Sharma, P., Vatsa, M., & Sharma, A. (2015). Effect of oral cooling on bolus 5-FUFA induced mucositis in cancer patients. International Journal of Nursing Education, 7, 249–255. 

DOI Link

Study Purpose

To evaluate the effect of oral cooling using ice-rolls on chemotherapy-induced mucositis in patients administered bolus 5-FUFA

Intervention Characteristics/Basic Study Process

Randomized, control trial of 53 patients with gastroinstenal tract cancer receiving 5-fluorouracil (5-FU) in an outpatient clinic either daily for three, four, or five days (n = 22) or weekly (n = 31). The intervention group (n = 27) was asked to do oral cooling using ice-rolls in and out of oral cavity for the following schedule (10 minutes before administration, 5 minutes during administration, and 15 minutes after the administration of 5-FU). Patients used oral cooling for a total of 30 minutes (SD = 5 minutes). Assessment of oral cavity was conducted every week for three weeks.

Sample Characteristics

  • N = 53 patients
  • AGE = 18–73 years
  • MALES: 53.7%, FEMALES: 52.3%
  • CURRENT TREATMENT: Chemotherapy
  • KEY DISEASE CHARACTERISTICS: Gastrointestinal tract cancer

Setting

  • SITE:Single site
  • SETTING TYPE:Outpatient
  • LOCATION: New Delhi

Phase of Care and Clinical Applications

PHASE OF CARE: Active antitumor treatment

Study Design

Randomized, controlled trial

Measurement Instruments/Methods

  • World Health Organization (WHO) Oral Toxicity Scale 
  • Patient-judged mucositis grading

Results

A significanct decrease in oral mucositis incidence was noted in the experimental group in week 1 (p = 0.001), week 2 (p = 0.014), and week 3 (p = 0.05) compared to the control group. Descriptive statistics showed only mild oral mucositis in the experimental group, whereas moderate and severe oral mucositis was reported in the control group.

Conclusions

Oral cooling was effective in reducing oral mucositis in patients receiving 5-FU.

Limitations

  • Small sample (< 100)
  • Findings not generalizable
  • Only one type of medication—5-FU—included

Nursing Implications

Oral cooling was 100% accepted as an intervention to reduce the incidence of oral mucositis induced by chemotherapy. Nurses need education on proper assessment tools for oral mucositis. Educational materials should also be given to patients and their families to enhance the proactivity of preventing mucositis induced by chemotherapy.