Prophylaxis of oral mucositis in irradiated head-and-neck cancer patients: a proposed classification scheme of interventions and meta-analysis of randomized controlled trials
Identifieur interne : 003B10 ( Istex/Checkpoint ); précédent : 003B09; suivant : 003B11Prophylaxis of oral mucositis in irradiated head-and-neck cancer patients: a proposed classification scheme of interventions and meta-analysis of randomized controlled trials
Auteurs : Susan E. Sutherland [Canada] ; George P. Browman [Canada]Source :
- International Journal of Radiation Oncology, Biology, Physics [ 0360-3016 ] ; 2001.
Descripteurs français
- Wicri :
- topic : Antibiotique, Base de données, Critère d'éligibilité, Histologie.
English descriptors
- KwdEn :
- Amifostine, Antibacterial, Antibiotic, Antibiotic lozenges, Basal epithelium, Benzydamine, Biol, Browman, Cancer patients, Carcinoma, Chemotherapy, Chlorhexidine, Clin, Clin oncol, Clinical trial, Clinical trials, Clinician, Control groups, Conventional fractionation, Cytoprotectants, Cytoprotection, Database, Direct cytoprotectants, Drug therapy, Eligibility criteria, Epithelium, Epstein, Fractionation, Head and neck neoplasms, Histology, Indirect cytoprotectants, Irradiation mucositis, Laser, Lozenge, Methodologic, Methodologic quality, Mucosal, Mucositis, Neck cancer, Neck cancer patients, Neck neoplasms, Neck radiotherapy, Neck region, Neck tumors, Oncol, Oncology, Onkol, Oral cavity, Oral complications, Oral mucositis, Oral pathol, Oral surg, Oropharynx, Oropharynx histology, Outcome measures, Overview, Patient assessments, Phys, Placebo, Prophylaxis, Prostaglandin, Quality score, Radiat, Radiat oncol biol phys, Radiation mucositis, Radiation oncology biology physics, Radiation therapy, Radiother oncol, Radiotherapy, Radiotherapy dose, Randomized, Randomized trial, Randomized trials, Reviewer, Seconds subsites, Stomatitis, Strahlenther, Strahlenther onkol, Subgroup, Subgroup analyses, Subgroup analysis, Subsites, Sucralfate, Sucralfate suspension, Surg, Systematic review, Treatment effect, Validity score.
- Teeft :
- Amifostine, Antibacterial, Antibiotic, Antibiotic lozenges, Basal epithelium, Benzydamine, Biol, Browman, Cancer patients, Carcinoma, Chemotherapy, Chlorhexidine, Clin, Clin oncol, Clinical trial, Clinical trials, Clinician, Control groups, Conventional fractionation, Cytoprotectants, Cytoprotection, Database, Direct cytoprotectants, Eligibility criteria, Epithelium, Epstein, Fractionation, Histology, Indirect cytoprotectants, Irradiation mucositis, Laser, Lozenge, Methodologic, Methodologic quality, Mucosal, Mucositis, Neck cancer, Neck cancer patients, Neck neoplasms, Neck radiotherapy, Neck region, Neck tumors, Oncol, Oncology, Onkol, Oral cavity, Oral complications, Oral mucositis, Oral pathol, Oral surg, Oropharynx, Oropharynx histology, Outcome measures, Overview, Patient assessments, Phys, Placebo, Prophylaxis, Prostaglandin, Quality score, Radiat, Radiat oncol biol phys, Radiation mucositis, Radiation oncology biology physics, Radiation therapy, Radiother oncol, Radiotherapy, Radiotherapy dose, Randomized, Randomized trial, Randomized trials, Reviewer, Seconds subsites, Stomatitis, Strahlenther, Strahlenther onkol, Subgroup, Subgroup analyses, Subgroup analysis, Subsites, Sucralfate, Sucralfate suspension, Surg, Systematic review, Treatment effect, Validity score.
Abstract
Abstract: Purpose: To identify, classify, and evaluate agents used in the prophylaxis of oral mucositis in irradiated head and neck cancer patients. Methods: Data sources included multiple databases and manual citation review of relevant literature. Based on the eligibility criteria, 59 studies were independently reviewed by two reviewers. Forty-two studies were included in the classification scheme, of which 15 met the criteria for inclusion in the meta-analysis. Data were extracted by duplicate independent review, with disagreement resolved by consensus. Results: Overall, the interventions reduced the odds of developing severe oral mucositis, when assessed by clinicians, by 36% (OR: 0.64; 95% CI: 0.46, 0.88). Subgroup analysis suggested that only the narrow-spectrum antibacterial lozenges were effective (OR: 0.45; 95% CI: 0.23, 0.86); however, the power of the aggregated data in the other classes may have been insufficient to detect differences. When the outcome was assessed by patients, no significant difference was seen in the outcome between the treatment and the control groups (OR: 0.79; 95% CI: 0.56–1.12). Conclusions: Overall, interventions chosen on a sound biologic basis to prevent severe oral mucositis are effective. In particular, when oral mucositis is assessed by clinicians, narrow-spectrum antibiotic lozenges appear to be beneficial. Methodologic limitations were evident in many of the studies. Further research using validated measurement tools in larger, methodologically sound trials is warranted.
Url:
DOI: 10.1016/S0360-3016(00)01456-5
Affiliations:
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ISTEX:1AC343C2A2961DFE1F4F5ED37B19635B8E080FFDLe document en format XML
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xml:lang="en"><term>Amifostine</term><term>Antibacterial</term><term>Antibiotic</term><term>Antibiotic lozenges</term><term>Basal epithelium</term><term>Benzydamine</term><term>Biol</term><term>Browman</term><term>Cancer patients</term><term>Carcinoma</term><term>Chemotherapy</term><term>Chlorhexidine</term><term>Clin</term><term>Clin oncol</term><term>Clinical trial</term><term>Clinical trials</term><term>Clinician</term><term>Control groups</term><term>Conventional fractionation</term><term>Cytoprotectants</term><term>Cytoprotection</term><term>Database</term><term>Direct cytoprotectants</term><term>Drug therapy</term><term>Eligibility criteria</term><term>Epithelium</term><term>Epstein</term><term>Fractionation</term><term>Head and neck neoplasms</term><term>Histology</term><term>Indirect cytoprotectants</term><term>Irradiation mucositis</term><term>Laser</term><term>Lozenge</term><term>Methodologic</term><term>Methodologic quality</term><term>Mucosal</term><term>Mucositis</term><term>Neck cancer</term><term>Neck cancer patients</term><term>Neck neoplasms</term><term>Neck radiotherapy</term><term>Neck region</term><term>Neck tumors</term><term>Oncol</term><term>Oncology</term><term>Onkol</term><term>Oral cavity</term><term>Oral complications</term><term>Oral mucositis</term><term>Oral pathol</term><term>Oral surg</term><term>Oropharynx</term><term>Oropharynx histology</term><term>Outcome measures</term><term>Overview</term><term>Patient assessments</term><term>Phys</term><term>Placebo</term><term>Prophylaxis</term><term>Prostaglandin</term><term>Quality score</term><term>Radiat</term><term>Radiat oncol biol phys</term><term>Radiation mucositis</term><term>Radiation oncology biology physics</term><term>Radiation therapy</term><term>Radiother oncol</term><term>Radiotherapy</term><term>Radiotherapy dose</term><term>Randomized</term><term>Randomized trial</term><term>Randomized trials</term><term>Reviewer</term><term>Seconds subsites</term><term>Stomatitis</term><term>Strahlenther</term><term>Strahlenther onkol</term><term>Subgroup</term><term>Subgroup analyses</term><term>Subgroup analysis</term><term>Subsites</term><term>Sucralfate</term><term>Sucralfate suspension</term><term>Surg</term><term>Systematic review</term><term>Treatment effect</term><term>Validity score</term></keywords><keywords scheme="Teeft" xml:lang="en"><term>Amifostine</term><term>Antibacterial</term><term>Antibiotic</term><term>Antibiotic lozenges</term><term>Basal epithelium</term><term>Benzydamine</term><term>Biol</term><term>Browman</term><term>Cancer patients</term><term>Carcinoma</term><term>Chemotherapy</term><term>Chlorhexidine</term><term>Clin</term><term>Clin oncol</term><term>Clinical trial</term><term>Clinical trials</term><term>Clinician</term><term>Control groups</term><term>Conventional 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d'éligibilité</term><term>Histologie</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Abstract: Purpose: To identify, classify, and evaluate agents used in the prophylaxis of oral mucositis in irradiated head and neck cancer patients. Methods: Data sources included multiple databases and manual citation review of relevant literature. Based on the eligibility criteria, 59 studies were independently reviewed by two reviewers. Forty-two studies were included in the classification scheme, of which 15 met the criteria for inclusion in the meta-analysis. Data were extracted by duplicate independent review, with disagreement resolved by consensus. Results: Overall, the interventions reduced the odds of developing severe oral mucositis, when assessed by clinicians, by 36% (OR: 0.64; 95% CI: 0.46, 0.88). Subgroup analysis suggested that only the narrow-spectrum antibacterial lozenges were effective (OR: 0.45; 95% CI: 0.23, 0.86); however, the power of the aggregated data in the other classes may have been insufficient to detect differences. When the outcome was assessed by patients, no significant difference was seen in the outcome between the treatment and the control groups (OR: 0.79; 95% CI: 0.56–1.12). Conclusions: Overall, interventions chosen on a sound biologic basis to prevent severe oral mucositis are effective. In particular, when oral mucositis is assessed by clinicians, narrow-spectrum antibiotic lozenges appear to be beneficial. Methodologic limitations were evident in many of the studies. Further research using validated measurement tools in larger, methodologically sound trials is warranted.</div></front></TEI><affiliations><list><country><li>Canada</li></country><region><li>Ontario</li></region><settlement><li>Toronto</li></settlement><orgName><li>Université de Toronto</li></orgName></list><tree><country name="Canada"><noRegion><name sortKey="Sutherland, Susan E" sort="Sutherland, Susan E" uniqKey="Sutherland S" first="Susan E" last="Sutherland">Susan E. Sutherland</name></noRegion><name sortKey="Browman, George P" sort="Browman, George P" uniqKey="Browman G" first="George P" last="Browman">George P. Browman</name><name sortKey="Sutherland, Susan E" sort="Sutherland, Susan E" uniqKey="Sutherland S" first="Susan E" last="Sutherland">Susan E. Sutherland</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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