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Systematic review of cytokines and growth factors for the management of oral mucositis in cancer patients |
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| Authors: | Judith E Raber-Durlacher Inger von B��ltzingsl?wen Richard M Logan Joanne Bowen Abdul Rahman Al-Azri Hele Everaus Erich Gerber Jes��s Garcia Gomez Bo G Pettersson Yoshihiko Soga Fred K L Spijkervet Wim J E Tissing Joel B Epstein Sharon Elad Rajesh V Lalla |
| Institution: | 1. Department of Periodontology ACTA (Academic Centre for Dentistry Amsterdam), University of Amsterdam and VU University Amsterdam, Gustav Mahlerlaan 3004, 1081 LA, Amsterdam, The Netherlands 2. Department of Oral and Maxillofacial Surgery, Academic Medical Center Amsterdam, Amsterdam, The Netherlands 3. Department of Oral Microbiology and Immunology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden 4. Discipline of Oral Diagnostic Sciences, The School of Dentistry, Faculty of Health Sciences, The University of Adelaide, Adelaide, Australia 5. School of Medical Sciences, The University of Adelaide, Adelaide, Australia 6. Discipline of Oral Pathology, School of Dentistry, Faculty of Health Sciences, The University of Adelaide, Adelaide, Australia 7. Hematology-Oncology Clinic, Tartu University and Tartu University Hospital, Tartu, Estonia 8. Institut for Radioonkologie, Kaiser Franz Josef Spital, Vienna, Austria 9. Medical Oncology Service, Complejo Hospitalario Universitario de Orense, Orense, Spain 10. Department of Orofacial Medicine, Public Dental Health, ?sterg?tland County, Sweden 11. Division of Hospital Dentistry, Central Clinical Department, Okayama University Hospital, Okayama, Japan 12. Department Oral & Maxillofacial Surgery, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands 13. Department of Pediatric Oncology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands 14. Division of Otolaryngology and Head and Neck Surgery, City of Hope, Duarte, CA, USA 15. Division of Oral Medicine, Eastman Institute for Oral Medicine, University of Rochester Medical Center, Rochester, NY, USA 16. Section of Oral Medicine and Neag Comprehensive Cancer Center, University of Connecticut Health Center, Farmington, CT, USA |
| Abstract: | PurposeThe aim of this project was to review the literature and define clinical practice guidelines for the use of cytokines and growth factor agents for the prevention or treatment of oral mucositis induced by cancer chemotherapy or radiotherapy.MethodsA systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO). The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. Based on the evidence level, one of the following three guideline determinations was possible: Recommendation, Suggestion, No guideline possible.ResultsSixty-four clinical studies across 11 interventions were evaluated. A recommendation was made for the use of recombinant human KGF-1 (palifermin) at a dose of 60???g/kg per day for 3?days prior to conditioning treatment and for 3?days post-transplant for prevention of oral mucositis in patients receiving high-dose chemotherapy and total body irradiation followed by autologous stem cell transplantation for hematological malignancies. A suggestion was made against using granulocyte macrophage colony-stimulating factor mouthwash for the prevention of oral mucositis in the setting of high-dose chemotherapy followed by autologous or allogeneic stem cell transplantation. No guideline was possible for any other cytokine or growth factor agents due to inconclusive evidence.ConclusionsOf the cytokine and growth factor agents studied for oral mucositis, the evidence only supports use of palifermin in the specific population listed above. Additional well-designed research is needed on other cytokine and growth factor interventions and in other cancer treatment settings. |
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