. 2019 Oct;27(10):3949-3967.

doi: 10.1007/s00520-019-04848-4. Epub 2019 Jul 8.

Systematic review of basic oral care for the management of oral mucositis in cancer patients and clinical practice guidelines

Catherine H L Hong¹, Luiz Alcino Gueiros², Janet S Fulton³, Karis Kin Fong Cheng⁴, Abhishek Kandwal⁵, Dimitra Galiti⁶, Jane M Fall-Dickson⁷, Jorgen Johansen⁸, Suzanne Ameringer⁹, Tomoko Kataoka¹⁰, Dianna Weikel¹¹, June Eilers¹², Vinasha Ranna¹³, Anusha Vaddi¹⁴, Rajesh V Lalla¹⁵, Paolo Bossi¹⁶, Sharon Elad¹⁷; Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO)

Affiliations

¹ Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, National University of Singapore, 21 Lower Kent Ridge Rd, Singapore, 119077, Singapore. denchhl@nus.edu.sg.
² Oral Medicine Unit, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
³ Indiana University School of Nursing, Indianapolis, IN, USA.
⁴ Alice Lee Center for Nursing Studies, National University of Singapore, Singapore, Singapore.
⁵ Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India.
⁶ Dental School, University of Athens, Athens, Greece.
⁷ Department of Professional Nursing Practice, Georgetown University School of Nursing & Health Studies, Washington, DC, USA.
⁸ Department of Oncology, Odense University Hospital, Odense, Denmark.
⁹ School of Nursing, Virginia Commonwealth University, Richmond, VA, USA.
¹⁰ Multi-institutional Clinical Trials Section, Research Management Division, Clinical Research Support Office, National Cancer Center Hospital, Tokyo, Japan.
¹¹ Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, USA.
¹² College of Nursing-Omaha Division, University of Nebraska Medical Center, Omaha, NE, USA.
¹³ Department of Oral and Maxillofacial Surgery, The Mount Sinai Hospital, New York, NY, USA.
¹⁴ Oral Medicine, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.
¹⁵ Section of Oral Medicine, University of Connecticut Health, Farmington, CT, USA.
¹⁶ Department of Medical and Surgical Specialties, Radiological Sciences and Public Health-Medical Oncology, University of Brescia, ASST-Spedali Civili, Brescia, Italy.
¹⁷ Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.

PMID: 31286232
DOI: 10.1007/s00520-019-04848-4

Systematic review of basic oral care for the management of oral mucositis in cancer patients and clinical practice guidelines

Catherine H L Hong et al. Support Care Cancer. 2019 Oct.

. 2019 Oct;27(10):3949-3967.

doi: 10.1007/s00520-019-04848-4. Epub 2019 Jul 8.

Authors

Affiliations

¹ Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, National University of Singapore, 21 Lower Kent Ridge Rd, Singapore, 119077, Singapore. denchhl@nus.edu.sg.
² Oral Medicine Unit, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
³ Indiana University School of Nursing, Indianapolis, IN, USA.
⁴ Alice Lee Center for Nursing Studies, National University of Singapore, Singapore, Singapore.
⁵ Cancer Research Institute, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, India.
⁶ Dental School, University of Athens, Athens, Greece.
⁷ Department of Professional Nursing Practice, Georgetown University School of Nursing & Health Studies, Washington, DC, USA.
⁸ Department of Oncology, Odense University Hospital, Odense, Denmark.
⁹ School of Nursing, Virginia Commonwealth University, Richmond, VA, USA.
¹⁰ Multi-institutional Clinical Trials Section, Research Management Division, Clinical Research Support Office, National Cancer Center Hospital, Tokyo, Japan.
¹¹ Marlene and Stewart Greenebaum Comprehensive Cancer Center, University of Maryland, Baltimore, MD, USA.
¹² College of Nursing-Omaha Division, University of Nebraska Medical Center, Omaha, NE, USA.
¹³ Department of Oral and Maxillofacial Surgery, The Mount Sinai Hospital, New York, NY, USA.
¹⁴ Oral Medicine, Eastman Institute for Oral Health, University of Rochester, Rochester, NY, USA.
¹⁵ Section of Oral Medicine, University of Connecticut Health, Farmington, CT, USA.
¹⁶ Department of Medical and Surgical Specialties, Radiological Sciences and Public Health-Medical Oncology, University of Brescia, ASST-Spedali Civili, Brescia, Italy.
¹⁷ Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.

PMID: 31286232
DOI: 10.1007/s00520-019-04848-4

Abstract

Purpose: The aim of this study was to update the clinical practice guidelines for the use of basic oral care (BOC) interventions 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 for 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 2013 MASCC/ISOO clinical practice guidelines. Based on the evidence level, one of the following three guideline determinations was possible: Recommendation, Suggestion, No guideline possible.

Results: A total of 17 new papers across six interventions were examined and merged with a previous database. Based on the literature, the following guidelines were possible. The panel suggests that the implementation of multi-agent combination oral care protocols is beneficial for the prevention of OM during chemotherapy, head and neck (H&N) radiation therapy (RT), and hematopoietic stem cell transplantation (Level of Evidence III). The panel suggests that chlorhexidine not be used to prevent OM in patients undergoing H&N RT (Level of Evidence III). No guideline was possible for professional oral care, patient education, saline, and sodium bicarbonate, and expert opinion complemented these guidelines.

Conclusions: The evidence supports the use of multi-agent combination oral care protocols in the specific populations listed above. Additional well-designed research is needed on the other BOC interventions prior to guideline formulation.

Keywords: Basic oral care; Cancer; Chlorhexidine; Dental care; Guidelines; Oral mucositis; Patient education; Saline; Sodium bicarbonate.

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Systematic review of basic oral care for the management of oral mucositis in cancer patients and clinical practice guidelines

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Systematic review of basic oral care for the management of oral mucositis in cancer patients and clinical practice guidelines

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