Guideline for the prevention of oral and oropharyngeal mucositis in children receiving treatment for cancer or undergoing haematopoietic stem cell transplantation
BMJ Open
; 7(1): [10], Aug. 28, 2019.
Article
in English
| BIGG - GRADE guidelines
| ID: biblio-1010328
Responsible library:
BR1.1
ABSTRACT
To develop an evidence-based clinical practice guideline for the prevention of oral mucositis in children (0-18â
years) receiving treatment for cancer or undergoing haematopoietic stem cell transplantation (HSCT). The Mucositis Prevention Guideline Development Group was interdisciplinary and included internationally recognised experts in paediatric mucositis. For the evidence review, we included randomised controlled trials (RCTs) conducted in either children or adults evaluating the following interventions selected according to prespecified criteria cryotherapy, low level light therapy (LLLT) and keratinocyte growth factor (KGF). We also examined RCTs of any intervention conducted in children. For all systematic reviews, we synthesised the occurrence of severe oral mucositis. The Grades of Recommendation, Assessment, Development and Evaluation approach was used to describe quality of evidence and strength of recommendations. We suggest cryotherapy or LLLT may be offered to cooperative children receiving chemotherapy or HSCT conditioning with regimens associated with a high rate of mucositis. We also suggest 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 is a lack of efficacy and toxicity data in children, and a lack of long-term follow-up data in paediatric cancers. No other interventions were recommended for oral mucositis prevention in children. All three specific interventions evaluated in this clinical practice guideline were associated with a weak recommendation for use. There may be important organisational and cost barriers to the adoption of LLLT and KGF. Considerations for implementation and key research gaps are highlighted.
Full text:
Available
Collection:
Tematic databases
Health context:
Sustainable Health Agenda for the Americas
/
SDG3 - Health and Well-Being
Health problem:
Goal 9: Noncommunicable diseases and mental health
/
Target 3.4: Reduce premature mortality due to noncommunicable diseases
Database:
BIGG - GRADE guidelines
Main subject:
Phototherapy
/
Stomatitis
/
Pharyngeal Diseases
Type of study:
Controlled clinical trial
/
Practice guideline
Language:
English
Journal:
BMJ Open
Year:
2019
Document type:
Article
Institution/Affiliation country:
Brigham and Women's Hospital/US
/
Children's Hospital of Eastern Ontario/CA
/
Children's Hospital, Western University/CA
/
McMaster University/CA
/
Pediatric Oncology Group of Ontario/CA
/
Stanford University/US
/
University Medical Center Groningen/NO
/
University of Toronto/CA
/
University of Toronto, Toronto/CA