University of Connecticut, Farmington, Connecticut.
Cancer. 2014 May 15;120(10):1453-61. doi: 10.1002/cncr.28592. Epub 2014 Feb 25.
Mucositis is a highly significant, and sometimes dose-limiting, toxicity of cancer therapy. The goal of this systematic review was to update the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) Clinical Practice Guidelines for mucositis.
A literature search was conducted to identify eligible published articles, based on predefined inclusion/exclusion criteria. Each article was independently reviewed by 2 reviewers. Studies were rated according to the presence of major and minor flaws as per previously published criteria. The body of evidence for each intervention, in each treatment setting, was assigned a level of evidence, based on previously published criteria. Guidelines were developed based on the level of evidence, with 3 possible guideline determinations: recommendation, suggestion, or no guideline possible.
The literature search identified 8279 papers, 1032 of which were retrieved for detailed evaluation based on titles and abstracts. Of these, 570 qualified for final inclusion in the systematic reviews. Sixteen new guidelines were developed for or against the use of various interventions in specific treatment settings. In total, the MASCC/ISOO Mucositis Guidelines now include 32 guidelines: 22 for oral mucositis and 10 for gastrointestinal mucositis. This article describes these updated guidelines.
The updated MASCC/ISOO Clinical Practice Guidelines for mucositis will help clinicians provide evidence-based management of mucositis secondary to cancer therapy.
黏膜炎是癌症治疗中一种非常严重、有时甚至是剂量限制的毒性。本系统评价的目的是更新多国癌症支持治疗协会和国际口腔肿瘤学会(MASCC/ISOO)的癌症治疗相关黏膜炎临床实践指南。
根据预先设定的纳入/排除标准,进行文献检索以确定合格的已发表文章。由 2 位评审员独立审查每篇文章。根据先前发表的标准,按照主要和次要缺陷的存在对研究进行评分。根据先前发表的标准,根据每个干预措施在每个治疗环境中的证据水平,为每个干预措施分配证据等级。指南的制定基于证据水平,有 3 种可能的指南决定:推荐、建议或无可能的指南。
文献检索确定了 8279 篇论文,其中 1032 篇根据标题和摘要进行了详细评估。其中,570 篇符合最终纳入系统评价的标准。为特定治疗环境中的各种干预措施制定了 16 条新的指南,建议使用或不建议使用这些干预措施。总的来说,MASCC/ISOO 黏膜炎指南现在包括 32 条指南:22 条用于口腔黏膜炎,10 条用于胃肠道黏膜炎。本文描述了这些更新的指南。
更新后的 MASCC/ISOO 癌症治疗相关黏膜炎临床实践指南将有助于临床医生为癌症治疗相关的黏膜炎提供循证管理。