Updated Clinical Practice Guidelines for the Prevention and Treatment of Mucositis

摘要

Background. The original MASCC/ISOO clinical practice guidelines for management of mucositis were published in 2004, and were based on published literature from January 1966 to May 2002 (Rubenstein 2004, Cancer supplement). The guidelines were accompanied by a second paper on pathogenesis, measurement, epidemiology and patient outcomes (Sonis 2004 Cancer supplement).There has been considerable progress in mucosal injury research and clinical practice since May 2002. The publication rate in the field of mucositis continues to increase rapidly, understanding of pathobiology has advanced, and the first active drug for the prevention and treatment of this condition has been approved by the United States Food and Drug Administration and other regulatory agencies in Europe and Australia. These changes have led to the need for an updated review of the literature and of the management guidelines.Methods. In the current update, panel members reviewed the biomedical literature on mucositis published in English between January 2002 and May 2005. Four teleconferences were conducted prior to a workshop in June 2005, at which consensus was reached on the evidence in the literature. Criteria based on American Society of Clinical Oncology (ASCO) criteria were again utilized.Results. There have been several changes in the guidelines. These include new recommendations for the use of palifermin for oral mucositis in stem cell transplantation, amifostine in radiation proctitis, and cryotherapy for high dose melphalan.