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

MASCC ISOO, Joanne M. Bowen*, Rachel J. Gibson, Janet K. Coller, Nicole Blijlevens, Paolo Bossi, Noor Al-Dasooqi, Emma H. Bateman, Karen Chiang, Charlotte de Mooij, Bronwen Mayo, Andrea M. Stringer, Wim Tissing, Hannah R. Wardill, Ysabella Z. A. van Sebille, Vinisha Ranna, Anusha Vaddi, Dorothy M. K. Keefe, Rajesh V. Lalla, Karis Kin Fong ChengSharon Elad

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

20 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)4011-4022
Number of pages12
JournalSupportive Care in Cancer
Volume27
Issue number10
DOIs
Publication statusPublished - Oct-2019

Keywords

  • Mucositis
  • Guidelines
  • Clinical management
  • Gastrointestinal
  • PATIENTS RECEIVING RADIOTHERAPY
  • CHEMOTHERAPY-INDUCED DIARRHEA
  • ACUTE RADIATION ENTERITIS
  • QUALITY-OF-LIFE
  • DOUBLE-BLIND
  • FRUCTO-OLIGOSACCHARIDE
  • COLONIC IRRIGATION
  • COLORECTAL-CANCER
  • HYPERBARIC-OXYGEN
  • MUCOSAL INJURY

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