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Interventions for preventing oral mucositis for patients with cancer receiving treatment

  • Review
  • Intervention




Treatment of cancer is increasingly more effective but is associated with short and long term side effects. Oral side effects remain a major source of illness despite the use of a variety of agents to prevent them. One of these side effects is oral mucositis (mouth ulcers).


To evaluate the effectiveness of prophylactic agents for oral mucositis in patients with cancer receiving treatment, compared with other potentially active interventions, placebo or no treatment.

Search methods

Electronic searches of Cochrane Oral Health Group and PaPaS Trials Registers (to 16 February 2011), CENTRAL (The Cochrane Library 2011, Issue 1), MEDLINE via OVID (1950 to 16 February 2011), EMBASE via OVID (1980 to 16 February 2011), CINAHL via EBSCO (1980 to 16 February 2011), CANCERLIT via PubMed (1950 to 16 February 2011), OpenSIGLE (1980 to 2005) and LILACS via the Virtual Health Library (1980 to 16 February 2011) were undertaken. Reference lists from relevant articles were searched and the authors of eligible trials were contacted to identify trials and obtain additional information.

Selection criteria

Randomised controlled trials of interventions to prevent oral mucositis in patients receiving treatment for cancer.

Data collection and analysis

Information regarding methods, participants, interventions, outcome measures, results and risk of bias were independently extracted, in duplicate, by two review authors. Authors were contacted for further details where these were unclear. The Cochrane Collaboration statistical guidelines were followed and risk ratios calculated using random-effects models.

Main results

A total of 131 studies with 10,514 randomised participants are now included. Overall only 8% of these studies were assessed as being at low risk of bias. Ten interventions, where there was more than one trial in the meta-analysis, showed some statistically significant evidence of a benefit (albeit sometimes weak) for either preventing or reducing the severity of mucositis, compared to either a placebo or no treatment. These ten interventions were: aloe vera, amifostine, cryotherapy, granulocyte-colony stimulating factor (G-CSF), intravenous glutamine, honey, keratinocyte growth factor, laser, polymixin/tobramycin/amphotericin (PTA) antibiotic pastille/paste and sucralfate.

Authors' conclusions

Ten interventions were found to have some benefit with regard to preventing or reducing the severity of mucositis associated with cancer treatment. The strength of the evidence was variable and implications for practice include consideration that benefits may be specific for certain cancer types and treatment. There is a need for further well designed, and conducted trials with sufficient numbers of participants to perform subgroup analyses by type of disease and chemotherapeutic agent.








Cochrane Oral Health Group and PaPaS Trials Registers( 2011年2月16日まで)、CENTRAL(コクラン・ライブラリ2011,年第1号)、MEDLINE via OVID(1950年~ 2011年2月16日)、EMBASE via OVID(1980年~ 2011年2月16日)、 CINAHL via EBSCO(1980年 ~ 2011年2月16日)、 CANCERLIT via PubMed(1950年~ 2011年2月16日)、 OpenSIGLE(1980年 ~ 2005年)、 LILACS via the Virtual Health Library(1980年~ 2011年2月16日)を電子検索した。関連する論文の参考文献を検索し、適合した試験の著者とコンタクトをとって試験について確認をとり、さらなる情報を入手した。










《実施組織》厚生労働省「「統合医療」に係る情報発信等推進事業」(eJIM:[2015.12.22]  《注意》この日本語訳は、臨床医、疫学研究者などによる翻訳のチェックを受けて公開していますが、訳語の間違いなどお気づきの点がございましたら、eJIM事務局までご連絡ください。なお、2013年6月からコクラン・ライブラリーのNew review, Updated reviewとも日単位で更新されています。eJIMでは最新版の日本語訳を掲載するよう努めておりますが、タイム・ラグが生じている場合もあります。ご利用に際しては、最新版(英語版)の内容をご確認ください。

Plain language summary

Interventions for preventing oral mucositis for patients with cancer receiving treatment

Treatment for cancer (including bone marrow transplant) can cause oral mucositis (severe ulcers in the mouth). This painful condition can cause difficulties in eating, drinking and swallowing, and may also be associated with infections which may require the patient to stay longer in hospital. Different strategies are used to try and prevent this condition, and the review of trials found that some of these are effective. Two interventions, cryotherapy (ice chips) and keratinocyte growth factor (palifermin®) showed some benefit in preventing mucositis. Sucralfate is effective in reducing the severity of mucositis, and a further seven interventions, aloe vera, amifostine, intravenous glutamine, granulocyte-colony stimulating factor (G-CSF), honey, laser and antibiotic lozenges containing polymixin/tobramycin/amphotericin (PTA) showed weaker evidence of benefit. These were evaluated in patients with different types of cancer, undergoing different types of cancer treatment. Benefits may be restricted to the disease and treatment combinations evaluated.





《実施組織》厚生労働省「「統合医療」に係る情報発信等推進事業」(eJIM:[2015.12.22]  《注意》この日本語訳は、臨床医、疫学研究者などによる翻訳のチェックを受けて公開していますが、訳語の間違いなどお気づきの点がございましたら、eJIM事務局までご連絡ください。なお、2013年6月からコクラン・ライブラリーのNew review, Updated reviewとも日単位で更新されています。eJIMでは最新版の日本語訳を掲載するよう努めておりますが、タイム・ラグが生じている場合もあります。ご利用に際しては、最新版(英語版)の内容をご確認ください。

Laički sažetak

Postupci za sprječavanje upale sluznice usta (oralnog mukozitisa) u pacijenata koji primaju terapiju za karcinom

Liječenje karcinoma (uključujući presađivanje koštane srži) može uzrokovati oralni mukozitis (teške ulceracije u ustima). To bolno stanje može otežati jedenje, pijenje i gutanje, a može biti povezano s infekcijama zbog kojih može biti potrebno liječiti pacijenta dulje u bolnici. Koriste se različiti postupci da bi se spriječilo to stanje, a ovaj je Cochrane sustavni pregled utvrdio da su neke od njih učinkovite. Dvije intervencije, krioterapija (komadići leda, engl. ice chips) i keratinocitni faktor rasta (palifermin®), pokazale su pozitivan učinak u sprječavanju mukozitisa. Sukralfat može učinkovito smanjiti težinu mukozitisa, a ostalih sedam intervencija koje su dosad ispitane u kliničkim pokusima: aloe vera, amifostin, intravenozni glutamin, faktor stimulacije kolonija granulocita, med, laser i antibiotici uključujući polimiksin/tobramicin/amfotericin (PTA) su pokazale slabije dokaze učinkovitosti. Uspješnost tih postupaka ispitana je na pacijentima s različitim vrstama karcinoma koji su primali različite vrse liječenja za karcinom. Pozitivan učinak možda je ograničen na određene kombinacije bolesti i tipa liječenja koji se proučavaju.

Bilješke prijevoda

Hrvatski Cochrane
Prevela: Ivana Pelaić
Ovaj sažetak preveden je u okviru volonterskog projekta prevođenja Cochrane sažetaka. Uključite se u projekt i pomozite nam u prevođenju brojnih preostalih Cochrane sažetaka koji su još uvijek dostupni samo na engleskom jeziku. Kontakt:

Ringkasan bahasa mudah

Intervensi untuk mencegah mukositis oral dalam kalangan pesakit kanser yang menerima rawatan.

Rawatan untuk kanser (termasuk transplan sumsum tulang) boleh menyebabkan mukositis oral (ulser yang teruk di dalam mulut) Kesakitan yang berlaku akan menyukarkan makan, minum dan menelan, dan boleh dikaitkan dengan jangkitan yang mungkin memerlukan pesakit tersebut tinggal lebih lama di hospital. Pelbagai strategi diguna untuk mencegah keadaan ini dan ulasan-ulasan kajian mendapati sesetengah strategi adalah berkesan. Dua intervensi, krioterapi (ketul ais) dan faktor pertumbuhan keratinosit (palifermin ®) menunjukkan sedikit manfaat dalam mencegah mukositis. Sukralfat adalah berkesan untuk mengurangkan keterukan mukositis, dan tujuh intervensi lain juga berkesan iaitu aloe vera, amifostine, glutamin intravena, faktor perangsang koloni granulosit (G-CSF), madu, laser dan lozeng antibiotik polymixin/tobramycin/amohotericin (PTA) menunjukkan bukti manfaat tetapi lebih lemah. Strategi-strategi tersebut dinilai dalam kalangan pesakit pelbagai jenis kanser yang menerima pelbagai jenis rawatan kanser.Manfaat mungkin merujuk kepada jenis penyakit dan kombinasi rawatan yang dinilai.

Catatan terjemahan

Diterjemahkan oleh Noorliza Mastura Ismail (Kolej Perubatan Melaka-Manipa). Disunting oleh Mohd. Shaharudin Shah Che Hamzah (Universiti Sains Malaysia). Untuk pertanyaan tentang terjemahan ini, sila hubungi