Cochrane · intervention · CD000978

Interventions for preventing oral mucositis for patients with cancer receiving treatment

Worthington, HV, Clarkson, JE, Bryan, G, et al. · Cochrane Database of Systematic Reviews · 2011 · Cochrane Library

Oral Health Oral medicine and oral cancer5 versionsAMSTAR 2: not assessed

Full textEvery question was extracted from the full review (methods and results), not only its Summary of Findings table.

Questions

current version

GRADE rated

No studies

Included studies

131

as reported

No studies 0 · 0%Ungraded 86 · 89.6%Very low 1 · 1%Low 6 · 6.3%Moderate 3 · 3.1%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

Element	Planned (methods)	Found (results)
Population	Anyone with cancer who received radiotherapy chemotherapy or targeted therapies	One hundred and fourteen (87%) of the included trials recruited only adult patients, 13 included both adults and children (with a difference in age as large as 1 to 70 years) and three trials were conducted solely on paediatric patients, the age group being unclear in one trial. The type of cancer for which patients were being treated was exclusively head and neck cancer in 69 trials (53%), leukaemia in 13 trials, solid tumours in 22 trials and a combination of haematological and solid tumours in 21 trials, the cancer type being unclear in six trials
Intervention	Any agent prescribed as prophylaxis for oral mucositis	Aciclovir (n=1); Allopurinol mouthrinse (n=4); Aloe vera (n=2); Amifostine (n=11); Antibiotic pastille/paste (n=1); Antibiotic systemic clarithromycin (n=1); Azulene (n=1); Benzydamine (n=4); Beta carotene (n=1); Camomile (n=1); Chewing gum (n=1); Chinese herbs (n=2); Chlorhexidine (n=10); Cryotherapy (n=7); Dental stent (n=1); Epidermal growth factor (n=1); Glutamine (n=10); G-CSF (n=4); GM-CSF (n=9); Histamine gel (n=1); Honey (n=3); Hydrolytic enzymes (n=3); Indigo wood root (n=1); Indomethacin (n=1); Intestinal trefoil factor (n=1); Iseganan (n=2); Keratinocyte growth factor (n=7); Laser (n=6); Non-steroidal anti-inflammatory drug (n=1); Oral care (n=2); Pentoxifylline (n=1); Pilocarpine (n=2); Polaprezinc (n=1); Povidone iodine (n=4); Prednisone (n=1); Propantheline (n=1); Prostaglandin (n=5); Radiotherapy morning versus evening (n=2); Shenqi-fanghou (n=1); Superoxide dismutase (n=1); Sucralfate (n=13); Traumeel (n=1); Yangyin-humo decoctalion (n=1); Zinc sulphate (n=2)
Comparison	Placebo/No treatment/Another active intervention	Placebo (n=117); No treatment (n=45); Water (n=NA); Glycine (n=NA); Sugar solution (n=NA); Polycal (n=NA); Saline (n=NA); Albumin (n=NA)
Outcomes	Mucositis (at all levels of severity) (ulcers); Oral hygiene measures; Relief of pain/use of analgesia; Duration or severity of dysphagia; Use of parenteral nutrition or feeding tube; Incidence of systemic infection or use of antibiotics; Febrile episodes; Blood changes; Treatment interruption; Days of stay in hospital; Toxicity (nausea/vomiting/constipation/diarrhoea); Toxicity - skin changes; Toxicity - unspecific; Xerostomia; Cost of care; Patient quality of life; Death; Weight loss/gain; Caloric intake by oral nutrition; Eating/drinking difficulty; Overall health; Recurrence of cancer	Oral hygiene measures (n=27); Relief of pain (n=48); Use of analgesia (morphine) (n=48); Duration or severity of dysphagia (n=37); Use of parenteral nutrition or feeding tube (n=30); Incidence of systemic infection or use of antibiotics (n=38); Febrile episodes (n=24); Blood changes (n=49); Treatment interruption (n=27); Days of stay in hospital (n=12); Toxicity - nausea/vomiting/constipation/diarrhoea (n=46); Toxicity - skin changes (n=24); Toxicity - unspecific (n=18); Xerostomia (n=27); Cost (n=18); Patient quality of life (n=7); Death (n=21); Weight loss (n=41); Caloric intake by oral nutrition (n=11); Eating/drinking difficulty (n=25); Overall health (n=18); Recurrence of cancer (n=24)
Study designs	Only randomised controlled trials were eligible for inclusion in this review including both cross-over and parallel group studies	NR
Timing	Not specified	The duration of the trials varied from a few days up to a year after treatment. The interval during which mucositis was recorded varied from 5 to 90 days or until the end of the radiotherapy, or the leukocyte count was above 8000 mm³. Several studies presented data at different time points, with the median time point being 28 days

Search date: 2011-02. Databases: Cochrane Oral Health Group Trials Register; Cochrane Pain, Palliative and Supportive Care (PaPaS) Group Trials Register; CENTRAL; MEDLINE; EMBASE; CANCERLIT; OpenSIGLE; LILACS; CINAHL