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Support Care Cancer. 2019 Jul 8. doi: 10.1007/s00520-019-04892-0. [Epub ahead of print]

Systematic review of agents for the management of cancer treatment-related gastrointestinal mucositis and clinical practice guidelines.

Author information

1
Adelaide Medical School, University of Adelaide, Adelaide, Australia. joanne.bowen@adelaide.edu.au.
2
Division of Health Sciences, University of South Australia, Adelaide, Australia.
3
Adelaide Medical School, University of Adelaide, Adelaide, Australia.
4
Radboud University Medical Centre, Nijmegen, The Netherlands.
5
Department of Medical and Surgical Specialties, Radiological Sciences and Public Health - Medical Oncology, University of Brescia, Brescia, Italy.
6
St Vincent's Hospital, Melbourne, Australia.
7
University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
8
Department of Oral and Maxillofacial Surgery, The Mount Sinai Hospital, New York, NY, USA.
9
Oral Medicine, Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA.
10
Section of Oral Medicine, University of Connecticut Health, Farmington, CT, USA.
11
Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Abstract

PURPOSE:

The aim of this study was to update the clinical practice guidelines for the use of agents for the prevention and/or treatment of gastrointestinal mucositis (GIM).

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. Based on the evidence level, one of the following three guideline determinations was possible: Recommendation, Suggestion, and No Guideline Possible.

RESULTS:

A total of 78 papers across 13 interventions were examined of which 25 were included in the final review. No new guidelines were possible for any agent due to inadequate and/or conflicting evidence. Existing guidelines for probiotics and hyperbaric oxygen were unchanged.

CONCLUSIONS:

Of the agents studied for the prevention and treatment of GIM, the evidence continues to support use of probiotics containing Lactobacillus spp. for prevention of chemoradiotherapy and radiotherapy-induced diarrhea in patients with pelvic malignancy, and hyperbaric oxygen therapy to treat radiation-induced proctitis. Additional well-designed research is encouraged to enable a decision regarding palifermin, glutamine, sodium butyrate, and dietary interventions, for the prevention or treatment of GIM.

KEYWORDS:

Clinical management; Gastrointestinal; Guidelines; Mucositis

PMID:
31286233
DOI:
10.1007/s00520-019-04892-0

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