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Braguês R, Marvão MF, Correia P, Silva RM. Oral Mucositis Management in Children under Cancer Treatment: A Systematic Review. Cancers (Basel) 2024; 16:1548. [PMID: 38672630 PMCID: PMC11048343 DOI: 10.3390/cancers16081548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Children undergoing antineoplastic treatment often present severe side effects due to the dosage and duration of treatments, with oral mucositis emerging as one of the most prevalent and painful inflammatory conditions. There is a growing body of evidence on therapeutic interventions such as cryotherapy, low-level laser therapy, and natural compounds for this condition. The aim of this systematic review was to identify and compare therapies for the management of cancer treatment-induced oral mucositis in pediatric patients. From 2655 articles obtained in initial searches, 39 articles were considered in this systematic review, after applying inclusion/exclusion criteria. Low-level laser therapy, palifermin, honey, and zinc demonstrated reductions in oral mucositis incidence, duration, severity, and pain reported by the patient. Although there are several therapies in place for the prevention and treatment of oral mucositis in children, evidence of their efficacy is still inconclusive to establish accurate clinical protocols.
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Affiliation(s)
- Ricardo Braguês
- Universidade Católica Portuguesa, Faculty of Dental Medicine, 3504-505 Viseu, Portugal; (R.B.); (M.F.M.); (P.C.)
| | - Maria Francisca Marvão
- Universidade Católica Portuguesa, Faculty of Dental Medicine, 3504-505 Viseu, Portugal; (R.B.); (M.F.M.); (P.C.)
| | - Patrícia Correia
- Universidade Católica Portuguesa, Faculty of Dental Medicine, 3504-505 Viseu, Portugal; (R.B.); (M.F.M.); (P.C.)
- Universidade Católica Portuguesa, Center for Interdisciplinary Research in Health (CIIS), 3504-505 Viseu, Portugal
| | - Raquel M. Silva
- Universidade Católica Portuguesa, Faculty of Dental Medicine, 3504-505 Viseu, Portugal; (R.B.); (M.F.M.); (P.C.)
- Universidade Católica Portuguesa, Center for Interdisciplinary Research in Health (CIIS), 3504-505 Viseu, Portugal
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Treister NS, Nieder M, Baggott C, Olson E, Lo T, Jin X, Gao Y, Chen L, Dang H, Sung L. Validation of healthcare professional proxy-reported children's International Mucositis Evaluation Scale. Oral Dis 2023; 29:747-754. [PMID: 33993618 PMCID: PMC9308945 DOI: 10.1111/odi.13918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 05/07/2021] [Accepted: 05/09/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The objective was to describe the reliability and validity of the healthcare professional proxy-report version of the Children's International Mucositis Evaluation Scale (ChIMES). METHODS We included pediatric patients who were between 4 and 21 years of age and scheduled to undergo hematopoietic cell transplantation. Mucositis was evaluated by trained healthcare professionals who scored ChIMES, the World Health Organization oral toxicity scale, mouth, and throat pain visual analogue scale, National Cancer Institute-Common Terminology Criteria and the Oral Mucositis Daily Questionnaire. Measures were completed daily and evaluated on days 7-17 post-stem cell infusion for this analysis. Psychometric properties examined were internal consistency, test-retest reliability (days 13 and 14), and convergent construct validity. RESULTS There were 192 participants included. Cronbach's alpha was 0.90 for ChIMES Total Score and 0.93 for ChIMES Percentage Score. Test-retest reliability were as follows: intraclass correlation coefficient (ICC) 0.82 (95% confidence interval (CI) 0.77-0.85) for ChIMES Total Score and ICC 0.82 (95% CI 0.77-0.86) for ChIMES Percentage Score. In terms of construct validation, all correlations between measures met or exceeded those hypothesized (all p < 0.05). CONCLUSIONS The healthcare professional proxy-report version of ChIMES is reliable and valid for children and adolescents undergoing hematopoietic cell transplantation.
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Affiliation(s)
- Nathaniel S Treister
- Division of Oral Medicine and Dentistry, Brigham and Women's Hospital, Boston, MA, USA
| | - Michael Nieder
- Department of Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Christina Baggott
- Pediatric Hematology-Oncology, Stanford Medical Center, Stanford, CA, USA
| | - Ellen Olson
- Children's Healthcare of Atlanta, Aflac Cancer and Blood Disorders Center, Atlanta, GA, USA
| | - Tammy Lo
- Department of Research and Evaluation, Kaiser Permanente, Pasadena, CA, USA
| | - Xichen Jin
- Data Operations, Global Drug Development, Novartis, Shanghai, China
| | - Yun Gao
- Children's Oncology Group, Monrovia, CA, USA
| | - Lu Chen
- Division of Biostatistics, City of Hope, Duarte, CA, USA
| | - Ha Dang
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA
| | - Lillian Sung
- Division of Haematology/Oncology, The Hospital for Sick Children, Toronto, ON, Canada
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Colella G, Boschetti CE, Vitagliano R, Colella C, Jiao L, King-Smith N, Li C, Nuoh Lau Y, Lai Z, Mohammed AI, Cirillo N. Interventions for the Prevention of Oral Mucositis in Patients Receiving Cancer Treatment: Evidence from Randomised Controlled Trials. Curr Oncol 2023; 30:967-980. [PMID: 36661723 PMCID: PMC9858113 DOI: 10.3390/curroncol30010074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/04/2023] [Accepted: 01/06/2023] [Indexed: 01/13/2023] Open
Abstract
Oral mucositis is a common and most debilitating complication associated with cancer therapy. Despite the significant clinical and economic impact of this condition, there is little to offer to patients with oral mucositis, and the medications used in its management are generally only palliative. Given that mucositis is ultimately a predictable and, therefore, potentially preventable condition, in this study we appraised the scientific literature to evaluate effective methods of prevention that have been tested in randomised controlled trials (RCTs). Published high-level evidence shows that multiple preventative methods are potentially effective in the prevention of oral mucositis induced by radiotherapy, chemotherapy, or both. Anti-inflammatory medications (including benzydamine), growth factors and cytokines (including palifermin), cryotherapy, laser-and-light therapy, herbal medicines and supplements, and mucoprotective agents (including oral pilocarpine) showed some degree of efficacy in preventing/reducing the severity of mucositis with most anticancer treatments. Allopurinol was potentially effective in the prevention of radiotherapy-induced oral mucositis; antimicrobial mouthwash and erythropoietin mouthwash were associated with a lower risk of development of severe oral mucositis induced by chemotherapy. The results of our review may assist in highlighting the efficacy and testing the effectiveness of low-cost, safe preventative measures for oral mucositis in cancer patients.
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Affiliation(s)
- Giuseppe Colella
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Ciro Emiliano Boschetti
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Rita Vitagliano
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Chiara Colella
- Multidisciplinary Department of Medical-Surgical and Dental Specialties, Oral and Maxillofacial Surgery Unit, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy
| | - Lebei Jiao
- Melbourne Dental School, The University of Melbourne, Carlton, Melbourne, VIC 3053, Australia
| | - Natalie King-Smith
- Melbourne Dental School, The University of Melbourne, Carlton, Melbourne, VIC 3053, Australia
| | - Chong Li
- Melbourne Dental School, The University of Melbourne, Carlton, Melbourne, VIC 3053, Australia
| | - Yii Nuoh Lau
- Melbourne Dental School, The University of Melbourne, Carlton, Melbourne, VIC 3053, Australia
| | - Zacchaeus Lai
- Melbourne Dental School, The University of Melbourne, Carlton, Melbourne, VIC 3053, Australia
| | - Ali Ibrahim Mohammed
- Melbourne Dental School, The University of Melbourne, Carlton, Melbourne, VIC 3053, Australia
| | - Nicola Cirillo
- Melbourne Dental School, The University of Melbourne, Carlton, Melbourne, VIC 3053, Australia
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