Interventions for preventing oral mucositis for patients with cancer receiving treatment

Interventions for preventing oral mucositis for patients with cancer receiving treatmentTreatment for cancer (including bone marrow transplant) can cause oral mucositis (severe ulcers in the mouth). This painful condition can cause difficulties in eating, drinking and swallowing, and may also be associated with infections which may require the patient to stay longer in hospital. Different strategies are used to try and prevent this condition, and the review of trials found that some of these are effective. Two interventions, cryotherapy (ice chips) and keratinocyte growth factor (palifermin®) showed some benefit in preventing mucositis. Sucralfate is effective in reducing the severity of mucositis, and a further seven interventions, aloe vera, amifostine, intravenous glutamine, granulocyte‐colony stimulating factor (G‐CSF), honey, laser and antibiotic lozenges containing polymixin/tobramycin/amphotericin (PTA) showed weaker evidence of benefit. These were evaluated in patients with different types of cancer, undergoing different types of cancer treatment. Benefits may be restricted to the disease and treatment combinations evaluated

Nutrition support for bone marrow transplant patients

Citation: Murray SM, Pindoria S. Nutrition support for bone marrow transplant patients. Cochrane Database of Systematic Reviews 2009, Issue 1. Art. No.: CD002920. DOI: 10.1002/14651858.CD002920.pub3.Bone marrow transplant patients can experience prolonged poor appetite with vomiting and diarrhoea. Malnutrition is a consequence. To prevent this, patients can receive nutritious fluids orally or via a nasogastric tube, or intravenously as parenteral nutrition. The benefits of either route are unclear. Studies were found that compared these interventions but missing data prevents proper assessment of the benefits. However, the limited data available indicates that when patients undergo bone marrow transplantation and are given intravenous fluids and are encouraged to have an oral diet they are less likely to experience infections and are more likely to go home earlier than if they are given standard parenteral nutrition routinely. In the event that patients nutritional intake is inadequate because of an inadequate oral intake or because they are unable to tolerate tube feeding and are given parenteral nutrition with added glutamine they are likely to have less infections but may not necessarily leave hospital earlier.Peer reviewe