Systematic review of oral cryotherapy for the management of oral mucositis in cancer patients and clinical practice guidelines
- Study type
- Clinical guideline
- Study name
- MASCC/ISOO Oral Cryotherapy 2020
- Design
- Systematic review with clinical guideline development (update of the 2013 guideline of the Multinational Association of Supportive Care in Cancer / International Society of Oral Oncology, MASCC/ISOO)
- Sample size
- 36 papers reviewed (of 114 papers identified)
- Source
- Support Care Cancer · 2019
In plain words
Painful sores and inflammation of the mouth (oral mucositis) are common side effects of cancer treatment. This review shows that holding ice or a cold liquid in the mouth (oral cryotherapy) can prevent this side effect. It is recommended for patients who receive high-dose melphalan before a transplant of their own stem cells, and for patients who receive 5-fluorouracil as a quick injection (bolus). For other situations, there was not enough evidence to issue guidance.
Key points
Key guideline recommendations
- Recommendation (level of evidence upgraded; exact grade in the full text of the paper)
Oral cryotherapy is recommended for the prevention of oral mucositis in patients undergoing autologous haematopoietic stem cell transplantation with high-dose melphalan-containing conditioning protocols.
- Recommendation (confirmed; exact grade in the full text of the paper)
Oral cryotherapy is recommended for the prevention of oral mucositis in patients with solid tumours receiving bolus 5-fluorouracil (previous recommendation confirmed).
- No guideline possible
For other clinical settings, no guideline was possible.
Treatment arms and regimens
Oral cryotherapy for the prevention of oral mucositis. Dose details in the full text of the paper.
Source of the regimen details: Abstract of the paper; details of dose and method of delivery 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 cancer treatments who are at risk of oral mucositis (OM), including patients undergoing autologous haematopoietic stem cell transplantation with high-dose melphalan-containing conditioning regimens and patients with solid tumours receiving bolus 5-fluorouracil.
Endpoints
Prevention of cancer treatment-induced oral mucositis with oral cryotherapy. The level of evidence (LoE) was determined for each intervention and each cancer treatment modality, and on that basis the guideline was classified as "recommendation", "suggestion" or "no guideline possible".
Safety and side effects
No adverse event data are reported in the abstract.
Clinical significance and place in guidelines
This MASCC/ISOO guideline update recommends oral cryotherapy to prevent oral mucositis in two settings: autologous haematopoietic stem cell transplantation with high-dose melphalan (guideline upgraded to a "recommendation") and bolus 5-fluorouracil (previous recommendation confirmed). No guideline could be developed for other clinical settings. Adoption in other clinical guidelines should be checked separately.
Limitations
In the abstract, the small number of included papers (36 papers) and the inability to develop guidelines for other clinical settings point to limited evidence in those areas. Details of how cryotherapy is delivered and safety data are not given in the abstract.
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.