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 (MASCC/ISOO). (2014). MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer, 120, 1453–1461.  

DOI Link

Purpose & Patient Population

PURPOSE: To help clinicians treat mucositis through evidence based practice
 
TYPES OF PATIENTS ADDRESSED: Patients with cancer undergoing cancer treatment

Type of Resource/Evidence-Based Process

RESOURCE TYPE: Evidence-based guideline  
 
PROCESS OF DEVELOPMENT: Literature search with two people reviewing each publication
 
DATABASES USED: OVID interface to Medline
 
KEYWORDS: Mucositis, stomatitis, oral, gastrointestinal, guidelines
 
INCLUSION CRITERIA: English language publications reporting testing of an intervention for mucositis in humans, peer-reviewed journals, filed in Medline on or before December 31, 2010
 
EXCLUSION CRITERIA: Articles that did not report the effects of an intervention on mucositis or mucositis-related outcomes, animal or in vitro studies, and literature reviews

Phase of Care and Clinical Applications

PHASE OF CARE: Active antitumor treatment
 
APPLICATIONS: Pediatrics, elder care 

Results Provided in the Reference

570 articles were included in this literature review. Literature contained prevention and/or treatment methods for mucositis. Interventions for treatment of mucositis were given, recommendations against an intervention were provided, suggestions in favor of an intervention were supplied, and suggestions against an intervention were given.

Guidelines & Recommendations

Recommendations included a combination of teeth brushing, flossing, mouth rinsing, and use of growth factors and cytokines in treatment of mucositis. The use of anti-inflammatory agents was also recommended. Low level laser therapy was recommended in prevention of mucositis with specific types of cancer treatment. Cryotherapy was also recommended for patients receiving chemotherapy. A list of natural and miscellaneous agents was recommended for treatment and prevention of mucositis.

Limitations

Limitations of this study include clinical situations that were not seen in the literature review or that are rare in clinical settings. These limitations occur because of conflicting evidence or not enough evidence provided.

Nursing Implications

Nurses should be assessing patients' pain control, nutritional support, ability to eat, and oral hygiene practices, and should be teaching on the use of oral care products that are essential for prevention.