. 2019 Oct;27(10):3997-4010.

doi: 10.1007/s00520-019-04887-x. Epub 2019 Jul 8.

Systematic review of natural and miscellaneous agents for the management of oral mucositis in cancer patients and clinical practice guidelines-part 1: vitamins, minerals, and nutritional supplements

Noam Yarom^{1

2}, Allan Hovan³, Paolo Bossi⁴, Anura Ariyawardana^{5

6}, Siri Beier Jensen⁷, Margherita Gobbo⁸, Hanan Saca-Hazboun⁹, Abhishek Kandwal¹⁰, Alessandra Majorana¹¹, Giulia Ottaviani⁸, Monica Pentenero¹², Narmin Mohammed Nasr¹³, Tanya Rouleau¹⁴, Anna Skripnik Lucas¹⁵, Nathaniel Simon Treister^{16

17}, Eyal Zur¹⁸, Vinisha Ranna¹⁹, Anusha Vaddi²⁰, Karis Kin Fong Cheng²¹, Andrei Barasch²², Rajesh V Lalla²³, Sharon Elad²⁰; Mucositis Study Group of the Multinational Association of Supportive Care in Cancer / International Society of Oral Oncology (MASCC/ISOO)

Affiliations

¹ Oral Medicine Unit, Sheba Medical Center, Tel Hashomer, Israel. Noam.yarom@sheba.health.gov.il.
² School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel. Noam.yarom@sheba.health.gov.il.
³ British Columbia Cancer - Vancouver Centre, Vancouver, Canada.
⁴ Medical Oncology, ASST-Spedali Civili, University of Brescia, Brescia, Italy.
⁵ College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia.
⁶ Metro South Oral Health, Queensland Health, Brisbane, Australia.
⁷ Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Aarhus, Denmark.
⁸ Division of Oral Medicine and Pathology, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
⁹ Al-Maha Cancer foundation, Bethlehem, Palestine.
¹⁰ Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himayalan University, Dehradun, Uttarakhand, India.
¹¹ Department of Medical and Surgical Specialties, Radiological Science and Public Health, Dental School University of Brescia, Brescia, Italy.
¹² Department of Oncology, Oral Medicine and Oral Oncology Unit, University of Turin, Turin, Italy.
¹³ Special Needs Dentistry, Dental Services, Directorate General of Health Services-Muscat Governorate, Ministry of Health, Muscat, Oman.
¹⁴ Dental Oncology Program, Health Sciences North, North East Cancer Center, Sudbury, ON, Canada.
¹⁵ Medical Oncology Service, Department of Medicine, NYU Langone Perlmutter Cancer Center, New York, NY, USA.
¹⁶ Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA.
¹⁷ Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
¹⁸ Compounding Solutions, Tel-Mond, Israel.
¹⁹ Department of Oral and Maxillofacial Surgery, The Mount Sinai Hospital, New York, NY, 10029, USA.
²⁰ Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.
²¹ Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
²² Division of Oncology, Weill Cornell Medical College, New York, NY, USA.
²³ Section of Oral Medicine, University of Connecticut School of Dental Medicine, Farmington, CT, USA.

PMID: 31286229
DOI: 10.1007/s00520-019-04887-x

Systematic review of natural and miscellaneous agents for the management of oral mucositis in cancer patients and clinical practice guidelines-part 1: vitamins, minerals, and nutritional supplements

Noam Yarom et al. Support Care Cancer. 2019 Oct.

. 2019 Oct;27(10):3997-4010.

doi: 10.1007/s00520-019-04887-x. Epub 2019 Jul 8.

Authors

Affiliations

¹ Oral Medicine Unit, Sheba Medical Center, Tel Hashomer, Israel. Noam.yarom@sheba.health.gov.il.
² School of Dental Medicine, Tel Aviv University, Tel Aviv, Israel. Noam.yarom@sheba.health.gov.il.
³ British Columbia Cancer - Vancouver Centre, Vancouver, Canada.
⁴ Medical Oncology, ASST-Spedali Civili, University of Brescia, Brescia, Italy.
⁵ College of Medicine and Dentistry, James Cook University, Cairns, Queensland, Australia.
⁶ Metro South Oral Health, Queensland Health, Brisbane, Australia.
⁷ Department of Dentistry and Oral Health, Faculty of Health, Aarhus University, Aarhus, Denmark.
⁸ Division of Oral Medicine and Pathology, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy.
⁹ Al-Maha Cancer foundation, Bethlehem, Palestine.
¹⁰ Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himayalan University, Dehradun, Uttarakhand, India.
¹¹ Department of Medical and Surgical Specialties, Radiological Science and Public Health, Dental School University of Brescia, Brescia, Italy.
¹² Department of Oncology, Oral Medicine and Oral Oncology Unit, University of Turin, Turin, Italy.
¹³ Special Needs Dentistry, Dental Services, Directorate General of Health Services-Muscat Governorate, Ministry of Health, Muscat, Oman.
¹⁴ Dental Oncology Program, Health Sciences North, North East Cancer Center, Sudbury, ON, Canada.
¹⁵ Medical Oncology Service, Department of Medicine, NYU Langone Perlmutter Cancer Center, New York, NY, USA.
¹⁶ Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA.
¹⁷ Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Boston, MA, USA.
¹⁸ Compounding Solutions, Tel-Mond, Israel.
¹⁹ Department of Oral and Maxillofacial Surgery, The Mount Sinai Hospital, New York, NY, 10029, USA.
²⁰ Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.
²¹ Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
²² Division of Oncology, Weill Cornell Medical College, New York, NY, USA.
²³ Section of Oral Medicine, University of Connecticut School of Dental Medicine, Farmington, CT, USA.

PMID: 31286229
DOI: 10.1007/s00520-019-04887-x

Erratum in

Correction to: Systematic review of natural and miscellaneous agents, for the management of oral mucositis in cancer patients and Clinical Practice Guidelines - Part 1: vitamins, minerals and nutritional supplements.
Yarom N, Hovan A, Bossi P, Ariyawardana A, Jensen SB, Gobbo M, Saca-Hazboun H, Kandwal A, Majorana A, Ottaviani G, Pentenero M, Nasr NM, Rouleau T, Lucas AS, Treister NS, Zur E, Ranna V, Vaddi A, Cheng KKF, Barasch A, Lalla RV, Elad S; Mucositis Study Group of the Multinational Association of Supportive Care in Cancer / International Society of Oral Oncology (MASCC/ISOO). Yarom N, et al. Support Care Cancer. 2021 Jul;29(7):4175-4176. doi: 10.1007/s00520-021-06141-9. Support Care Cancer. 2021. PMID: 33761004 No abstract available.

Abstract

Purpose: To update the clinical practice guidelines for the use of natural and miscellaneous agents for the prevention and/or treatment of oral mucositis (OM).

Methods: A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer / International Society of Oral Oncology (MASCC/ISOO). The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. The findings were added to the database used to develop the 2014 MASCC/ISOO clinical practice guidelines. Based on the evidence level, the following guidelines were determined: Recommendation, Suggestion, and No Guideline Possible.

Results: A total of 78 papers were identified within the scope of this section, out of which 29 were included in this part, and were analyzed with 27 previously reviewed studies. A new Suggestion was made for oral glutamine for the prevention of OM in head and neck (H&N) cancer patients receiving radiotherapy with concomitant chemotherapy. The previous Recommendation against the use of parenteral glutamine for the prevention of OM in hematopoietic stem cell transplantation (HSCT) patients was re-established. A previous Suggestion for zinc to prevent OM in H&N cancer patients treated with radiotherapy or chemo-radiotherapy was reversed to No Guideline Possible. No guideline was possible for other interventions.

Conclusions: Of the vitamins, minerals, and nutritional supplements studied for the management of OM, the evidence supports a Recommendation against parenteral glutamine in HSCT patients and a Suggestion in favor of oral glutamine in H&N cancer patients for the management of OM.

Keywords: Glutamine; Guidelines; Herbal medicine; Natural; Oral mucositis; Supersaturated calcium phosphate rinse; Zinc.

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References

1. Cancer. 2007 Jan 15;109(2):322-31 - PubMed
1. Asia Pac J Clin Nutr. 2017 Jan;26(1):42-48 - PubMed
1. Cancer. 2014 May 15;120(10):1453-61 - PubMed
1. Can J Diet Pract Res. 2005 Summer;66(2):98-102 - PubMed
1. Mol Clin Oncol. 2015 Mar;3(2):381-386 - PubMed

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Systematic review of natural and miscellaneous agents for the management of oral mucositis in cancer patients and clinical practice guidelines-part 1: vitamins, minerals, and nutritional supplements

Affiliations

Systematic review of natural and miscellaneous agents for the management of oral mucositis in cancer patients and clinical practice guidelines-part 1: vitamins, minerals, and nutritional supplements

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