Section of Oral Medicine, Department of Oral Health & Diagnostic Sciences, School of Dental Medicine and Program in Head & Neck Cancer and Oral Oncology, Neag Comprehensive Cancer Center, University of Connecticut Health Center, Farmington, CT 06030-1605, USA.
Support Care Cancer. 2013 Jan;21(1):327-32. doi: 10.1007/s00520-012-1562-0. Epub 2012 Sep 21.
This systematic review analyzed the strength of the literature and defined clinical practice guidelines for the use of oral cryotherapy for the prevention and/or treatment of oral mucositis caused by cancer therapy.
A systematic review on relevant oral cryotherapy studies indexed prior to 31 December 2010 was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO) using OVID/MEDLINE, with publications selected for review based on defined inclusion and exclusion criteria. Findings from the reviewed studies were integrated into guidelines based on the overall level of evidence for each intervention. Guidelines were classified into three types: recommendation, suggestion, or no guideline possible.
Twenty-two clinical studies and two meta-analyses were analyzed. Results were compared with the MASCC/ISOO guidelines published in 2007. The recommendation for the use of oral cryotherapy to prevent oral mucositis in patients receiving bolus fluorouracil (5-FU) was maintained, in agreement with the 2007 guidelines. A suggestion for use of oral cryotherapy to prevent oral mucositis in patients receiving high-dose melphalan as conditioning regimen with or without total body irradiation for HCST was revised from the 2007 guidelines. No guideline was possible for any other intervention, due to insufficient evidence.
The evidence continues to support the use of oral cryotherapy for prevention of oral mucositis in patients receiving bolus 5-FU chemotherapy or high-dose melphalan. This intervention is consistent with the MASCC/ISOO guidelines published in 2007. The literature is limited by the fact that utilization of a double-blind study design is not feasible. Future studies that compare efficacy of oral cryotherapy with other mucositis agents in patients receiving chemotherapy with relatively short plasma half-lives would be useful.
本系统评价分析了文献的强度，并为癌症治疗所致口腔粘膜炎的预防和/或治疗制定了口腔冷冻疗法的临床实践指南。
多国支持治疗癌症协会/国际口腔肿瘤协会（MASCC/ISOO）口腔粘膜炎研究小组采用 OVID/MEDLINE 对 2010 年 12 月 31 日前发表的相关口腔冷冻疗法研究进行了系统评价，根据明确的纳入和排除标准选择进行评价的研究。将研究中得到的结果整合到每个干预措施的总体证据水平的指南中。指南分为三种类型：推荐、建议或无可能的指南。
分析了 22 项临床研究和 2 项荟萃分析。结果与 2007 年 MASCC/ISOO 指南进行了比较。与 2007 年指南一致，建议在接受氟尿嘧啶（5-FU）冲击治疗的患者中使用口腔冷冻疗法预防口腔粘膜炎。建议在接受高剂量美法仑作为预处理方案（伴或不伴全身照射）的 HCST 患者中使用口腔冷冻疗法预防口腔粘膜炎，这一建议是对 2007 年指南的修订。由于证据不足，对于任何其他干预措施，都不可能有指南。
证据继续支持在接受氟尿嘧啶冲击化疗或大剂量美法仑化疗的患者中使用口腔冷冻疗法预防口腔粘膜炎。这种干预与 2007 年 MASCC/ISOO 指南一致。文献的局限性在于，采用双盲研究设计是不可行的。未来在接受半衰期较短的化疗药物的患者中比较口腔冷冻疗法与其他粘膜炎药物的疗效的研究将是有用的。
