Department of Nursing, West China Hospital, Sichuan University/ West China School of Nursing, Sichuan University, Chengdu, Sichuan, China.
Department of General Practice, General Practice Medical Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
J Clin Nurs. 2024 Jun;33(6):2030-2049. doi: 10.1111/jocn.17087. Epub 2024 Mar 7.
To assess the effectiveness of different nonpharmacological treatments for severe radiation-induced oral mucositis in patients with head and neck cancer.
Radiation-induced oral mucositis is highly prevalent in patients with head and neck cancer. Current medications for radiation-induced oral mucositis are limited in effectiveness and susceptible to side effects, and while there is an increasing adoption of nonpharmacological interventions, the optimal one remains unclear.
Systematic review and network meta-analysis based on the PRISMA-NMA guidelines.
Six databases were searched. Two authors independently performed the literature screening, data extraction and methodological quality assessment of the included studies. Traditional pairwise meta-analysis was performed by R Studio. A network meta-analysis was then conducted to assess the effects of nonpharmacological interventions for severe radiation-induced oral mucositis in patients with head and neck cancer.
Fifty-two studies involving seven types of nonpharmacological interventions were enrolled. The network meta-analysis indicated that natural plant-based therapies might be the most effective, health education interventions might be the second most effective, and honey might be the third most effective interventions for reducing the incidence of severe radiation-induced oral mucositis. For reducing the incidence of severe oral mucositis-related pain, the pairwise meta-analysis showed that only natural plant-based therapies and health education interventions were effective.
Nonpharmacological interventions are effective in the management of severe radiation-induced oral mucositis among patients with head and neck cancer.
Nonpharmacological interventions are a category of safe and effective adjunctive therapies that should be encouraged in clinical practice.
CRD42023400745.
评估不同非药物治疗对头颈部癌症患者重度放射性口腔黏膜炎的疗效。
头颈部癌症患者放射性口腔黏膜炎的发生率很高。目前用于放射性口腔黏膜炎的药物在疗效上有限，且易产生副作用，虽然越来越多地采用非药物干预措施，但最佳方法仍不清楚。
基于 PRISMA-NMA 指南的系统评价和网络荟萃分析。
搜索了 6 个数据库。两位作者独立进行文献筛选、纳入研究的数据提取和方法学质量评估。使用 R Studio 进行传统的两两荟萃分析。然后进行网络荟萃分析，以评估非药物干预措施对头颈部癌症患者重度放射性口腔黏膜炎的疗效。
纳入了 52 项研究，涉及 7 种非药物干预措施。网络荟萃分析表明，天然植物疗法可能是最有效的，健康教育干预可能是第二有效的，而蜂蜜可能是第三有效的降低重度放射性口腔黏膜炎发生率的干预措施。对于降低重度口腔黏膜炎相关疼痛的发生率，两两荟萃分析显示，只有天然植物疗法和健康教育干预是有效的。
非药物干预措施对头颈部癌症患者重度放射性口腔黏膜炎的管理有效。
非药物干预措施是一类安全有效的辅助治疗方法，应在临床实践中加以鼓励。
CRD42023400745。
