PEP Topic 

The use of ice chips or ice-cold water has been studied for its efficacy in the prevention of oral mucositis. Patients suck on ice or hold ice-cold water in their mouths prior to, during, and after rapid infusions of mucotoxic agents with short half-lifes. Cryotherapy is based on the theory that vasoconstriction caused by cold temperatures decreases the exposure of the oral cavity mucous membranes to mucotoxic agents. Thirty minutes of oral cryotherapy is suggested for patients receiving bolus fluorouracil 5. Cryotherapy also has been used in patients receiving high-dose melphalan. Cryotherapy is not recommended for patients who also are receiving oxaliplatin because of the associated acute temperature sensitivity, which can cause severe discomfort (Lilleby et al., 2006; Tartarone, Matera, Romano, Vigliotti, & DiRenzo, 2005).

Lilleby, K., Garcia, P., Gooley, T., McDonnnell, P., Taber, R., Holmberg, L., . . . Bensinger, W. (2006). A prospective, randomized study of cryotherapy during administration of high-dose melphalan to decrease the severity and duration of oral mucositis in patients with multiple myeloma undergoing autologous peripheral blood stem cell transplantation. Bone Marrow Transplantation, 37, 1031–1035. doi:10.1038/sj.bmt.1705384

Lalla, R.V., Bowen, J., Barasch, A., Elting, L, Epstein, J., Keefe, D.M., . . . Mucositis Guidelines Leadership Group of the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology. (2014). MASCC/ISOO evidence based clinical practice guidelines for mucositis secondary to cancer therapy. Cancer, 120, 1453–1461. doi:10.1002/cncr.28592

Tartarone, A., Matera, R., Romano, G., Vigliotti, M.L., & Di Renzo, N. (2005). Prevention of high-dose melphalan-induced mucositis by cryotherapy. Leukemia and Lymphoma, 46, 633–634. doi:10.1080/10428190400029957

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