Evidence-Based Clinical Practice on the Interventions for Oral Mucositis for Patients with Cancer Receiving Treatment
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OBJECTIVES: This article is to develop a practical guideline on the interventions from prevention, treatment to nursing for the oral mucositis induced by anti-cancer treatment. MOTHODS: Using keywords "mucositis, cancer", search in the databases including National guideline clearinghouse, Cochrane library, Joanna Briggs institute, Registered nurses' association of Ontario, and Chinese Bio-medical literature database, etc. Only the clinical guideline, systematically review and best practice are included. RESULTS: Mainly, one clinical practice guideline, five systematic reviews, and one best practice are found. CONCLUSION: 1 It is a systematic and continuous process to intervene with the oral mucositis induced by anti-cancer treatment. 2 Considering the risk factor, till now there is no evidence-based suggestion. But some reports give advises the nurse should alert to the factors including age, gender, oral hygiene, salvation function, BMI, and smoking, etc. 3 Clinical nurse should choose a suitable evaluation scales, designed for special types of anti-cancer treatment, for his patients. Oral evaluation scales from the World Health Organization, National Cancer Institute are the most common used scales. 4 Supported by the evidence, there are some effective interventions. Designing standard nursing plan before and during the anti-cancer treatment is good for the prevention of mucositis. There are only two local antibiosis preparations, polymixin/tobramycin/amphotericin (PTA) antibiotic pastille/paste and iodophors solution, proven to be effective. Local preparations, including sucralfate, honey and aloe vera have protective effects on the oral mucous. Intravenous infusion of amifostine, granulocyte-colony stimulating factor (G-CSF), glutamine, or keratinocyte growth factor, can protect the normal cells and improve the healing process. The laser has the effect of stimulate the growth of the mucous cell. Cryotherapy protects the oral mucous because of the effects of reducing blood volume. Homeopathy is proven to be effective on treatment. Local and general analgesics or psychological method are helpful for the pain relief.