Sung, L., Robinson, P., Treister, N., Baggott, T., Gibson, P., Tissing, W., . . . Dupuis, L.L. (2015). Guideline for the prevention of oral and oropharyngeal mucositis in children receiving treatment for cancer or undergoing haematopoietic stem cell transplantation. BMJ Supportive and Palliative Care. Advance online publication. 

DOI Link

Purpose & Patient Population

PURPOSE: To develop an evidence-based clinical practice guideline for the prevention of oral mucositis in children
 
TYPES OF PATIENTS ADDRESSED: Children (aged 0–18 years) receiving treatment for cancer or undergoing hematopoietic stem cell transplantation (HSCT)

Type of Resource/Evidence-Based Process

RESOURCE TYPE: Evidence-based guideline  
 
PROCESS OF DEVELOPMENT: A large literature base of studies evaluating oral mucositis prevention in single-arm and randomized, controlled trials among adult and pediatric populations was reviewed. Toxicity for pediatric patients was then considered and reviewed, focusing the review on the pediatric population. The Cochrane Collaboration systematic reviews, the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer (MASCC), and International society of Oral Oncology (ISOO) were included. The decision making process was well described. 
 
SEARCH STRATEGY:
DATABASES USED: Cochrane Library, MASCC, and ISOO in addition to a preliminary extensive literature search
KEYWORDS: Not specified
INCLUSION CRITERIA: Not specified
EXCLUSION CRITERIA: Not specified

Phase of Care and Clinical Applications

PHASE OF CARE: Active antitumor treatment

Results Provided in the Reference

Cryotherapy or low-level laser therapy may be offered to cooperative children receiving chemotherapy or HSCT conditioning with regimens associated with a high rate of mucositis. Keratinocyte growth factor (KGF) may be offered to children receiving HSCT conditioning with regimens associated with a high rate of severe mucositis. However, KGF use merits caution as there was a lack of efficacy and significant toxicity data as well as a lack of long-term follow-up data in pediatric cancers. No other interventions were recommended for oral mucositis prevention in children.

Guidelines & Recommendations

  • Cryotherapy: Weak recommendation with moderate to quality evidence
  • Low-level laser therapy: Weak recommendation with high-quality evidence
  • KGF: Weak recommendation with high-quality evidence

Limitations

No keywords, inclusion criteria, or exclusion criteria were stated in the article.

Nursing Implications

Although some information was missing in this study, the decision making process and results of the evidence review were well-described. The inclusion of a description of research gaps, summarized in a table, showed the comprehensiveness of this review.