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.
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Acknowledgments
The authors would like to thank the following medical librarians for their valuable contribution to this project:
Lorraine Porcello, MSLIS, MSIM—Bibby Dental Library, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA and Daniel A. Castillo, MLIS—Edward G. Miner Library, University of Rochester Medical Center, Rochester, NY, USA.
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Per the MASCC Guidelines Policy, employees of commercial entities were not eligible to serve on this MASCC Guidelines Panel. All authors completed a Conflict of Interest disclosure form and conflicts are disclosed in the guideline’s publications.
The authors disclose no conflict of interest (MEPC, KC, AK, TM, CP, TR, JJT, VR, AV, DEP). PB has served an advisory role for Galera Therapeutics, AstraZeneca, Helsinn, and Kyowa Kyrin and received grants from Merck, Kyowa Kyrin, and Roche.
CLL reports personal fees from PledPharma, Disarm Therapeutics, Asahi Kasei, Metys Pharmaceuticals, and OnQuality, outside the submitted work.
RVL reports personal fees from Colgate Oral Pharmaceuticals, grants and personal fees from Galera Therapeutics, personal fees from Ingalfarma, other from Logic Biosciences, personal fees from Monopar Therapeutics, personal fees from Mundipharma, grants from Novartis, grants from Oragenics, grants and personal fees from Sucampo Pharma, personal fees from Alira Health, outside the submitted work.
SE reports no conflict in regard to mucositis and consulting to Falk Pharma outside the submitted work.
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On behalf of the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO)
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Correa, M.E.P., Cheng, K.K.F., Chiang, K. et al. Systematic review of oral cryotherapy for the management of oral mucositis in cancer patients and clinical practice guidelines. Support Care Cancer 28, 2449–2456 (2020). https://doi.org/10.1007/s00520-019-05217-x
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DOI: https://doi.org/10.1007/s00520-019-05217-x