Article Text
Abstract
Background One of the most common side effects of cancer treatment is oral mucositis. Although studies have shown that oral cryotherapy has a favourable effect on oral mucositis, the reliability of the results is questionable.
Objective The goal of this umbrella review was to provide insight into the effects of oral cryotherapy against oral mucositis in patients with cancer, as well as to assess the certainty of this evidence.
Method Studies were searched for through PubMed, Scopus and Web of Science, with no restrictions until August 2021. The risk ratio (RR) and 95% CI for each meta-analysis were recalculated using a random-effects model, and the certainty of the evidence was judged using Grading of Recommendations Assessment, Development and Evaluation.
Results Ten meta-analyses including 25 original RCTs that fit our inclusion criteria were included. The use of oral cryotherapy markedly reduced the occurrence of overall (RR 0.72, 95% CI 0.64 to 0.83, n=20 trials), moderate to severe (RR 0.60, 95% CI 0.45 to 0.80, n=16 trials) and severe oral mucositis (RR 0.48, 95% CI 0.34 to 0.67, n=16 trials), as well as average severity score of oral mucositis (standardised mean difference=−0.94, 95% CI −1.28 to −0.59, n=4 trials) in comparison to a control group; however, the certainty of evidence for all outcomes was rated very low.
Conclusion In patients with cancer, oral cryotherapy appears to greatly lower the severity and occurrence of oral mucositis, but, with very low certainty of evidence.
- cancer
- supportive care
- symptoms and symptom management
Data availability statement
All data relevant to the study are included in the article or uploaded as online supplemental information.
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Data availability statement
All data relevant to the study are included in the article or uploaded as online supplemental information.
Footnotes
Contributors The details of the authors’ responsibility in this project were as follows. RAK and ST collected and analysed the data and wrote the initial version of the work. HM and NT carefully read the text, tables and revised. HM as the guarantor accepts full responsibility for the work. The final version was reviewed and approved by all authors.
Funding The project was funded by the Students’ Scientific Research Center (SSRC) of Tehran University of Medical Sciences (code: IR.TUMS.MEDICINE.REC.1400.1368 and 1400-3-125-55494).
Competing interests None declared.
Provenance and peer review Not commissioned; externally peer reviewed.
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