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Type: Journal article
Title: Systematic review of natural agents for the management of oral mucositis in cancer patients
Author: Yarom, N.
Ariyawardana, A.
Hovan, A.
Barasch, A.
Jarvis, V.
Jensen, S.
Zadik, Y.
Elad, S.
Bowen, J.
Lalla, R.
Citation: Supportive Care in Cancer, 2013; 21(11):3209-3221
Publisher: Springer-Verlag
Issue Date: 2013
ISSN: 0941-4355
Statement of
Noam Yarom, Anura Ariyawardana, Allan Hovan, Andrei Barasch, Virginia Jarvis, Siri Beier Jensen, Yehuda Zadik, Sharon Elad, Joanne Bowen, Rajesh V. Lalla
Abstract: PURPOSE The aim of this study was to review the available literature and define clinical practice guidelines for the use of natural agents for the prevention and treatment of oral mucositis. METHODS A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology. The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. Based on the evidence level, one of the following three guideline determinations was possible: recommendation, suggestion, and no guideline possible. RESULTS A total of 49 papers across 15 interventions were examined. A new suggestion was developed in favor of systemic zinc supplements administered orally in the prevention of oral mucositis in oral cancer patients receiving radiation therapy or chemoradiation (Level III evidence). A recommendation was made against the use of intravenous glutamine for the prevention of oral mucositis in patients receiving high-dose chemotherapy prior to hematopoietic stem cell transplant (Level II evidence). No guideline was possible for any other agent, due to inadequate and/or conflicting evidence. CONCLUSIONS Of the various natural agents reviewed here, the available evidence supported a guideline only for two agents: a suggestion in favor of zinc and a recommendation against glutamine, in the treatment settings listed above. Well-designed studies of other natural agents are warranted.
Keywords: Glutamine; Guidelines; Natural agents; Oral mucositis; Zinc
Description: For the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO)
Rights: © 2013 Springer-Verlag Berlin Heidelberg.
RMID: 0020132185
DOI: 10.1007/s00520-013-1869-5
Appears in Collections:Physiology publications

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