Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, New York.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Cancer. 2020 Oct 1;126(19):4423-4431. doi: 10.1002/cncr.33100. Epub 2020 Jul 28.
Mucositis is a significant toxicity of cancer therapy with numerous systemic sequelae. 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 the management of mucositis.
The literature was reviewed systematically to identify interventions for mucositis. Studies were rated according to the presence of major and minor flaws according to previously published criteria. The body of evidence for each intervention and 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 guideline covers evidence from 1197 publications related to oral or gastrointestinal mucositis. Thirteen new guidelines were developed for or against the use of various interventions in specific treatment settings, and 11 previous guidelines were confirmed after aa review of new evidence. Thirteen previously established guidelines were carried over because there was no new evidence for these interventions.
The updated MASCC/ISOO Clinical Practice Guidelines for mucositis provide professional health caregivers with a clinical setting-specific, evidence-based tool to help with the management of mucositis in patients who have cancer.
黏膜炎是癌症治疗的一种严重毒性反应,会引发多种系统性并发症。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管理临床实践指南。
系统地审查文献,以确定用于治疗黏膜炎的干预措施。根据先前发表的标准,根据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,为每种干预措施和每种治疗环境中的证据体分配证据级别。根据证据级别制定指南,有 3 种可能的指南决定:推荐、建议或不可能制定指南。
本指南涵盖了与口腔或胃肠道黏膜炎相关的 1197 篇文献的证据。在特定治疗环境中,针对各种干预措施的使用,制定了 13 条新的指南,在审查新证据后,确认了 11 条先前的指南。由于这些干预措施没有新的证据,因此沿用了 13 条先前确定的指南。
更新后的 MASCC/ISOO 癌症治疗相关黏膜炎管理临床实践指南为专业医护人员提供了一种基于临床环境的循证工具,帮助管理癌症患者的黏膜炎。