Karagozoglu, S., & Filiz Ulusoy, M.F. (2005). Chemotherapy: The effect of oral cryotherapy on the development of mucositis. Journal of Clinical Nursing, 14, 754–765.

The study group used oral cryotherapy, via ice cubes “at a size that could be moved easily in the mouth and whose corners have been smoothed in order that they will not cause irritation in the mouth,\" beginning five minutes before chemotherapy initiation and maintained use during IV infusions of etoposide, platinol, mitomycin, and vinblastin. For random allocation, patients were assigned to the study group or a control group in sets of five.

• The study involved 60 patients, with 30 in the study group and 30 in the control group.
• The majority of patients (66.7%) were older than 60 years of age.
• Patients were excluded from the study if they
  • Had previously undergone their first chemotherapy.
  • Were not receiving combined courses.
  • Were given chemotherapy agents other than etoposide, platinol, mitomycin, or vinblastine.
  • Had malignancy in the oral cavity. Five of the patients had oral infection findings in the oral cavity prior to study.
• Cancer diagnoses were epidermoid (43.3%), small cell (28.3%), adenocarcinoma (11.7%), and mesothelioma (16.7%).
• Chemotherapy regimens were one-day etoposide-platinol (43.3%); three successive days of etoposide-platinol (28.3%); one-day mitomycin, vinblastin, platinol (11.7%); and one-day mitomycin-platinol (16.7%).

The study was conducted at a respiratory disease clinic in Turkey from August 2000 to May 2001.

• A data collection form and patient-judged 0–4 mucositis grading scale were used on days 1–21. A 0–4 physician-judged mucositis grading scale was used on day 21 for patients receiving single-day protocols and on days 2, 3, and 21 for patients receiving three-day protocols. The mucositis grading scales were based on the Mucositis Grading System of the World Health Organization (WHO).
• An oral pH measurement scale was used before and after single-day chemotherapy regimens, before and after each day of chemotherapy for multiday chemotherapy regimens, and on day 21 for all subjects.

• The study group experienced a decrease in the severity and duration of mucositis and in oral pH values.
• Rates of mucositis were lower in the study group.
  • Patient-judged mucositis was 36.7% in the study group and 90.0% in the control group (p < 0.05).
  • Physician-judged mucositis was 10.0% in the study group and 50.0% in the control group (p < 0.05).

• The sample size was small.
• Physicians only assessed mucositis on days 1, 2, 3, and 21, but not during the entire chemotherapy course.
• Application to other chemotherapy agents is not known.