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Abstract：
OBJECTIVE: To update the clinical practice guidelines for the use of antimicrobials, mucosal coating agents, anesthetics, and analgesics for the prevention and/or treatment of oral mucositis (OM).
METHODS: A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. The findings were added to the database used to develop the 2014 MASCC/ISOO clinical practice guidelines. Based on the evidence level, the following guidelines were determined: Recommendation, Suggestion, and No Guideline Possible.
RESULTS: A total of 9 new papers were identified within the scope of this section, adding to the 62 papers reviewed in this section previously. A new Suggestion was made for topical 0.2% morphine for the treatment of OM-associated pain in head and neck (H&N) cancer patients treated with RT-CT (modification of previous guideline). A previous Recommendation against the use of sucralfate-combined systemic and topical formulation in the prevention of OM in solid cancer treatment with CT was changed from Recommendation Against to No Guideline Possible. Suggestion for doxepin and fentanyl for the treatment of mucositis-associated pain in H&N cancer patients was changed to No Guideline Possible.
CONCLUSIONS: Of the agents studied for the management of OM in this paper, the evidence supports a Suggestion in favor of topical morphine 0.2% in H&N cancer patients treated with RT-CT for the treatment of OM-associated pain.
METHODS: A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. The findings were added to the database used to develop the 2014 MASCC/ISOO clinical practice guidelines. Based on the evidence level, the following guidelines were determined: Recommendation, Suggestion, and No Guideline Possible.
RESULTS: A total of 9 new papers were identified within the scope of this section, adding to the 62 papers reviewed in this section previously. A new Suggestion was made for topical 0.2% morphine for the treatment of OM-associated pain in head and neck (H&N) cancer patients treated with RT-CT (modification of previous guideline). A previous Recommendation against the use of sucralfate-combined systemic and topical formulation in the prevention of OM in solid cancer treatment with CT was changed from Recommendation Against to No Guideline Possible. Suggestion for doxepin and fentanyl for the treatment of mucositis-associated pain in H&N cancer patients was changed to No Guideline Possible.
CONCLUSIONS: Of the agents studied for the management of OM in this paper, the evidence supports a Suggestion in favor of topical morphine 0.2% in H&N cancer patients treated with RT-CT for the treatment of OM-associated pain.
摘要：
目的：更新抗菌药物的临床实践指南，粘膜涂层剂，麻醉剂,用于预防和/或治疗口腔粘膜炎(OM)的镇痛药。
方法：由国际口腔肿瘤学会（MASCC/ISOO）的多国癌症支持护理协会粘膜炎研究组进行了系统评价。每次干预的证据，在每种癌症治疗环境中，被分配了一个证据级别。研究结果被添加到用于制定2014年MASCC/ISOO临床实践指南的数据库中。根据证据水平,确定了以下准则：建议，建议,没有可能的指导方针。
结果：在本部分范围内总共确定了9篇新论文，增加了本节先前审查的62篇论文。对于接受RT-CT治疗的头颈部（H＆N）癌症患者，局部使用0.2％吗啡治疗与OM相关的疼痛提出了新的建议（对先前指南的修改）。先前关于使用硫糖铝联合全身和局部制剂预防用CT治疗实体癌的OM的建议从“不建议”改为“无可能指南”。多塞平和芬太尼用于治疗H&N癌症患者粘膜炎相关疼痛的建议改为无可能的指南。
结论：在本文研究的OM管理代理中，有证据支持以下建议:在接受RT-CT治疗的H&N癌症患者中,局部使用0.2%吗啡治疗OM相关疼痛.
方法：由国际口腔肿瘤学会（MASCC/ISOO）的多国癌症支持护理协会粘膜炎研究组进行了系统评价。每次干预的证据，在每种癌症治疗环境中，被分配了一个证据级别。研究结果被添加到用于制定2014年MASCC/ISOO临床实践指南的数据库中。根据证据水平,确定了以下准则：建议，建议,没有可能的指导方针。
结果：在本部分范围内总共确定了9篇新论文，增加了本节先前审查的62篇论文。对于接受RT-CT治疗的头颈部（H＆N）癌症患者，局部使用0.2％吗啡治疗与OM相关的疼痛提出了新的建议（对先前指南的修改）。先前关于使用硫糖铝联合全身和局部制剂预防用CT治疗实体癌的OM的建议从“不建议”改为“无可能指南”。多塞平和芬太尼用于治疗H&N癌症患者粘膜炎相关疼痛的建议改为无可能的指南。
结论：在本文研究的OM管理代理中，有证据支持以下建议:在接受RT-CT治疗的H&N癌症患者中,局部使用0.2%吗啡治疗OM相关疼痛.
