Systematic review of basic oral care for the management of oral mucositis in cancer patients and clinical practice guidelines
- Study type
- Clinical guideline
- Study name
- MASCC/ISOO Basic Oral Care 2019
- Design
- Systematic review and clinical guideline update by the MASCC/ISOO Mucositis Study Group
- Sample size
- 17 new papers on six interventions (merged with the 2013 guideline database)
- Source
- Support Care Cancer · 2019
In plain words
Mouth sores and inflammation (oral mucositis) are common side effects of chemotherapy, radiotherapy to the head and neck area, and stem cell transplantation. This review found that a mouth care plan combining several measures may help prevent this side effect. For patients having head and neck radiotherapy, chlorhexidine mouthwash is not suggested for prevention. For other approaches, such as salt water or baking soda, there is not yet enough evidence to make a guideline. Agree any mouth care plan with your doctor or treatment team.
Key points
Key guideline recommendations
- Suggestion, level of evidence III
The panel suggests that implementing multi-agent combination oral care protocols is beneficial for preventing oral mucositis during chemotherapy, head and neck radiotherapy and haematopoietic stem cell transplantation.
- Suggestion, level of evidence III
The panel suggests that chlorhexidine not be used to prevent oral mucositis in patients receiving head and neck radiotherapy.
- No guideline possible
For professional oral care, patient education, saline and sodium bicarbonate, no guideline was possible, and expert opinion complemented these guidelines.
Treatment arms and regimens
Combination oral care protocols to prevent oral mucositis. Dose details in the full text of the paper.
Use for preventing oral mucositis in patients receiving head and neck radiotherapy. Dose details in the full text of the paper.
Professional oral care, patient education, saline and sodium bicarbonate. Dose details in the full text of the paper.
Source of the regimen details: Abstract of the paper; dose details in the full text of the paper
Doses are given for the information of specialists, as in this study’s protocol, and are not a prescription. Every drug must be prescribed by the treating physician for the individual patient.
Study population
Cancer patients receiving chemotherapy, head and neck radiotherapy or haematopoietic stem cell transplantation who are at risk of oral mucositis (OM). Exact study inclusion criteria are not given in the abstract.
Endpoints
Determining the level of evidence for each intervention in each cancer treatment setting and issuing one of three guideline outcomes: Recommendation, Suggestion or No guideline possible.
Safety and side effects
The abstract gives no information on adverse effects of the interventions.
Clinical significance and place in guidelines
This MASCC/ISOO guideline update suggests that multi-agent combination oral care protocols be used to prevent oral mucositis during chemotherapy, head and neck radiotherapy and haematopoietic stem cell transplantation, and that chlorhexidine not be used for prevention during head and neck radiotherapy. Both are suggestions (not strong recommendations) based on level III evidence. For other basic interventions, evidence was insufficient to issue a guideline. The status of adoption of this guideline in other guidelines should be checked separately.
Limitations
Only 17 new papers on six interventions were reviewed. Both active suggestions are based on level III evidence. For professional oral care, patient education, saline and sodium bicarbonate, evidence was insufficient to develop a guideline, and further well-designed research is needed.
This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.