Findings

What do systematic reviews say?

95 questions · 107 findings · 3 reviews · Oral Health

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No studies found 0 · 0%GRADE not reported 78 · 72.9%Very low 13 · 12.1%Low 9 · 8.4%Moderate 6 · 5.6%High 1 · 0.9%

Epidermal growth factor (EGF), oral spray vs placebo

Oral mucositis (severe) · Adults with cancer receiving treatment

Epidermal growth factor (EGF), oral spray showed no clear difference in oral mucositis (severe) compared with placebo; GRADE not reported.

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
Chemoradiotherapy to the head and neck
RR 1.03 [0.59, 1.80]
1 study · 136 participants
GRADE not reported

GM-CSF vs placebo or no treatment

Oral mucositis (severe) · Adults with cancer receiving treatment

Granulocyte-macrophage colony-stimulating factor (GM-CSF) showed no clear difference in oral mucositis (severe) compared with placebo or no treatment (low certainty).

3 findings from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
BMT/SCT after conditioning for mixed cancers
RR 0.74 [0.33, 1.67]
3 studies · 235 participants
Low
Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
Chemotherapy alone for mixed cancers
RR 0.59 [0.05, 7.11]
2 studies · 65 participants
Very low
Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
RT to head and neck
RR 0.31 [0.01, 7.09]
1 study · 29 participants
Very low

G‐CSF vs placebo or no treatment

Oral mucositis (severe) · Adults with cancer receiving treatment

Granulocyte-colony stimulating factor (G-CSF) may leads to lower oral mucositis (severe) compared with placebo or no treatment (low certainty).

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
RT to head and neck
RR 0.37 [0.15, 0.87]
2 studies · 54 participants
Low

Erythropoietin mouthwash vs placebo

Oral mucositis (severe) · Adults receiving bone marrow/stem cell transplantation after conditioning therapy for haematological cancers

Erythropoietin mouthwash showed no clear difference in oral mucositis (severe) compared with placebo; GRADE not reported.

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
RR 0.40 [0.14, 1.17]
1 study · 80 participants
GRADE not reported

Granulocyte-macrophage colony-stimulating factor (GM-CSF), mouthwash vs Sucralfate mouthwash

Oral mucositis (severe) · Adults receiving radiotherapy to the head and neck

Granulocyte-macrophage colony-stimulating factor (GM-CSF), mouthwash showed no clear difference in oral mucositis (severe) compared with sucralfate mouthwash; GRADE not reported.

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
RT to head and neck
RR 0.54 [0.24, 1.21]
1 study · 40 participants
GRADE not reported

Keratinocyte growth factor (KGF; palifermin or repifermin), intravenous vs placebo

Oral mucositis (severe) · Adults with cancer receiving treatment

Keratinocyte growth factor (KGF; palifermin or repifermin),… may leads to lower oral mucositis (severe) compared with placebo (low certainty).

3 findings from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
Chemotherapy alone for mixed cancers
RR 0.30 [0.14, 0.65]
3 studies · 263 participants
Low
Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
BMT/SCT after conditioning for haematological cancers
RR 0.85 [0.65, 1.11]
6 studies · 852 participants
Low
Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
RT to head and neck with cisplatin/fluorouracil
RR 0.79 [0.69, 0.90]
3 studies · 471 participants
High

Granulocyte-macrophage colony-stimulating factor (GM-CSF), higher dose (1260 to 12,600 micrograms) vs Granulocyte-macrophage colony-stimulating factor (GM-CSF), lower dose (12.6 to 126 micrograms)

Oral mucositis (severe) · breast cancer patients undergoing chemotherapy

Granulocyte-macrophage colony-stimulating factor (GM-CSF), higher… led to higher oral mucositis (severe) compared with granulocyte-macrophage colony-stimulating factor (GM-CSF), lower…; GRADE not reported.

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
RR 2.75 [1.07, 7.04]
1 study · 36 participants
GRADE not reported

Keratinocyte growth factor (KGF; palifermin or repifermin), intravenous vs Chlorhexidine mouthwash

Oral mucositis (severe) · Children with acute lymphoblastic leukaemia receiving chemotherapy alone

Keratinocyte growth factor (KGF), intravenous led to lower oral mucositis (severe) compared with chlorhexidine mouthwash; GRADE not reported.

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
Children
RR 0.01 [0.00, 0.19]
1 study · 90 participants
GRADE not reported

Intestinal trefoil factor (ITF), oral spray vs placebo

Oral mucositis (severe) · Adults receiving chemotherapy alone for colorectal cancer

Intestinal trefoil factor (ITF), oral spray showed no clear difference in oral mucositis (severe) compared with placebo; GRADE not reported.

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: cytokines and growth factors 2017 · Cochrane All outcomes
RR 1.52 [0.06, 36.39]
1 study · 99 participants
GRADE not reported

Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed ice held in the mouth during cancer treatment) vs no intervention or control intervention (control)

Oral mucositis (severe) · All patients with cancer who are receiving treatment

Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed… probably leads to lower oral mucositis (severe) compared with control (no treatment or standard/usual oral care, e.g. saline rinse) (moderate certainty).

3 findings from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy 2015 · Cochrane All outcomes
High-dose melphalan-based treatment prior to HSCT (haematological cancers)
RR 0.38 [0.20, 0.72]
5 studies · 270 participants
Moderate
Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy 2015 · Cochrane All outcomes
Low-dose methotrexate for GVHD prophylaxis after allogeneic HSCT
RR 0.88 [0.61, 1.25]
1 study · 122 participants
Very low
Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy 2015 · Cochrane All outcomes
Fluorouracil (5FU) treatment for solid cancers
RR 0.40 [0.27, 0.61]
5 studies · 444 participants
Moderate

Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed ice held in the mouth during cancer treatment) vs High-dose leucovorin rinse

Oral mucositis (severe) · Patients with osteosarcoma (bone cancer) receiving high-dose methotrexate, vincristine and leucovorin

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy 2015 · Cochrane All outcomes
Oral mucositis (severe). Not estimable - no participants had developed severe oral mucositis by the fourth day after chemotherapy when the data were reported (Zhang 2011, Analysis 4.3, subgroup 3.2); 81 participants in…
1 study · 81 participants
GRADE not reported

Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed ice held in the mouth during cancer treatment) vs Low-dose leucovorin rinse

Oral mucositis (severe) · Patients with osteosarcoma (bone cancer) receiving high-dose methotrexate, vincristine and leucovorin

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy 2015 · Cochrane All outcomes
Oral mucositis (severe). Not estimable - no participants had developed severe oral mucositis by the fourth day after chemotherapy when the data were reported (Zhang 2011, Analysis 4.3, subgroup 3.1); 118 participants…
1 study · 118 participants
GRADE not reported

Cryotherapy (ice chips) 30 minutes vs Cryotherapy (ice chips) 60 minutes

Oral mucositis (severe) · Adults with solid cancers receiving fluorouracil (5FU) and leucovorin

It is very uncertain whether oral cryotherapy for 30 minutes changes oral mucositis (severe) compared with oral cryotherapy for 60 minutes (very low certainty).

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy 2015 · Cochrane All outcomes
RR 0.60 [0.23, 1.58]
1 study · 178 participants
Very low

Oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed ice held in the mouth during cancer treatment) vs Chlorhexidine rinse

Oral mucositis (severe) · Adults with solid cancers receiving fluorouracil (5FU) and leucovorin

It is very uncertain whether oral cryotherapy (ice chips, ice-cold water, ice cubes or crushed… changes oral mucositis (severe) compared with chlorhexidine rinse (very low certainty).

1 finding from 1 review

Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy 2015 · Cochrane All outcomes
RR 0.86 [0.34, 2.18]
1 study · 133 participants
Very low