Non-Cochrane · intervention · PM42169561
Corticoids Reduce Incidence of Oral Mucositis during Antineoplastic Treatment? A Systematic Review and Meta-Analysis of Randomized and Nonrandomized Clinical Trials.
Silva Marques Araújo Ana Beatriz, Barbosa Jennifer Vianna, Vieira Barreto Giulianna Aparecida, et al. · Asian Pacific journal of cancer prevention : APJCP · 2026 · PubMed · doi:10.31557/apjcp.2026.27.5.1567
Findings
7 findings
| Population | ||||
|---|---|---|---|---|
| Patients undergoing antineoplastic treatment (chemotherapy and/or head and neck radiotherapy, or HSCT) | Any corticosteroid (topical and systemic) | Placebo, no corticoid, oral care, other mouthwash or low-dose corticoid | Severity of oral mucositis (mean OM scores) Overall (topical and systemic combined) | SMD 0.05 [-0.12, 0.22] 0.05 [-0.12, 0.22] SMD Moderate Downgraded: risk of bias, inconsistency 4 studies · 527 participants |
| Patients undergoing antineoplastic treatment (chemotherapy and/or head and neck radiotherapy, HSCT) | Topical corticosteroids | Placebo, no corticosteroid, oral care, or other topical agent (licorice, chlorhexidine, dexamethasone elixir) | Incidence of oral mucositis Leave-one-out: Ghalayani et al. removed | RR 0.2 [0.06, 0.65] GRADE not reported 2 studies |
| Patients undergoing antineoplastic treatment (chemotherapy and/or head and neck radiotherapy, or HSCT) | Any corticosteroid (topical and systemic) | Placebo, no corticoid, oral care, other mouthwash or low-dose corticoid | Incidence of oral mucositis (any episode) Overall (topical and systemic combined) | RR 0.77 [0.59, 1.01] 155/272 (57.0%) vs 128/316 (40.5%) Moderate Downgraded: risk of bias, imprecision 5 studies · 588 participants |
| Patients undergoing antineoplastic treatment (chemotherapy and/or head and neck radiotherapy, or HSCT) | Topical corticosteroids | Placebo, no corticoid, oral care, other mouthwash or low-dose corticoid | Severity of oral mucositis (mean OM scores) Topical subgroup | SMD 0.10 [-0.08, 0.28] GRADE not reported 3 studies · 461 participants |
| Patients undergoing antineoplastic treatment (chemotherapy and/or head and neck radiotherapy, or HSCT) | Topical corticosteroids | Placebo, no corticoid, oral care, other mouthwash or low-dose corticoid | Incidence of oral mucositis (any episode) Topical subgroup | RR 0.99 [0.85, 1.14] GRADE not reported 3 studies · 365 participants |
| Patients undergoing antineoplastic treatment (chemotherapy and/or head and neck radiotherapy, or HSCT) | Systemic corticosteroids | Placebo, no corticoid, oral care, other mouthwash or low-dose corticoid | Severity of oral mucositis (mean OM scores) Systemic subgroup | SMD -0.27 [-0.76, 0.21] GRADE not reported 1 study · 66 participants |
| Patients undergoing antineoplastic treatment (chemotherapy and/or head and neck radiotherapy, or HSCT) | Systemic corticosteroids | Placebo, no corticoid, oral care, other mouthwash or low-dose corticoid | Incidence of oral mucositis (any episode) Systemic subgroup | RR 0.44 [0.29, 0.66] GRADE not reported 2 studies · 223 participants |
Included primary studies 8
Open in Studies| Study | Year | Also included by | Outcomes it informs here | Trial data |
|---|---|---|---|---|
| Ghalayani et al., 2014 Comparison of triamcinolone acetonide mucoadhesive film with licorice mucoadhesive film on radiotherapy-induced oral mucositis: A… PMID:25347930 | 2017 | this review only | Incidence of oral mucositis (any episode); Severity of oral mucositis (mean OM scores) | not extracted yet |
| Kawashita et al., 2019 A retrospective study of factors associated with the development of oral candidiasis in patients receiving radiotherapy for head and neck… PMID:30383690 | 2018 | this review only | Incidence of oral mucositis (any episode) | not extracted yet |
| Kuba et al., 2023 Study protocol for efficacy and safety of steroid-containing mouthwash to prevent chemotherapy-induced stomatitis in women with breast… PMID:32060155 | 2020 | this review only | not stated | not extracted yet |
| Leborgne et al., 1997 Corticosteroids and radiation mucositis in head and neck cancer. A double-blind placebo-controlled randomized trial. PMID:9683361 | 1998 | this review only | Severity of oral mucositis (mean OM scores) | not extracted yet |
| Li et al., 2023 Radiation-induced mucositis: A retrospective study of dexamethasone-lidocaine-vitamin B12 mouth rinse versus compound chlorhexidine… PMID:37215901 | 2023 | this review only | Severity of oral mucositis (mean OM scores) | not extracted yet |
| Noce et al., 2014 Randomized double-blind clinical trial comparing clobetasol and dexamethasone for the topical treatment of symptomatic oral chronic… PMID:24727333 | 2014 | this review only | Incidence of oral mucositis (any episode); Severity of oral mucositis (mean OM scores) | not extracted yet |
| Saito et al., 2022 Impact of systemic dexamethasone administration on oral mucositis induced by anthracycline-containing regimens in breast cancer treatment. PMID:35869165 | 2022 | this review only | Incidence of oral mucositis (any episode) | not extracted yet |
| Saito et al., 2023 Impact of systemic dexamethasone dosage on docetaxel-induced oral mucositis in patients with breast cancer. PMID:37349388 | 2023 | this review only | Incidence of oral mucositis (any episode) | not extracted yet |
Review question
| Element | Planned (methods) | Found (results) |
|---|---|---|
| Population | Patients under antineoplastic treatment | Patients with head and neck radiotherapy (n=4 studies), breast cancer chemotherapy (n=3), myeloproliferative disease/HSCT (n=1); 718 patients |
| Intervention | Any formulation of corticoid | Systemic corticosteroids (n=3 studies: prednisone, dexamethasone) and topical corticosteroids (n=5) |
| Comparison | Placebo, no corticoid, or low-dose corticoid | Low-dose dexamethasone or placebo (systemic); oral care, dexamethasone elixir, chlorhexidine or licorice film (topical) |
| Outcomes | Incidence and/or severity of oral mucositis | Oral mucositis incidence (5 studies in meta-analysis) and severity scores (4 studies) |
| Study designs | Controlled clinical trials | 5 RCTs and 3 non-randomized clinical trials |
| Timing | Not specified | Evaluation days varied (daily, weekly, within first chemotherapy cycle, 28 days, up to day 90) |
AMSTAR 2 items
Two independent extractors rated each item. Their ratings are shown side by side because they have not been reconciled yet. The overall rating follows Shea et al. 2017: one critical flaw gives Low, more than one gives Critically Low.
| Item | Extractor A | Extractor B | Agree |
|---|---|---|---|
| 1Research question includes PICO components | Yes | Yes | yes |
| 2Protocol established before the reviewcritical | Partial Yes | Partial Yes | yes |
| 3Choice of study designs explained | No | No | yes |
| 4Comprehensive literature searchcritical | No | Partial Yes | no |
| 5Study selection in duplicate | Yes | Yes | yes |
| 6Data extraction in duplicate | Yes | Yes | yes |
| 7List of excluded studies with reasonscritical | No | No | yes |
| 8Included studies described in detail | Partial Yes | Partial Yes | yes |
| 9Risk of bias assessed satisfactorilycritical | NRSI: Yes · RCT: Yes | NRSI: Yes · RCT: Yes | yes |
| 10Funding of included studies reported | No | No | yes |
| 11Appropriate meta-analysis methodscritical | RCT: No · NRSI: No | NRSI: No · RCT: No | no |
| 12Impact of risk of bias on the pooled results | No | No | yes |
| 13Risk of bias accounted for in interpretationcritical | Yes | Yes | yes |
| 14Heterogeneity explained | Yes | Yes | yes |
| 15Publication bias investigatedcritical | Yes | Yes | yes |
| 16Conflicts of interest reported | No | Yes | no |
| Overall | Critically Low | Critically Low | yes |