Guidelines were developed by the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) to facilitate the evidence-based management of mucositis.
Mucositis is characterized by erythema and ulceration of the mucosal lining of the gastrointestinal (GI) tract. It is a common complication of radiotherapy (RT), chemotherapy (CT), a combination of RT and CT (RTCT), and hematopoietic stem cell transplantation (HSCT). Oral mucositis (OM) is associated with pain, difficulty in eating and swallowing, the need for enteral or parenteral nutrition, increased opioid consumption, and interruptions to cancer therapy.
There has been enormous growth in mucositis research since the last guideline update in 2014. The MASCC/ISOO performed a new systematic review and updated the clinical guidelines to provide clinicians with a set of interventions for mucositis with solid evidence to support or refute their use in specific clinical circumstances.
Background: Mucositis is a significant toxicity of cancer therapy with numerous systemic sequelae. This systematic review aimed to update the Multinational Association of Supportive Care in Cancer and the International Society of Oral Oncology (MASCC/ISOO) Clinical Practice Guidelines for managing mucositis.
Methods: The literature was reviewed systematically to identify interventions for mucositis. Studies were rated according to the presence of major and minor flaws according to previously published criteria. The body of evidence for each intervention and treatment setting was assigned a level of evidence based on previously published standards. Guidelines were developed based on the level of evidence, with 3 possible guideline determinations: recommendation, suggestion, or no guideline possible.
Results: The guideline covers evidence from 1197 publications on oral or gastrointestinal mucositis. Thirteen new guidelines were developed for or against various interventions in specific treatment settings, and 11 previous guidelines were confirmed after a review of new evidence. Thirteen previously established guidelines were carried over because there was no further evidence for these interventions.
Conclusions: The updated MASCC/ISOO Clinical Practice Guidelines for mucositis provide professional health caregivers with a clinical setting-specific, evidence-based tool to help manage mucositis in patients who have cancer.