Prevention and the treatment of oral mucositis: the efficacy of sodium bicarbonate vs other agents: a systematic review

Abstract

Introduction Oral mucositis (OM) is a major side effect of cancer therapy, which is associated with significant symptoms, treatment delays and increased costs for the health system. It is an important component of the quality of life of cancer patients and, until now, there has been no gold standard regarding prevention or treatment of this pathology. Notwithstanding the paucity of treatment guidelines (due to limited evidence from high-quality, rigorous studies), sodium bicarbonate (SB) rinses are one of the most used agents for OM management. Objectives A systematic review (2000–2022) was performed in order to compare and examine different agents versus sodium bicarbonate (SB) in preventing or treating OM. Sources Eleven randomized controlled trials (RCT) were evaluated: four were conducted for the prevention and seven for the management of OM. The risk of bias of RCTs was assessed using the revised Cochrane risk of bias tool for randomized trials. Study selection According to the RoB2 evaluation for randomized trials, four RCTs were judged to be at a high risk of bias, two were rated as ‘problematic’, while five were deemed to be a low risk of bias. Conclusions The results revealed that there was no evidence for supporting SB in OM treatment regarding management and prevention. Clinical significance Results showed in this review takes on a strategic importance in the use of SB for OM management or prevention; indiscriminate use of SB could be counterproductive because it causes a sudden pH increase and it delays proper OM pharmacological treatment.

Bibliometric Analysis of Oral Mucositis Studies in the Nursing Field: A Descriptive Study

“…However, due to a lack of evidence-based recommendations, there is currently no gold standard. 27 Due to the lack of an effective and standard protocol for its prevention and treatment, OM remains a very common side effect. As a result, the number of research studies on this issue is expected to rise further.…”

“…Previous systematic reviews, however, show that the level of evidence for publications on OM in nursing is low. 27,36,37 The MASCC/ISOO panel's report states that basic oral care is still a crucial best practice for cancer patients; however, there is limited evidence from highquality, rigorous studies in this area. 36 In the field of nursing, it is recommended to conduct studies with a high level of qualified evidence on the prevention and treatment of OM.…”

The effectiveness of the Mucosept for the treatment of radiotherapy-induced oral mucositis in head and neck cancer patients: A multicenter randomized controlled trial

“…Последние представлены большим разнообразием: от простых и доступных гидрокарбоната натрия, хлоргексидина, натуральных композиций до лекарственных средств вроде бензидамина либо их комбинациями [ 18 ] . Подобное разнообразие и отсутствие определенного протокола является следствием недостаточной доказанности эффективности либо непереносимости компонентов [ 19,20 ] .…”

Attempts to Understand Oral Mucositis in Head and Neck Cancer Patients Through Omics Studies

“…Therefore, effective management of OM is an important part of cancer treatment and may involve a range of supportive care measures to manage symptoms and prevent complications, such as pain management, nutritional support, oral hygiene measures, anti-infectives, and glucocorticoids. Studies continue to explore interventions [16][17][18][19] and potential treatments [20][21][22] for OM, showing mixed results. In 2020, the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) updated their Clinical Practice Guidelines for the management of mucositis [23].…”