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Topical Treatment of Oral Mucositis in Cancer Patients: A Systematic Review of Randomized Clinical Trials

BACKGROUND AND PURPOSE: Evidence-based protocols of topical therapy for oral mucositis (OM) induced by chemoradiotherapy (CRT) are continuously established and updated. Thus, the present systematic review aims to evaluate the scientific literature in terms of effectiveness of topical treatment of OM...

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Autores principales: Ana, Geisa Sant, Normando, Ana Gabriela Costa, de Toledo, Isabela Porto, dos Reis, Paula Elaine Diniz, Guerra, Eliete Neves Silva
Formato: Online Artículo Texto
Lenguaje:English
Publicado: West Asia Organization for Cancer Prevention 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7573410/
https://www.ncbi.nlm.nih.gov/pubmed/32711408
http://dx.doi.org/10.31557/APJCP.2020.21.7.1851
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author Ana, Geisa Sant
Normando, Ana Gabriela Costa
de Toledo, Isabela Porto
dos Reis, Paula Elaine Diniz
Guerra, Eliete Neves Silva
author_facet Ana, Geisa Sant
Normando, Ana Gabriela Costa
de Toledo, Isabela Porto
dos Reis, Paula Elaine Diniz
Guerra, Eliete Neves Silva
author_sort Ana, Geisa Sant
collection PubMed
description BACKGROUND AND PURPOSE: Evidence-based protocols of topical therapy for oral mucositis (OM) induced by chemoradiotherapy (CRT) are continuously established and updated. Thus, the present systematic review aims to evaluate the scientific literature in terms of effectiveness of topical treatment of OM in cancer patients undergoing CRT. MATERIALS AND METHODS: This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist. Randomized clinical trials were identified through electronic database searches on CINAHL, Cochrane Library, LILACS, Livivo, PubMed, SCOPUS, and Web of Science. Grey literature was also assessed on Google Scholar, Open Grey, and ProQuest. The risk of bias in the included studies was assessed by the Cochrane Collaboration Risk of Bias Tool. RESULTS: Twenty-three randomized clinical trials (n=1169 patients) met the inclusion criteria. Twenty-three different topical agents were examined and categorized into five groups: analgesics (30.4%), natural agents (21.7%), other topical agents (21.7%), antimicrobial agents (17.4%), and growth factors (8.8%). Of the included studies, 50% presented a resolution of OM within 14 days. Topical natural agents yielded good results with average resolution time of 3–7 days. The included studies generally demonstrated that patients treated with mouthwashes presented superior benefits compared to the control, depending on OM severity. CONCLUSION: Topical agents effectively reduced the severity of OM lesions and pain intensity in patients receiving chemoradiotherapy, although the effects varied by agent type. However, the heterogeneity in the results of these topical intervention studies underscores the need for standardized clinical trial methodologies. CLINICAL RELEVANCE: Topical agents were effective in patients with severe OM lesions receiving chemoradiotherapy and are a good alternative of home care in relation to pain control, reduction of inflammation and consequent improvement in quality of life.
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spelling pubmed-75734102020-10-30 Topical Treatment of Oral Mucositis in Cancer Patients: A Systematic Review of Randomized Clinical Trials Ana, Geisa Sant Normando, Ana Gabriela Costa de Toledo, Isabela Porto dos Reis, Paula Elaine Diniz Guerra, Eliete Neves Silva Asian Pac J Cancer Prev Review Article BACKGROUND AND PURPOSE: Evidence-based protocols of topical therapy for oral mucositis (OM) induced by chemoradiotherapy (CRT) are continuously established and updated. Thus, the present systematic review aims to evaluate the scientific literature in terms of effectiveness of topical treatment of OM in cancer patients undergoing CRT. MATERIALS AND METHODS: This systematic review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Checklist. Randomized clinical trials were identified through electronic database searches on CINAHL, Cochrane Library, LILACS, Livivo, PubMed, SCOPUS, and Web of Science. Grey literature was also assessed on Google Scholar, Open Grey, and ProQuest. The risk of bias in the included studies was assessed by the Cochrane Collaboration Risk of Bias Tool. RESULTS: Twenty-three randomized clinical trials (n=1169 patients) met the inclusion criteria. Twenty-three different topical agents were examined and categorized into five groups: analgesics (30.4%), natural agents (21.7%), other topical agents (21.7%), antimicrobial agents (17.4%), and growth factors (8.8%). Of the included studies, 50% presented a resolution of OM within 14 days. Topical natural agents yielded good results with average resolution time of 3–7 days. The included studies generally demonstrated that patients treated with mouthwashes presented superior benefits compared to the control, depending on OM severity. CONCLUSION: Topical agents effectively reduced the severity of OM lesions and pain intensity in patients receiving chemoradiotherapy, although the effects varied by agent type. However, the heterogeneity in the results of these topical intervention studies underscores the need for standardized clinical trial methodologies. CLINICAL RELEVANCE: Topical agents were effective in patients with severe OM lesions receiving chemoradiotherapy and are a good alternative of home care in relation to pain control, reduction of inflammation and consequent improvement in quality of life. West Asia Organization for Cancer Prevention 2020-07 /pmc/articles/PMC7573410/ /pubmed/32711408 http://dx.doi.org/10.31557/APJCP.2020.21.7.1851 Text en This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Ana, Geisa Sant
Normando, Ana Gabriela Costa
de Toledo, Isabela Porto
dos Reis, Paula Elaine Diniz
Guerra, Eliete Neves Silva
Topical Treatment of Oral Mucositis in Cancer Patients: A Systematic Review of Randomized Clinical Trials
title Topical Treatment of Oral Mucositis in Cancer Patients: A Systematic Review of Randomized Clinical Trials
title_full Topical Treatment of Oral Mucositis in Cancer Patients: A Systematic Review of Randomized Clinical Trials
title_fullStr Topical Treatment of Oral Mucositis in Cancer Patients: A Systematic Review of Randomized Clinical Trials
title_full_unstemmed Topical Treatment of Oral Mucositis in Cancer Patients: A Systematic Review of Randomized Clinical Trials
title_short Topical Treatment of Oral Mucositis in Cancer Patients: A Systematic Review of Randomized Clinical Trials
title_sort topical treatment of oral mucositis in cancer patients: a systematic review of randomized clinical trials
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7573410/
https://www.ncbi.nlm.nih.gov/pubmed/32711408
http://dx.doi.org/10.31557/APJCP.2020.21.7.1851
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