PREVENTION OF ORAL MUCOSITIS IN CANCER PATIENTS WITH ANTINEOPLASIC TREATMENT: A SYSTEMATIC REVIEW
DOI:
https://doi.org/10.15332/us.v10i1.1146Keywords:
Mucositis, Neoplasms head and neck, Randomized controlled trials, Stomatitis, SucralfateAbstract
Objective: To evaluate the effectiveness of interventions for the prevention of oral mucositis in cancer patients antineoplasic treated.
Methods: The Cochrane Oral Health Group Trials Register, MEDLINE LILACS y SCIELO were searched. Randomized clinical trials were selected. The preventive measures must have been begun the first day of the antineoplasic treatment. Only were include the studies publish in the last 10 years. Review the title and abstract of each result of the search and extracted the outcome measures and results in duplicate. Meta-analysis was performed when two or more studies use the same intervention and was comparable. The statistical analysis was made by EPIDAT y RevMan 5.
Results: Forty six studies were eligible, 24 were excluded. Fifteen interventions were evaluated, of the included interventions in this study nine showed evidence of some benefit for either preventing or reducing the severity of mucositis, three interventions were present in more than one study and comparable for performing meta-analysis: amifostine, laser He/Ne y zinc. The meta-analysis of zinc was the only one that showed beneficial effect in preventing moderate and severe mucositis.
Conclusions: Especially administration of zinc, honey and sucralfate had showed some benefit at preventing or reducing the severity of mucositis associated with cancer treatment. Nevertheless the quality and the sample size of these studies are not enough for recommend and specific intervention instead of another.
Downloads
References
Fang L Sonis ST, Fazio RC. Complicações bucais da quimioterapia do câncer. Medicina Oral. Rio de Janeiro: Guanabara Koogan, 1989.
Puyal-Casado M, Jimenez-Martinez C, Chimenos-Kustner E, Lopez-Lopez J. A protocol for the evaluation and treatment of oral mucositis in patients with hematological malignancies. Med Oral 2003; 8: 10 - 18.
Adamietz IA, Rahn R, Böttcher HD, Schäfer V, Reimer K, Fleischer W. Prophylaxis with povidone-iodine against induction of oral mucositis by radiochemotherapy. Support Care Cancer 1998; 6: 373 - 377.
Parulekar W, Mackenzie R, Bjarnason G, Jordan RCK. Scoring oral mucositis. Oral Oncol 1998; 34: 63 - 71.
Raber-Durlacher JE. Current practices for management of oral mucositis in cancer patients. Support Care Cancer 1999; 7: 71 - 74.
Lalla RV, Peterson DE. Oral mucositis. Dent Clin North Am Jan. 2005; 49: 167 – 184.
Trotti A, Bellm LA, Epstein JB, Frame D, Fuchs HJ, Gwede CK, et al. Mucositis incidence, severity and associated outcomes in patients with head and neck cancer receiving radiotherapy with or without chemotherapy: a systematic literature review. Radiother Oncol 2003; 66: 253 - 262.
Bensadoun RJ, Magné N, Marcy PY, Demard F. Chemotherapy and radiotherapy-induced mucositis in head and neck cancer patients: new trends in pathophysiology, prevention and treatment. Eur Arch Otorhinolaryngol 2001; 258: 481 - 487.
Sonis ST. Mucositis is as a biological process: a new hypothesis for development of chemotherapy-induced stomato-toxicity. Oral Oncol 1998; 34: 39 - 43.
Worthington HV, Clarkson JE, Eden OB. Intervenciones para la prevención de la mucositis oral en pacientes que reciben tratamiento para el cáncer (Revisión Cochrane traducida). En: la Biblioteca Cochrane Plus, 2008 Número 2. Oxford: Update Software Ltd.
Sasse AD, Clark LG, Sasse EC, Clark OA. Amifostine reduces side effects and improves complete response rate during radiotherapy: results of a meta-analysis. Int J Radiat Oncol Biol Phys 2006; 64: 784 - 791.
Gallego C. La mucositis, un efecto del tratamiento quimioterapéutico: fisiopatología y manejo. Rev Fac Odontol Univ Antioq 2007; 18: 84 - 92.
Bagchi D, Bagchi M, Stohs SJ. Comparative in vitro oxygen radical scavenging ability of zinc methionine and selected zinc salts and antioxidants. Gen Pharmacol 1997; 28: 85 – 91.
Vacha P, Fehlauer F, Mahlmann B, Marx M, Hinke A, Sommer K, et al. Randomized phase III trial of postoperative radiochemotherapy amifostine in head and neck cancer: Is there evidence for radioprotection? Strahlenther Onkol 2003; 179: 385 - 389.
Bensadoun RJ, Franquin JC, Ciais G, Darcourt V, Schubert MM, Viot M, et al. Low-energy He/Ne laser in the prevention of radiation-induced mucositis. A multicentre phase III randomized study in patients with head and neck cancer. Support Care Cancer 1999; 7: 244 - 252.
Arun Maiya G, Sagar MS, Fernandes D. Effect of low-level helium-neon (He-Ne) laser therapy in the prevention & treatment of radiation induced mucositis in head & neck cancer patients. Indian J Med Res 2006; 124: 399 - 402.
Arora, H, Pai KM., Maiya A, Vidyasagar MS, Rajeev A. Efficacy of He-Ne Laser in the prevention and treatment of radiotherapy-induced oral mucositis in oral cancer patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008; 105: 180 - 186.
Wadleigh RG, Redman RS, Graham ML, Krasnow SH, Anderson A, Cohen MH. Vitamin E in the treatment of chemotherapy-induced mucositis. Am J Med 1992; 92: 481 - 484.
Etiz D, Erkal HS, Serin M, Küçük B, Hepari A, Elhan AH, et al. Clinical and histopathological evaluation of sucralfate in prevention of oral mucositis induced by radiation therapy in patients with head and neck malignancies. Oral Oncol 2000; 36: 116 - 120.
Motallebnejad M, Akram S, Moghadamnia A, Moulana Z, Omidi S. The effect of topical application of pure honey on radiation-induced mucositis: a randomized clinical trial. J Contemp Dent Pract 2008; 9: 40 - 47.
