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01-05-2020 | Analgesics in Dentistry | Special Article

Systematic review of antimicrobials, mucosal coating agents, anesthetics, and analgesics for the management of oral mucositis in cancer patients and clinical practice guidelines

Authors: Deborah P. Saunders, Tanya Rouleau, Karis Cheng, Noam Yarom, Abhishek Kandwal, Jamie Joy, Kivanc Bektas Kayhan, Marianne van de Wetering, Norman Brito-Dellan, Tomoko Kataoka, Karen Chiang, Vinisha Ranna, Anusha Vaddi, Joel Epstein, Rajesh V. Lalla, Paolo Bossi, Sharon Elad, On behalf of the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO)

Published in: Supportive Care in Cancer | Issue 5/2020

Abstract

Purpose

To update the clinical practice guidelines for the use of antimicrobials, mucosal coating agents, anesthetics, and analgesics 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 9 new papers were identified within the scope of this section, adding to the 62 papers reviewed in this section previously. A new Suggestion was made for topical 0.2% morphine for the treatment of OM-associated pain in head and neck (H&N) cancer patients treated with RT-CT (modification of previous guideline). A previous Recommendation against the use of sucralfate-combined systemic and topical formulation in the prevention of OM in solid cancer treatment with CT was changed from Recommendation Against to No Guideline Possible. Suggestion for doxepin and fentanyl for the treatment of mucositis-associated pain in H&N cancer patients was changed to No Guideline Possible.

Conclusions

Of the agents studied for the management of OM in this paper, the evidence supports a Suggestion in favor of topical morphine 0.2% in H&N cancer patients treated with RT-CT for the treatment of OM-associated pain.

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Title: Systematic review of antimicrobials, mucosal coating agents, anesthetics, and analgesics for the management of oral mucositis in cancer patients and clinical practice guidelines
Authors: Deborah P. Saunders
Tanya Rouleau
Karis Cheng
Noam Yarom
Abhishek Kandwal
Jamie Joy
Kivanc Bektas Kayhan
Marianne van de Wetering
Norman Brito-Dellan
Tomoko Kataoka
Karen Chiang
Vinisha Ranna
Anusha Vaddi
Joel Epstein
Rajesh V. Lalla
Paolo Bossi
Sharon Elad
On behalf of the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO)
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Keywords: Analgesics in Dentistry
Morphine
Anesthetics
Fentanyl
Doxepin
Anesthetics
Cytostatic Therapy
Published in: Supportive Care in Cancer / Issue 5/2020
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-019-05181-6

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