study Group of MASCC/ISOO. The body of evidence for each intervention, in each clinical setting, was assigned an evidence level. The findings were added to the database used to develop the 2014 MASCC/ISOO clinical practice guidelines. Based on the evidence level, one of the following guidelines were determined: Recommendation, Suggestion, No Guideline Possible. RESULTS: A total of 78 papers were identified within the scope of this section, of which 49 were included in this review and merged with nine publications that were reported in the previous guidelines update. A new Suggestion was made for honey (combined topical and systemic delivery) for the prevention of OM in head and neck cancer patients receiving radiotherapy with or without chemotherapy. A new Suggestion clarified that chewing gum is not effective for the prevention of OM in pediatric patients with hematological or solid cancer treated with chemotherapy. No guideline was possible for other interventions. CONCLUSIONS: Numerous natural products and herbal remedies were studied for the management of OM. Of the agents reviewed in this systematic review, a guideline in favor was made for honey (combined topical and systemic), while a guideline against was made for chewing gum. Additional research is warranted to clarify the potential of other interventions.
OBJECTIVE: To update the clinical practice guidelines for the management of oral mucositis (OM) that were developed by the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). This part focuses on honey, herbal compounds, saliva stimulants, probiotics, and miscellaneous agents. METHODS: A systematic review was conducted by the Mucositis Study Group of MASCC/ISOO. The body of evidence for each intervention, in each clinical setting, was assigned an evidence level. The findings were added to the database used to develop the 2014 MASCC/ISOO clinical practice guidelines. Based on the evidence level, one of the following guidelines were determined: Recommendation, Suggestion, No Guideline Possible. RESULTS: A total of 78 papers were identified within the scope of this section, of which 49 were included in this review and merged with nine publications that were reported in the previous guidelines update. A new Suggestion was made for honey (combined topical and systemic delivery) for the prevention of OM in head and neck cancerpatients receiving radiotherapy with or without chemotherapy. A new Suggestion clarified that chewing gum is not effective for the prevention of OM in pediatric patients with hematological or solid cancer treated with chemotherapy. No guideline was possible for other interventions. CONCLUSIONS: Numerous natural products and herbal remedies were studied for the management of OM. Of the agents reviewed in this systematic review, a guideline in favor was made for honey (combined topical and systemic), while a guideline against was made for chewing gum. Additional research is warranted to clarify the potential of other interventions.
Entities:
Keywords:
Cancer; Complementary; Herbal; Management; Natural; Oral mucositis; Traditional
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