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

Journal Publication ResearchOnline@JCU
Yarom, Noam;Hovan, Allan;Bossi, Paolo;Ariyawardana, Anura;Jensen, Siri Beier;Gobbo, Margherita;Saca-Hazboun, Hanan;Kandwal, Abhishek;Majorana, Alessandra;Ottaviani, Giulia;Pentenero, Monica;Nasr, Narmin Mohammed;Rouleau, Tanya;Lucas, Anna Skripnik;Treister, Nathaniel Simon;Zur, Eyal;Ranna, Vinisha;Vaddi, Anusha;Cheng, Karis Kin Fong;Barasch, Andrei;Lalla, Rajesh V.;Elad, Sharon;MASCC/ISOO,
Anura Ariyawardana
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 wereanalyzed 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 reestablished. A previous Suggestion for zinc to prevent OM in H&N cancer patients treated with radiotherapy or chemoradiotherapy 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.

Journal

Supportive Care in Cancer

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Volume

27

ISBN/ISSN

1433-7339

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Issue

10

Pages Count

14

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Publisher

Springer

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DOI

10.1007/s00520-019-04887-x