Discipline of Orthodontics and Paediatric Dentistry, Faculty of Dentistry, National University of Singapore, 21 Lower Kent Ridge Rd, Singapore, 119077, Singapore.
Oral Medicine Unit, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
Support Care Cancer. 2019 Oct;27(10):3949-3967. doi: 10.1007/s00520-019-04848-4. Epub 2019 Jul 8.
The aim of this study was to update the clinical practice guidelines for the use of basic oral care (BOC) interventions for the prevention and/or treatment of oral mucositis (OM).
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. The findings were added to the database used to develop the 2013 MASCC/ISOO clinical practice guidelines. Based on the evidence level, one of the following three guideline determinations was possible: Recommendation, Suggestion, No guideline possible.
A total of 17 new papers across six interventions were examined and merged with a previous database. Based on the literature, the following guidelines were possible. The panel suggests that the implementation of multi-agent combination oral care protocols is beneficial for the prevention of OM during chemotherapy, head and neck (H&N) radiation therapy (RT), and hematopoietic stem cell transplantation (Level of Evidence III). The panel suggests that chlorhexidine not be used to prevent OM in patients undergoing H&N RT (Level of Evidence III). No guideline was possible for professional oral care, patient education, saline, and sodium bicarbonate, and expert opinion complemented these guidelines.
The evidence supports the use of multi-agent combination oral care protocols in the specific populations listed above. Additional well-designed research is needed on the other BOC interventions prior to guideline formulation.
本研究旨在更新基本口腔护理（BOC）干预措施用于预防和/或治疗口腔黏膜炎（OM）的临床实践指南。
多学科支持治疗癌症协会/国际口腔肿瘤协会（MASCC/ISOO）口腔黏膜炎研究小组进行了系统评价。为每个癌症治疗环境中的每个干预措施的证据体分配了一个证据水平。这些发现被添加到用于制定 2013 年 MASCC/ISOO 临床实践指南的数据库中。根据证据水平，可能做出以下三种指南决定之一：推荐、建议、无指南。
共检查了六个干预措施的 17 篇新论文，并与之前的数据库合并。根据文献，以下指南是可能的。专家组建议，多药物联合口腔护理方案的实施有利于预防化疗、头颈部（H&N）放疗（RT）和造血干细胞移植期间的 OM（证据水平 III）。专家组建议不要使用洗必泰预防 H&N RT 患者的 OM（证据水平 III）。专业口腔护理、患者教育、盐水和碳酸氢钠没有制定指南，专家意见补充了这些指南。
证据支持在上述特定人群中使用多药物联合口腔护理方案。在制定指南之前，需要对其他 BOC 干预措施进行更多精心设计的研究。
