Materiały źródłowe

• #1 Interventions for the Prevention of Oral Mucositis in Patients Receiving Cancer Treatment: Evidence from Randomised Controlled Trials

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9858113/

  Oral mucositis is a common and most debilitating complication associated with cancer therapy. […] 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.

• #2 Interventions for the Prevention of Oral Mucositis in Patients Receiving Cancer Treatment: Evidence from Randomised Controlled Trials

  https://www.mdpi.com/1718-7729/30/1/74

  Oral mucositis is a common and most debilitating complication associated with cancer therapy. […] 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. […] 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. […] Given that the nature of OM is fundamentally iatrogenic, it is reasonable that attempts have been made to prevent this serious complication of cancer treatment.

• #3 Interventions for the Prevention of Oral Mucositis in Patients Receiving Cancer Treatment: Evidence from Randomised Controlled Trials

  https://www.mdpi.com/1718-7729/30/1/74?type=check_update&version=1

  Oral mucositis is a common and most debilitating complication associated with cancer therapy. […] 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. […] 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. […] Presently, a considerable body of scientific literature is available that describes possible interventions for preventing OM; however, due to the lack of solid evidence, the vast majority may not be effective or appropriate for a specific anticancer regimen.

• #4 FF #130 Oral Mucositis: Prevention and Treatment | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/oral-mucositis-prevention-and-treatment/

  Fast Fact Number: 130 Oral Mucositis: Prevention and Treatment […] Introduction Radiation- and chemotherapy-induced mucositis cause pain, difficulty swallowing, and decreased oral intake. This Fast Fact focuses on prevention of radiation- (XRT) and chemotherapy-induced oral mucositis while broadly touching upon treatment options. […] Risk factors The first step to preventing mucositis is to identify patients at risk of developing it. Patients undergoing radiation for head and neck cancer and/or patients undergoing cytotoxic chemotherapy regimens especially those containing fluorouracil, methotrexate, or etoposide seem to be at particular risk for mucositis. Additionally, patients who smoke, have poor hygiene, poor nutritional status, and age greater than 65 may be at greater risk for severe symptoms.

• #5 FF #130 Oral Mucositis: Prevention and Treatment – Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/oral-mucositis-prevention-and-treatment/?print=print

  Mucositis Prevention, Prophylaxis […] The first step to preventing mucositis is to identify patients at risk of developing it. […] There are many prevention schemas to consider for patients at risk of developing mucositis, but unfortunately, there is no gold standard protocol. A systematic review of suggested that no intervention is proven to prevent or treat mucositis on its own. Instead, individualized, multi-modal strategies are recommended. […] At least two weeks prior to the start of radiation to the head and neck region, or the use of chemotherapy that is expected to cause severe and prolonged neutropenia (e.g., for acute leukemia), patients should undergo a thorough oral/dental exam with appropriate dental extraction and repair or removal of dental prostheses. […] Ice chip therapy (patient holds ice chips in their mouth 30 minutes prior to an infusion of a cytotoxic chemotherapy) may reduce the incidence of severe chemotherapy-induced mucositis. […] For radiation-induced mucositis in head and neck cancers, povidone iodine rinses; honey swish and spits administered before each radiation dose, daily zinc supplementation, and 5-15 grams of oral glutamine 2-3 times a day may help prevent mucositis. […] Advanced radiotherapy techniques such as 3D-conformal therapy and intensity modulated therapy decrease radiation toxicity by limiting doses to the normal oral mucosa. […] Prophylactic feeding tube placement: for patients with severe pain brought on by oral intake, gastric feeding tube placement may be considered to prevent mucositis pain.

• #6 FF #130 Oral Mucositis: Prevention and Treatment | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/oral-mucositis-prevention-and-treatment/

  Prevention There are many prevention schemas to consider for patients at risk of developing mucositis, but unfortunately, there is no gold standard protocol. A systematic review suggested that no intervention is proven to prevent or treat mucositis on its own. Instead, individualized, multi-modal strategies are recommended. […] Oral care: At least two weeks prior to the start of radiation to the head and neck region, or the use of chemotherapy that is expected to cause severe and prolonged neutropenia (e.g., for acute leukemia), patients should undergo a thorough oral/dental exam with appropriate dental extraction and repair or removal of dental prostheses. Patients should be educated on maintaining good oral hygiene including daily brushing with a soft bristle toothbrush, flossing, use of fluoride plaques, and avoiding denture use. Mouth rinses that contain chlorhexidine or a mixture of baking soda, salt, and water can prevent the build-up of bacterial overgrowth and remove dead cells. Patients should avoid caustic and drying foods such as: sharp potato chips, alcoholic beverages, mouth rinses with alcohol, hot beverages, and acidic foods.

• #7 FF #130 Oral Mucositis: Prevention and Treatment – Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/oral-mucositis-prevention-and-treatment/?print=print

  Mucositis Prevention, Prophylaxis […] The first step to preventing mucositis is to identify patients at risk of developing it. […] There are many prevention schemas to consider for patients at risk of developing mucositis, but unfortunately, there is no gold standard protocol. A systematic review of suggested that no intervention is proven to prevent or treat mucositis on its own. Instead, individualized, multi-modal strategies are recommended. […] At least two weeks prior to the start of radiation to the head and neck region, or the use of chemotherapy that is expected to cause severe and prolonged neutropenia (e.g., for acute leukemia), patients should undergo a thorough oral/dental exam with appropriate dental extraction and repair or removal of dental prostheses. […] Ice chip therapy (patient holds ice chips in their mouth 30 minutes prior to an infusion of a cytotoxic chemotherapy) may reduce the incidence of severe chemotherapy-induced mucositis. […] For radiation-induced mucositis in head and neck cancers, povidone iodine rinses; honey swish and spits administered before each radiation dose, daily zinc supplementation, and 5-15 grams of oral glutamine 2-3 times a day may help prevent mucositis. […] Advanced radiotherapy techniques such as 3D-conformal therapy and intensity modulated therapy decrease radiation toxicity by limiting doses to the normal oral mucosa. […] Prophylactic feeding tube placement: for patients with severe pain brought on by oral intake, gastric feeding tube placement may be considered to prevent mucositis pain.

• #8 Prevention of oral mucositis in cancer patients treated with chemotherapy or radiotherapy | Evidence-Based Dentistry

  https://www.nature.com/articles/6400452

  The search yielded 109 publications, 45 articles being included in the meta-analyses. These evaluated eight different interventions: local application of chlorhexidine; iseganan; PTA (polymyxin E, tobramycine and amphotericin B); granulocyte macrophage-colony-stimulating factor/ granulocyte colony-stimulating factor (GM-CSF/ G-CSF); oral cooling; sucralfate and glutamine; and systemic administration of amifostine and GM-CSF/G-CSF. Four interventions showed a significant preventive effect on the development or severity of oral mucositis: PTA [odds ratio (OR), 0.61; 95% confidence interval (CI), 0.390.96]; GM-CSF (OR, 0.53; 95% CI, 0.330.87); oral cooling (OR, 0.3; 95% CI, 0.160.56); and amifostine (OR, 0.37; 95% CI, 0.150.89). […] From current data, it can be concluded that no single intervention is capable of completely preventing oral mucositis. Future studies should evaluate a combination of interventions for the prevention of oral mucositis. In contrast, novel therapies could be developed that will improve outcomes and be used as single agents.

• #9

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3935910/

  Oral mucositis is one of the most common side effects of cancer treatment (chemotherapy and/or radiotherapy). […] This points to the importance of establishing therapeutic tools of use in the prevention and/or treatment of mucositis. […] In relation to OM secondary to chemotherapy, many studies have evaluated the efficacy of different interventions designed to prevent and/or treat the disease. […] The present review examines those therapeutic tools that have been shown to be useful in the prevention or treatment of OM. […] The main strategies and drugs described in the literature over the last 10 years designed to prevent and/or treat OM secondary to chemotherapy are the following: […] Oral care can reduce the presence of microbial flora, the pain and bleeding, and prevent infections.

• #10 Mucositis Prevention – Hematology/Oncology Fellowship – Pediatric Fellowships – Education & Training – Pediatrics – Rochester NY – University of Rochester Medical Center

  https://www.urmc.rochester.edu/pediatrics/hematology-oncology-fellowship/fellowship-research/mucositis/prevention.aspx

  Preventing mucositis […] Good oral hygiene can decrease infection the risk of the mouth being a target for chemotherapy due to on-going inflammation from infection and/or trauma. […] First, the use of rinsing the mouth helps to reduce the amount of time the chemotherapy spends in contact with the oral tissue reducing the risk of tissue breakdown. Secondly, oral rinses help to improve oral hygiene by removing food and plaque build-up that can promote inflammation. Chemotherapy is naturally attracted to inflamed tissue, thus reducing inflammation of the mouth can decrease the risk of oral tissue (mucosa) becoming a target. […] Lubrication of the oral mucosa and prevention of dryness can help to decrease risk of cytotoxic damage from chemo since dryness and/or peeling can increase inflammation that is targeted by chemotherapy.

• #11 FF #130 Oral Mucositis: Prevention and Treatment | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/oral-mucositis-prevention-and-treatment/

  Prevention There are many prevention schemas to consider for patients at risk of developing mucositis, but unfortunately, there is no gold standard protocol. A systematic review suggested that no intervention is proven to prevent or treat mucositis on its own. Instead, individualized, multi-modal strategies are recommended. […] Oral care: At least two weeks prior to the start of radiation to the head and neck region, or the use of chemotherapy that is expected to cause severe and prolonged neutropenia (e.g., for acute leukemia), patients should undergo a thorough oral/dental exam with appropriate dental extraction and repair or removal of dental prostheses. Patients should be educated on maintaining good oral hygiene including daily brushing with a soft bristle toothbrush, flossing, use of fluoride plaques, and avoiding denture use. Mouth rinses that contain chlorhexidine or a mixture of baking soda, salt, and water can prevent the build-up of bacterial overgrowth and remove dead cells. Patients should avoid caustic and drying foods such as: sharp potato chips, alcoholic beverages, mouth rinses with alcohol, hot beverages, and acidic foods.

• #12

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3935910/

  The antimicrobial agent most widely studied in the management of OM is chlorhexidine, used in oral rinses at concentrations of 0.12-0.2%, since it has been suggested to be useful in maintaining improved oral hygiene and in reducing mucosal inflammation. […] Amifostine (Ethyol) is an organic thiophosphate believed to act as a reactive oxygen species (ROS) scavenger. […] Glutamine is one of the most abundant amino acids in the body, where it is involved in numerous beneficial functions. […] Allopurinol has been used on an experimental basis for both the prevention and treatment of mucositis induced by fluorouracil. […] The application of ice within the oral cavity causes local vasoconstriction, which in turn lessens blood flow to the oral mucosa and reduces the amount of cytotoxic medication reaching the cells thereby lowering the incidence of mucositis.

• #13 FF #130 Oral Mucositis: Prevention and Treatment | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/oral-mucositis-prevention-and-treatment/

  Prevention There are many prevention schemas to consider for patients at risk of developing mucositis, but unfortunately, there is no gold standard protocol. A systematic review suggested that no intervention is proven to prevent or treat mucositis on its own. Instead, individualized, multi-modal strategies are recommended. […] Oral care: At least two weeks prior to the start of radiation to the head and neck region, or the use of chemotherapy that is expected to cause severe and prolonged neutropenia (e.g., for acute leukemia), patients should undergo a thorough oral/dental exam with appropriate dental extraction and repair or removal of dental prostheses. Patients should be educated on maintaining good oral hygiene including daily brushing with a soft bristle toothbrush, flossing, use of fluoride plaques, and avoiding denture use. Mouth rinses that contain chlorhexidine or a mixture of baking soda, salt, and water can prevent the build-up of bacterial overgrowth and remove dead cells. Patients should avoid caustic and drying foods such as: sharp potato chips, alcoholic beverages, mouth rinses with alcohol, hot beverages, and acidic foods.

• #14

  https://www.johs.com.sa/pages/issue/abstract/?id=132

  The updated MASCC/ISOO recommendations suggest following a routine oral care routine that includes using a soft toothbrush, flossing, and non-medicated rinses such as sodium bicarbonate or saline rinses. […] The keratinocyte growth factor is used effectively to treat chemo-radiotherapy-induced oral mucositis because of its strong cytoprotective properties for epithelial cells. […] To avert oral mucositis in cancer patients receiving moderate-dose RT, there is sufficient clinical evidence to advise them to use benzydamine mouthwash. […] The effectiveness of photobiomodulation (PBM) has been demonstrated in well-designed clinical trials and may be regarded as a patient-friendly therapy option, particularly for children who might have trouble adhering to traditional treatments like mouthwash.

• #15 FF #130 Oral Mucositis: Prevention and Treatment | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/oral-mucositis-prevention-and-treatment/

  Over-the-counter supplements: Ice chip therapy (patient holds ice chips in their mouth 30 minutes prior to an infusion of a cytotoxic chemotherapy) may reduce the incidence of severe chemotherapy-induced mucositis. For radiation-induced mucositis in head and neck cancers, povidone iodine rinses; honey swish and spits administered before each radiation dose, daily zinc supplementation, and 5-15 grams of oral glutamine 2-3 times a day may help prevent mucositis. […] Radiation therapy technique: Advanced radiotherapy techniques such as 3D-conformal therapy and intensity modulated therapy decrease radiation toxicity by limiting doses to the normal oral mucosa. Other XRT modifications that decrease toxicity include using shields over normal tissues, decreasing the radiation fraction size, and decreasing overall treatment time. Severe mucositis may require a 5-to-7-day radiation treatment break to allow for tissue recovery. However, a prolonged break is associated with inferior local control rates and survival. […] Prophylactic feeding tube placement: for patients with severe pain brought on by oral intake, gastric feeding tube placement may be considered to prevent mucositis pain.

• #16 FF #130 Oral Mucositis: Prevention and Treatment – Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/oral-mucositis-prevention-and-treatment/?print=print

  Mucositis Prevention, Prophylaxis […] The first step to preventing mucositis is to identify patients at risk of developing it. […] There are many prevention schemas to consider for patients at risk of developing mucositis, but unfortunately, there is no gold standard protocol. A systematic review of suggested that no intervention is proven to prevent or treat mucositis on its own. Instead, individualized, multi-modal strategies are recommended. […] At least two weeks prior to the start of radiation to the head and neck region, or the use of chemotherapy that is expected to cause severe and prolonged neutropenia (e.g., for acute leukemia), patients should undergo a thorough oral/dental exam with appropriate dental extraction and repair or removal of dental prostheses. […] Ice chip therapy (patient holds ice chips in their mouth 30 minutes prior to an infusion of a cytotoxic chemotherapy) may reduce the incidence of severe chemotherapy-induced mucositis. […] For radiation-induced mucositis in head and neck cancers, povidone iodine rinses; honey swish and spits administered before each radiation dose, daily zinc supplementation, and 5-15 grams of oral glutamine 2-3 times a day may help prevent mucositis. […] Advanced radiotherapy techniques such as 3D-conformal therapy and intensity modulated therapy decrease radiation toxicity by limiting doses to the normal oral mucosa. […] Prophylactic feeding tube placement: for patients with severe pain brought on by oral intake, gastric feeding tube placement may be considered to prevent mucositis pain.

• #17 Mucositis – Wikipedia

  https://en.wikipedia.org/wiki/Mucositis

  A 2015 Cochrane systematic review assessing the prevention of chemotherapy-induced oral mucositis concluded that oral cryotherapy leads to large reductions in the incidence of oral mucositis of all severities in adults receiving 5-FU treatment for solid cancers. […] The evidence also indicates a reduction of oral mucositis in adults receiving high-dose melphalan-based cancer treatment prior to haematopoietic stem cell transplantation, although there is uncertainty regarding the size of the reduction in this instance. […] Oral cryotherapy involves the placement of rounded ice chips in the mouth, which cools the oral tissues and causes vasoconstriction. […] This decreases blood flow to the region and, hence, also restricts the amounts of the chemotherapy drugs delivered to the tissues.

• #18

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3935910/

  The antimicrobial agent most widely studied in the management of OM is chlorhexidine, used in oral rinses at concentrations of 0.12-0.2%, since it has been suggested to be useful in maintaining improved oral hygiene and in reducing mucosal inflammation. […] Amifostine (Ethyol) is an organic thiophosphate believed to act as a reactive oxygen species (ROS) scavenger. […] Glutamine is one of the most abundant amino acids in the body, where it is involved in numerous beneficial functions. […] Allopurinol has been used on an experimental basis for both the prevention and treatment of mucositis induced by fluorouracil. […] The application of ice within the oral cavity causes local vasoconstriction, which in turn lessens blood flow to the oral mucosa and reduces the amount of cytotoxic medication reaching the cells thereby lowering the incidence of mucositis.

• #19 Mucositis – Wikipedia

  https://en.wikipedia.org/wiki/Mucositis

  A 2015 Cochrane systematic review assessing the prevention of chemotherapy-induced oral mucositis concluded that oral cryotherapy leads to large reductions in the incidence of oral mucositis of all severities in adults receiving 5-FU treatment for solid cancers. […] The evidence also indicates a reduction of oral mucositis in adults receiving high-dose melphalan-based cancer treatment prior to haematopoietic stem cell transplantation, although there is uncertainty regarding the size of the reduction in this instance. […] Oral cryotherapy involves the placement of rounded ice chips in the mouth, which cools the oral tissues and causes vasoconstriction. […] This decreases blood flow to the region and, hence, also restricts the amounts of the chemotherapy drugs delivered to the tissues.

• #20 Cryotherapy as A Prophylaxis of Mucositis in Children with Cancer Undergoing Chemotherapy at Dr. M. Djamil General Hospital | Hasni | Indonesian Journal of Cancer

  https://www.indonesianjournalofcancer.or.id/e-journal/index.php/ijoc/article/view/828

  Cryotherapy can cause vasoconstriction and decrease blood flow to the oral mucosa, resulting in lower concentrations of chemotherapy agents to prevent mucositis. […] This study aims at determining the effectiveness of oral cryotherapy as prophylaxis mucositis in children with cancer undergoing chemotherapy. […] The results showed that there was a difference in the incidence of mucositis between before and after intervention in the intervention group (p = 0.003) and the control group (p = 0.000), and cryotherapy was effective in preventing mucositis (p = 0.01). […] Cryotherapy is effective against the prevention of mucositis. Nurses and families need to be able to apply oral cryotherapy and other evidence-based treatment as a method to prevent mucositis.

• #21 Interventions for the Prevention of Oral Mucositis in Patients Receiving Cancer Treatment: Evidence from Randomised Controlled Trials

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9858113/

  The preventative strategies that were assessed in this review included anti-inflammatory and anti-microbial medications, growth factors and cytokines, laser and light therapy, cryotherapy, herbal medications, supplements, muco-protective agents, and others. […] Reduction in severity and/or duration of OM were recorded for a number of medications, including: anti-inflammatory benzydamine, laser-and-light therapy, allopurinol, cryotherapy, multiple herbal agents, supplements, and mucoprotective agents. […] Importantly, our analysis identified a significant level of heterogeneity in the published data, making it difficult to compare and evaluate the quality of evidence. […] Therefore, evidence demonstrates that LLLT can potentially be used as a routine preventative intervention for OM in patients undergoing chemotherapy, radiotherapy, or combination therapy.

• #22

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3935910/

  According to the review published by Clarkson et al., LLLT is the only technique to have shown certain evidence of efficacy in the treatment of established mucositis. […] It is also important to emphasize the importance of correct oral hygiene in cancer patients. […] Our conclusions coincide with the guidelines the Multinational Association of Supportive Care in Cancer (MASCC) and the International Society of Oral Oncology (ISOO), which were updated in 2012 through several review articles. […] In sum, at present no concrete intervention may be regarded as the gold standard for the prevention and/or treatment of oral mucositis, and we therefore must resort to recommendations based on the documented evidence.

• #23 Mucositis – NHS

  https://www.nhs.uk/conditions/mucositis/

  Mucositis is when your mouth or gut is sore and inflamed. It’s a common side effect of chemotherapy and radiotherapy. […] There are some things you can do to help ease the symptoms of mucositis while you’re having chemotherapy or radiotherapy. […] If you have mucositis in your mouth, treatments your care team may offer include: […] There’s also a treatment for oral mucositis called low-level laser therapy. […] The light can help prevent and treat mucositis.

• #24 Interventions for the Prevention of Oral Mucositis in Patients Receiving Cancer Treatment: Evidence from Randomised Controlled Trials

  https://www.mdpi.com/1718-7729/30/1/74

  Our review drawing from the results of RCTs shows that while several agents are potentially effective in reducing the incidence and severity of oral mucositis, there is considerable heterogeneity in the published data. […] The preventative strategies that were assessed in this review included anti-inflammatory and anti-microbial medications, growth factors and cytokines, laser and light therapy, cryotherapy, herbal medications, supplements, muco-protective agents, and others. […] Importantly, our analysis identified a significant level of heterogeneity in the published data, making it difficult to compare and evaluate the quality of evidence. […] Overall, these results are consistent with the guidelines by the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) Clinical Practice Guidelines for Mucositis 2021, which recommended a preventive low-level laser therapy in patients undergoing high-dose chemotherapy, radiotherapy, or radiotherapy with chemotherapy.

• #25 Photobiomodulation preconditioning for oral mucositis prevention and quality of life improvement in chemotherapy patients: a randomized clinical trial | BMC Oral Health | Full Text

  https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-025-05579-1

  Preconditioning before starting chemotherapy, whether with the intraoral red laser alone or in combination with the extraoral infrared laser, has shown significant results in preventing oral mucositis and dry mouth, and it has also played a major role in improving patients quality of life. […] Currently, there are no effective treatments or standardized guidelines for preventing oral side effects caused by anticancer chemotherapy. This lack of effective prevention negatively impacts patients quality of life, prognosis, and care requirements. […] The use of intraoral PBM treatment with laser for the prevention of OM and related discomfort was recommended by the Multinational Society for Supportive Care in Cancer and the International Society of Oral Oncology (MASCC/ISOO) expert panel. […] The most effective strategy for managing mucositis is prevention rather than mitigation or repair.

• #26 Mucositis: causes and treatment | CURAPROX

  https://curaprox.us/blog/post/treating-and-preventing-mucositis?srsltid=AfmBOoob-aCyrqj3SWWRgpSbVjunFzUjpWuqLuCYqyRZZvxefo8IFn_I

  Avoid sticky foods (e.g. honey, caramel, jelly babies – can stick to the teeth/mouth cavity and thus promote the growth of microorganisms that promote inflammation) […] Prevent mucositis with laser therapy? […] Low-level laser therapy (LLLT) is recognised and proven to be effective in the prevention of radiogenic mucositis. It is a low-energy laser treatment that does not cause any thermal damage during irradiation. The laser activates processes that have a positive effect on cell repair mechanisms. Cancer patients should seek advice from their doctor as to whether such laser treatment is a sensible prophylactic option in their individual case before starting cancer therapy.

• #27 Photobiomodulation preconditioning for oral mucositis prevention and quality of life improvement in chemotherapy patients: a randomized clinical trial | BMC Oral Health | Full Text

  https://bmcoralhealth.biomedcentral.com/articles/10.1186/s12903-025-05579-1

  Preconditioning before starting chemotherapy, whether with the intraoral red laser alone or in combination with the extraoral infrared laser, has shown significant results in preventing oral mucositis and dry mouth, and it has also played a major role in improving patients quality of life. […] Currently, there are no effective treatments or standardized guidelines for preventing oral side effects caused by anticancer chemotherapy. This lack of effective prevention negatively impacts patients quality of life, prognosis, and care requirements. […] The use of intraoral PBM treatment with laser for the prevention of OM and related discomfort was recommended by the Multinational Society for Supportive Care in Cancer and the International Society of Oral Oncology (MASCC/ISOO) expert panel. […] The most effective strategy for managing mucositis is prevention rather than mitigation or repair.

• #28 Oral Mucositis – Prevention and Treatment Now Available – Sollay Cosmetic Medical & Laser Center in Baltimore MD

  https://www.sollaylasercenter.com/oral-mucositis-prevention-treatment-now-available/

  Photobiomodulation therapy reduces the onset, severity and duration of oral mucositis. The effects of photobiomodulation therapy (previously known as low level laser therapy or LLLT) is very effective when used for prevention of oral mucositis in patients undergoing chemotherapy, radiation therapy or stem cell transplantation in adult and pediatric patients. […] Clinical trials have demonstrated that treatment starting before cancer therapy begins and continuing during cancer therapy prevents the onset of this very painful complication of therapy. Photobiomodulation therapy is an effective treatment for oral mucositis.

• #29

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3935910/

  Growth factors are proteins that stimulate cell growth, proliferation and differentiation. […] Palifermin (Kepivance) is a recombinant human keratinocyte growth factor that stimulates epithelial cell proliferation and increases the thickness of the non-keratinized layers of the oral and gastrointestinal mucosa. […] Although the results have been promising in almost all of these trials, the publication with the strongest methodological design was that carried out by Spielberger et al., who found palifermin to be very effective in the prevention of oral mucositis in patients scheduled for conditioning treatment (chemotherapy and total body irradiation) prior to hematopoietic stem cell transplantation. […] Interest in the development of radiation techniques for the prevention and treatment of OM has grown in recent years.

• #30 Interventions for the Prevention of Oral Mucositis in Patients Receiving Cancer Treatment: Evidence from Randomised Controlled Trials

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9858113/

  However, given that cryotherapy using ice is well tolerated and inexpensive, further studies are warranted, particularly in patients receiving radiotherapy in the head and neck region. […] The efficacy of palifermin in preventing OM was subsequently confirmed in patients with solid tumours receiving either chemotherapy or chemoradiotherapy. […] However, palifermin failed to reduce OM in a chemotherapy-only, high-dose melphalan transplant setting, suggesting that its efficacy is dependent upon the type of cancer treatment. […] The study on the rebamipide gargle, however, did not show any clinical preventative effect against chemoradiotherapy-induced OM. […] The findings of this review may assist in paving the way for future management options, which is vital considering the adverse consequences associated with the condition.

• #31 FF #130 Oral Mucositis: Prevention and Treatment | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/oral-mucositis-prevention-and-treatment/

  Over-the-counter supplements: Ice chip therapy (patient holds ice chips in their mouth 30 minutes prior to an infusion of a cytotoxic chemotherapy) may reduce the incidence of severe chemotherapy-induced mucositis. For radiation-induced mucositis in head and neck cancers, povidone iodine rinses; honey swish and spits administered before each radiation dose, daily zinc supplementation, and 5-15 grams of oral glutamine 2-3 times a day may help prevent mucositis. […] Radiation therapy technique: Advanced radiotherapy techniques such as 3D-conformal therapy and intensity modulated therapy decrease radiation toxicity by limiting doses to the normal oral mucosa. Other XRT modifications that decrease toxicity include using shields over normal tissues, decreasing the radiation fraction size, and decreasing overall treatment time. Severe mucositis may require a 5-to-7-day radiation treatment break to allow for tissue recovery. However, a prolonged break is associated with inferior local control rates and survival. […] Prophylactic feeding tube placement: for patients with severe pain brought on by oral intake, gastric feeding tube placement may be considered to prevent mucositis pain.

• #32

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3935910/

  The antimicrobial agent most widely studied in the management of OM is chlorhexidine, used in oral rinses at concentrations of 0.12-0.2%, since it has been suggested to be useful in maintaining improved oral hygiene and in reducing mucosal inflammation. […] Amifostine (Ethyol) is an organic thiophosphate believed to act as a reactive oxygen species (ROS) scavenger. […] Glutamine is one of the most abundant amino acids in the body, where it is involved in numerous beneficial functions. […] Allopurinol has been used on an experimental basis for both the prevention and treatment of mucositis induced by fluorouracil. […] The application of ice within the oral cavity causes local vasoconstriction, which in turn lessens blood flow to the oral mucosa and reduces the amount of cytotoxic medication reaching the cells thereby lowering the incidence of mucositis.

• #33 Mucositis Prevention – Hematology/Oncology Fellowship – Pediatric Fellowships – Education & Training – Pediatrics – Rochester NY – University of Rochester Medical Center

  https://www.urmc.rochester.edu/pediatrics/hematology-oncology-fellowship/fellowship-research/mucositis/prevention.aspx

  L-glutamine is the most abundant amino acid in the body that improves production of IgA antibody that lines the GI mucosal lining increasing protection against bacterial and translocation of microbes that can occur when there is mucosal damage or breakdown from chemo and/or radiation. It also aids in promoting more rapid healing of damaged tissues.

• #34 Interventions for the Prevention of Oral Mucositis in Patients Receiving Cancer Treatment: Evidence from Randomised Controlled Trials

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9858113/

  Oral mucositis is a common and most debilitating complication associated with cancer therapy. […] 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.

• #35

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3935910/

  The antimicrobial agent most widely studied in the management of OM is chlorhexidine, used in oral rinses at concentrations of 0.12-0.2%, since it has been suggested to be useful in maintaining improved oral hygiene and in reducing mucosal inflammation. […] Amifostine (Ethyol) is an organic thiophosphate believed to act as a reactive oxygen species (ROS) scavenger. […] Glutamine is one of the most abundant amino acids in the body, where it is involved in numerous beneficial functions. […] Allopurinol has been used on an experimental basis for both the prevention and treatment of mucositis induced by fluorouracil. […] The application of ice within the oral cavity causes local vasoconstriction, which in turn lessens blood flow to the oral mucosa and reduces the amount of cytotoxic medication reaching the cells thereby lowering the incidence of mucositis.

• #36 FF #130 Oral Mucositis: Prevention and Treatment | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/oral-mucositis-prevention-and-treatment/

  Over-the-counter supplements: Ice chip therapy (patient holds ice chips in their mouth 30 minutes prior to an infusion of a cytotoxic chemotherapy) may reduce the incidence of severe chemotherapy-induced mucositis. For radiation-induced mucositis in head and neck cancers, povidone iodine rinses; honey swish and spits administered before each radiation dose, daily zinc supplementation, and 5-15 grams of oral glutamine 2-3 times a day may help prevent mucositis. […] Radiation therapy technique: Advanced radiotherapy techniques such as 3D-conformal therapy and intensity modulated therapy decrease radiation toxicity by limiting doses to the normal oral mucosa. Other XRT modifications that decrease toxicity include using shields over normal tissues, decreasing the radiation fraction size, and decreasing overall treatment time. Severe mucositis may require a 5-to-7-day radiation treatment break to allow for tissue recovery. However, a prolonged break is associated with inferior local control rates and survival. […] Prophylactic feeding tube placement: for patients with severe pain brought on by oral intake, gastric feeding tube placement may be considered to prevent mucositis pain.

• #37 Prevention and Treatment of Oropharyngeal Mucositis – Page 5

  https://www.medscape.com/viewarticle/480699_5

  Recently, efforts have been made to use a midline sparing blocks technique to protect the mucosa of the aerodigestive tract in the low-neck field during head and neck irradiation in treating oropharyngeal and nasopharyngeal tumors. […] It was hypothesized that anticholinergic therapy decreases saliva production, which may result in decreased mucosal secretion of etoposide and thus result in less oral mucositis. […] Azelastine hydrochloride, an antioxidant, is known to suppress neutrophil reactive oxygen production and cytokine release from lymphocytes. […] Sucralfate’s mechanism of action is related to the formation of an ionic bond to proteins in an ulcer site, thereby creating a protective barrier. […] Prostaglandin E2 (PGE2) is suggested to possess cytoprotective properties. […] Use of low-dose intramuscular immunoglobulin and intermediate-dose intravenous immunoglobulin were studied with the hypothesis of down-regulating the inflammatory cytokine release and thus retarding inflammatory local mucosal reaction to cancer treatment.

• #38 FF #130 Oral Mucositis: Prevention and Treatment | Palliative Care Network of Wisconsin

  https://www.mypcnow.org/fast-fact/oral-mucositis-prevention-and-treatment/

  Over-the-counter supplements: Ice chip therapy (patient holds ice chips in their mouth 30 minutes prior to an infusion of a cytotoxic chemotherapy) may reduce the incidence of severe chemotherapy-induced mucositis. For radiation-induced mucositis in head and neck cancers, povidone iodine rinses; honey swish and spits administered before each radiation dose, daily zinc supplementation, and 5-15 grams of oral glutamine 2-3 times a day may help prevent mucositis. […] Radiation therapy technique: Advanced radiotherapy techniques such as 3D-conformal therapy and intensity modulated therapy decrease radiation toxicity by limiting doses to the normal oral mucosa. Other XRT modifications that decrease toxicity include using shields over normal tissues, decreasing the radiation fraction size, and decreasing overall treatment time. Severe mucositis may require a 5-to-7-day radiation treatment break to allow for tissue recovery. However, a prolonged break is associated with inferior local control rates and survival. […] Prophylactic feeding tube placement: for patients with severe pain brought on by oral intake, gastric feeding tube placement may be considered to prevent mucositis pain.

• #39 Mucositis: causes and treatment | CURAPROX

  https://curaprox.us/blog/post/treating-and-preventing-mucositis?srsltid=AfmBOoob-aCyrqj3SWWRgpSbVjunFzUjpWuqLuCYqyRZZvxefo8IFn_I

  Fluoridation to protect the teeth […] Close clinical monitoring and counselling during cancer treatment […] Taking zinc supplements […] Taking benzydamine during radiotherapy (anti-inflammatory, pain-relieving and antibacterial agent in the form of gargle solution, spray or lozenges) […] Proper diet for oral mucositis – and for prevention […] In addition to the tips mentioned above, diet plays an important role in the prevention and treatment of inflamed oral mucosa. […] Abstaining from alcohol and tobacco […] Avoid foods that irritate the mucous membranes, such as sour, spicy or citrus fruits […] Avoid drinks with a high sugar content […] Favour soft food (e.g. fish or mashed potatoes) […] Drink enough […] Avoid raw food […] Avoid crumbly, hard and sharp-edged foods

• #40 EU/3/11/903 – orphan designation for prevention of oral mucositis in head and neck cancer patients undergoing radiation therapy | European Medicines Agency (EMA)

  https://www.ema.europa.eu/en/medicines/human/orphan-designations/eu-3-11-903

  On 27 September 2011, orphan designation (EU/3/11/903) was granted by the European Commission to ActoGeniX N.V., Belgium, for genetically modified Lactococcus lactis bacteria containing the human trefoil factor 1 gene for the prevention of oral mucositis in head and neck cancer patients undergoing radiation therapy. […] At the time of designation, mouth rinses containing calcium phosphate and povidone iodine were authorised in some EU countries for preventing oral mucositis in head and neck cancer patients undergoing radiation therapy. […] The sponsor has provided sufficient information to show that genetically modified Lactococcus lactis bacteria containing the human trefoil factor 1 gene might be of significant benefit for mucositis in head and neck cancer patients undergoing radiotherapy because it works in a different way to existing methods and early studies show that it might offer benefits to patients with this condition, possibly in combination with existing methods. This assumption will need to be confirmed at the time of marketing authorisation, in order to maintain the orphan status.

• #41 Selective NLRP3 Inhibitor Fast Tracked for Prevention, Reduction of Severe Oral Mucositis

  https://www.empr.com/home/news/drugs-in-the-pipeline/selective-nlrp3-inhibitor-fast-tracked-for-prevention-reduction-of-severe-oral-mucositis/

  RRx-001 is an investigational small molecule inflammasome NLRP3 inhibitor and Nrf2 upregulator designed to protect healthy tissues by promoting antioxidant and anti-inflammatory properties. […] The Food and Drug Administration (FDA) has granted Fast Track designation to RRx-001 for the prevention/attenuation of severe oral mucositis in chemotherapy and radiation-treated head and neck cancer patients. […] The Fast Track Designation is great news for EpicentRx, and it puts us one step closer to a potential treatment for this critical unmet need of oral mucositis with RRx-001, said EpicentRx CEO, Dr Tony Reid.

• #42 Virgin Coconut Oil Mouth Rinse for the Prevention of Oral Mucositis in Pediatric Patients Receiving Myeloablative Conditioning Regimens – NCIFacebookFollow on XInstagramYoutubeLinkedin

  https://www.cancer.gov/about-cancer/treatment/clinical-trials/search/v?id=NCI-2024-06522

  This phase II clinical trial compares the addition of virgin coconut oil (VCO) mouth rinse to standard of care (SOC) oral rinses to SOC oral rinses alone at preventing inflammation of the mouth tissue (oral mucositis) in pediatric patients receiving myeloablative conditioning regimens. […] VCO mouth rinse has potential anti-inflammatory, anti-microbial and antioxidant activities that may prevent inflammation of the mucosal membranes in the mouth. […] Using VCO mouth rinse with SOC oral rinses may be better than SOC oral rinses alone at preventing oral mucositis in pediatric patients receiving myeloablative conditioning regimens. […] PRIMARY OBJECTIVE: I. To evaluate the severity of oral mucositis in subjects receiving standard of care with the addition of VCO mouth rinses (Arm A) to the standard of care (Arm B) for the prevention of severe oral mucositis in pediatric patients undergoing myeloablative conditioning regimens in preparation for hematopoietic stem cell transplantation (HSCT).

• #43 MASCC Guidelines – MASCC

  https://mascc.org/resources/mascc-guidelines/

  Mucositis Study Group, MASCC/ISOO mucositis guidelines – Summary – Original article MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy Elad S et al. Cancer (2020). […] Mucositis Study Group, MASCC/ISOO mucositis guidelines – Basic oral care Systematic review of basic oral care for the management of oral mucositis in cancer patients and clinical practice guidelines Hong CHL et al. Supportive Care in Cancer (2019). […] Mucositis Study Group, MASCC/ISOO mucositis guidelines – Photobiomodulation therapy / laser Systematic review of photobiomodulation for the management of oral mucositis in cancer patients and clinical practice guidelines Zadik Y et al. Supportive Care in Cancer (2019). […] Mucositis Study Group, MASCC/ISOO mucositis guidelines – Anti-inflammatory agents Systematic review of anti-inflammatory agents for the management of oral mucositis in cancer patients and clinical practice guidelines Ariyawardana A et al. Supportive Care in Cancer (2019).

• #44 MASCC Guidelines – MASCC

  https://mascc.org/resources/mascc-guidelines/

  Mucositis Study Group, MASCC/ISOO mucositis guidelines – Natural and miscellaneous agents – Part 1 Systematic review of natural and miscellaneous agents for the management of oral mucositis in cancer patients and clinical practice guidelines-part 1: Vitamins, minerals, and nutritional supplements Yarom N et al. Supportive Care in Cancer (2019). […] Mucositis Study Group, MASCC/ISOO mucositis guidelines – Natural and miscellaneous agents – Part 2 Systematic review of natural and miscellaneous agents, for the management of oral mucositis in cancer patients and clinical practice guidelines – part 2: Honey, herbal compounds, saliva stimulants, probiotics, and miscellaneous agents Yarom N et al. Supportive Care in Cancer (2020). […] Mucositis Study Group, MASCC/ISOO mucositis guidelines – Antimicrobials, mucosal coating agents, anesthetics, and analgesics Systematic review of antimicrobials, mucosal coating agents, anesthetics, and analgesics for the management of oral mucositis in cancer patients and clinical practice guidelines Saunders DP et al. Supportive Care in Cancer (2020).

• #45 New Guidelines for Managing Mucositis Now Available – MASCC

  https://mascc.org/new-guidelines-for-managing-mucositis-now-available/

  Updated clinical practice guidelines for managing mucositis, a very common and often debilitating complication of cancer therapy, was recently published with open access in the journal Cancer. […] The new guidelines summary, which will provide healthcare professionals better tools to deliver care for cancer patients, is the result of extensive and meticulous literature review and clinical interpretation by the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology. […] Highlights from this newly published summary paper include additional recommendations for the use of photobiomodulation therapy and benzydamine, as well as a stronger guideline statement for cryotherapy. […] “Interestingly, natural honey had sufficient evidence, when used topically and then swallowed, to suggest possible mucositis prevention for patients with head and neck cancer who receive treatment with either radiotherapy or radio-chemotherapy,” said Dr. Elad.

• #46 Evidence-Based Criteria Standardized Oral Mucositis Prevention in Pediatric HSCT – Oncology Nurse Advisor

  https://www.oncologynurseadvisor.com/news/stem-cell-hsct-oral-mucositis-evidence-based-criteria-treatment-risk/

  In the baseline group, the incidence of OM was 66.6%, whereas it was 36.7% in the postimplementation group, reflecting a significantly lower rate of OM after implementation. […] A recent study demonstrated the potential to increase compliance to standardized practices in preventing oral mucositis (OM) in pediatric patients undergoing hematopoietic stem cell transplantation (HSCT). […] After evaluating evidence, the research team developed an action plan and implemented evidence-based criteria for an approach to preventing OM in this population. […] The researchers identified 12 evidence-based criteria related to oral care aimed at preventing chemotherapy-induced OM in pediatric patients undergoing HSCT. […] By implementing evidence-based OM prevention measures, the study effectively standardized prevention protocols and nursing behaviors, solidified nursing habits, and enhanced clinical nurses adherence to best practices.

• #47 Evidence-Based Criteria Standardized Oral Mucositis Prevention in Pediatric HSCT – Oncology Nurse Advisor

  https://www.oncologynurseadvisor.com/news/stem-cell-hsct-oral-mucositis-evidence-based-criteria-treatment-risk/

  However, after initiating the evidence-based implementation approach, nurse compliance with each of these 6 criteria was considered significantly improved (P .0001 for each). […] In the baseline group, the incidence of OM was 66.6%, whereas it was 36.7% in the postimplementation group, reflecting a significantly lower rate of OM after implementation (P =.02). […] By implementing evidence-based OM prevention measures, the study effectively standardized prevention protocols and nursing behaviors, solidified nursing habits, and enhanced clinical nurses adherence to best practices, the researchers wrote in their report.

• #48 Interventions for the Prevention of Oral Mucositis in Patients Receiving Cancer Treatment: Evidence from Randomised Controlled Trials

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9858113/

  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. […] Given that the nature of OM is fundamentally iatrogenic, it is reasonable that attempts have been made to prevent this serious complication of cancer treatment. Presently, a considerable body of scientific literature is available that describes possible interventions for preventing OM; however, due to the lack of solid evidence, the vast majority may not be effective or appropriate for a specific anticancer regimen. […] Our review drawing from the results of RCTs shows that while several agents are potentially effective in reducing the incidence and severity of oral mucositis, there is considerable heterogeneity in the published data.

• #49 Interventions for the Prevention of Oral Mucositis in Patients Receiving Cancer Treatment: Evidence from Randomised Controlled Trials

  https://www.mdpi.com/1718-7729/30/1/74

  Therefore, evidence demonstrates that LLLT can potentially be used as a routine preventative intervention for OM in patients undergoing chemotherapy, radiotherapy, or combination therapy. […] However, as these interventions were only examined by a small number of studies identified by this review and hence further investigation is warranted to test their true efficacy.

• #50 Treatment Options for Cancer Patients Suffering from Oral Mucositis | Asian Pacific Journal of Cancer Care

  http://waocp.com/journal/index.php/apjcc/article/view/1018

  Mucositis prevention should be a priority for all healthcare practitioners. […] Chlorhexidine gluconate mouthwash (0.12% or 0.2%) has been found to reduce the severity and duration of oral mucositis in patients undergoing severe chemotherapy. […] Patients should be taught to use fluoride toothpaste after each meal and before bed, as well as floss once per day. […] The frequency of these exams should be dictated by the toxicity of the drug and the patient’s oral state at baseline. […] Oral cleansing may minimise mucositis, hence decreasing bacteraemia. […] In patients who are anticipated to develop severe mucositis, a gastrostomy tube is occasionally put prophylactically, but the frequency of this practice varies substantially from centre to centre.

• #51 SciELO Brazil – PREVENTION AND TREATMENT OF MUCOSITIS AT AN ONCOLOGY OUTPATIENT CLINIC: A COLLECTIVE CONSTRUCTION PREVENTION AND TREATMENT OF MUCOSITIS AT AN ONCOLOGY OUTPATIENT CLINIC: A COLLECTIVE CONSTRUCTION

  https://www.scielo.br/j/tce/a/zGJBzkHMXzhpnjWjQsRq7pR/

  The aim was to develop a nursing care protocol for the prevention and treatment of chemotherapy-induced mucositis at an outpatient clinic of a High Complexity Center in Oncology. […] Care was related to oral hygiene, mouth rinse, cryotherapy, laser therapy and interventions related to the nutritional scope. The implementation of this care protocol has standardized the care strategies. […] There are ways to prevent or reduce the intensity of the mucositis. These include oral hygiene, rinsing using appropriate mouthwash, lip lubrication, appropriate nutrition, xerostomy control, cryotherapy, use of low-potency laser and suspension of substances and foods irritating to the mucosa, such as tobacco. […] The protocol is a proposal to standardize procedures, which the health professionals can elaborate to guide their practice.

• #52 SciELO Brazil – PREVENTION AND TREATMENT OF MUCOSITIS AT AN ONCOLOGY OUTPATIENT CLINIC: A COLLECTIVE CONSTRUCTION PREVENTION AND TREATMENT OF MUCOSITIS AT AN ONCOLOGY OUTPATIENT CLINIC: A COLLECTIVE CONSTRUCTION

  https://www.scielo.br/j/tce/a/zGJBzkHMXzhpnjWjQsRq7pR/

  The use of the protocol is expected to be able to contribute to the reduction and prevention of chemotherapy-induced mucosites in the study context. In their activities, the nurses have responsibilities and conducts towards oral mucositis, such as systematic action to monitor the oral cavity and mucositis symptoms, evidence-based nursing intervention planning, always appropriate to the place of their care practice and considering each patient’s individual characteristics and needs.

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