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01-01-2013 | Special Article

Systematic review of cytokines and growth factors for the management of oral mucositis in cancer patients

Authors: Judith E. Raber-Durlacher, Inger von Bültzingslöwen, Richard M. Logan, Joanne Bowen, Abdul Rahman Al-Azri, Hele Everaus, Erich Gerber, Jesùs Garcia Gomez, Bo G. Pettersson, Yoshihiko Soga, Fred K. L. Spijkervet, Wim J. E. Tissing, Joel B. Epstein, Sharon Elad, Rajesh V. Lalla, For 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 1/2013

Abstract

Purpose

The aim of this project was to review the literature and define clinical practice guidelines for the use of cytokines and growth factor agents for the prevention or treatment of oral mucositis induced by cancer chemotherapy or radiotherapy.

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, No guideline possible.

Results

Sixty-four clinical studies across 11 interventions were evaluated. A recommendation was made for the use of recombinant human KGF-1 (palifermin) at a dose of 60 μg/kg per day for 3 days prior to conditioning treatment and for 3 days post-transplant for prevention of oral mucositis in patients receiving high-dose chemotherapy and total body irradiation followed by autologous stem cell transplantation for hematological malignancies. A suggestion was made against using granulocyte macrophage colony-stimulating factor mouthwash for the prevention of oral mucositis in the setting of high-dose chemotherapy followed by autologous or allogeneic stem cell transplantation. No guideline was possible for any other cytokine or growth factor agents due to inconclusive evidence.

Conclusions

Of the cytokine and growth factor agents studied for oral mucositis, the evidence only supports use of palifermin in the specific population listed above. Additional well-designed research is needed on other cytokine and growth factor interventions and in other cancer treatment settings.

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Title: Systematic review of cytokines and growth factors for the management of oral mucositis in cancer patients
Authors: Judith E. Raber-Durlacher
Inger von Bültzingslöwen
Richard M. Logan
Joanne Bowen
Abdul Rahman Al-Azri
Hele Everaus
Erich Gerber
Jesùs Garcia Gomez
Bo G. Pettersson
Yoshihiko Soga
Fred K. L. Spijkervet
Wim J. E. Tissing
Joel B. Epstein
Sharon Elad
Rajesh V. Lalla
For the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO)
Publication date: 01-01-2013
Publisher: Springer-Verlag
Published in: Supportive Care in Cancer / Issue 1/2013
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-012-1594-5

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