1 Section 02 - Paediatric Dentistry, Department of Odontology, Faculty of Health and Medical Sciences, Københavns Universitet2 Sheba Medical Centre, Tel Aviv University, Tel Aviv3 James Cook University4 unknown5 Section 01 - Prosthetics, Department of Odontology, Faculty of Health and Medical Sciences, Københavns Universitet6 Hebrew Univeristy7 University of Rochester Medical Center8 University of Adelaide9 Neag Comprehensive Cancer Center, University of Connecticut Health Center, Farmington, Connecticut, USA.10 Section 01 - Prosthetics, Department of Odontology, Faculty of Health and Medical Sciences, Københavns Universitet11 University of Adelaide
Abstract PURPOSE: The aim of this study was to review the available literature and define clinical practice guidelines for the use of natural agents for the prevention and treatment of oral mucositis. 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. 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 49 papers across 15 interventions were examined. A new suggestion was developed in favor of systemic zinc supplements administered orally in the prevention of oral mucositis in oral cancer patients receiving radiation therapy or chemoradiation (Level III evidence). A recommendation was made against the use of intravenous glutamine for the prevention of oral mucositis in patients receiving high-dose chemotherapy prior to hematopoietic stem cell transplant (Level II evidence). No guideline was possible for any other agent, due to inadequate and/or conflicting evidence. CONCLUSIONS: Of the various natural agents reviewed here, the available evidence supported a guideline only for two agents: a suggestion in favor of zinc and a recommendation against glutamine, in the treatment settings listed above. Well-designed studies of other natural agents are warranted.
Journal review article
Supportive Care in Cancer, 2013, Vol 21, Issue 11, p. 3209-3221