Efficacy of Oral Cryotherapy in the Prevention of Oral Mucositis Associated with Cancer Chemotherapy: Systematic Review with Meta-Analysis and Trial Sequential Analysis
Background: This review aimed to evaluate the efficacy of oral cryotherapy in the prevention of chemotherapy-induced oral mucositis using meta-analysis and trial sequential analysis, as well as to assess the quality of the results by the Grading of Recommendations, Assessment, Development and Evalua...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-07-01
|
| Series: | Current Oncology |
| Subjects: | |
| Online Access: | https://www.mdpi.com/1718-7729/28/4/250 |
| _version_ | 1797520766687772672 |
|---|---|
| author | Ali Hatem Manfi Al-Rudayni Divya Gopinath Mari Kannan Maharajan Sajesh Kalkandi Veettil Rohit Kunnath Menon |
| author_facet | Ali Hatem Manfi Al-Rudayni Divya Gopinath Mari Kannan Maharajan Sajesh Kalkandi Veettil Rohit Kunnath Menon |
| author_sort | Ali Hatem Manfi Al-Rudayni |
| collection | DOAJ |
| description | Background: This review aimed to evaluate the efficacy of oral cryotherapy in the prevention of chemotherapy-induced oral mucositis using meta-analysis and trial sequential analysis, as well as to assess the quality of the results by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Methods: A comprehensive search of three databases including Medline, Embase and Central was performed to identify randomized controlled trials that used oral cryotherapy for the prevention of chemotherapy-induced oral mucositis. The primary outcome was the incidence of oral mucositis for trials employing oral cryotherapy as the intervention for the prevention of oral mucositis. The meta-analysis was performed using the random-effects model and random errors of the meta-analyses were detected by trial sequential analysis. Results: A total of 14 RCTs with 1577 participants were included in the present meta-analysis. Patients treated with oral cryotherapy were associated with a significantly lower risk of developing oral mucositis of any grade (risk ratio (RR), 0.67 (95% CI: 0.56–0.81, <i>p</i> < 0.05)). Findings from the subgroup analyses showed that oral cryotherapy significantly reduced the risk of oral mucositis in patients undergoing bone marrow transplantation (RR 0.69, CI: 0.54–0.89, <i>p</i> < 0.05) as well as chemotherapy (RR 0.66, CI: 0.58–0.75, <i>p</i> < 0.05). Findings from the trial sequential analysis suggested that the evidence on oral cryotherapy as a preventive intervention for oral mucositis in patients with solid malignancies receiving conventional chemotherapy was conclusive. Conclusion: Oral cryotherapy is effective in preventing oral mucositis in patients undergoing chemotherapy for the management of solid malignancies. The use of oral cryotherapy in preventing oral mucositis in bone marrow transplantation settings showed promising efficacy, but the evidence is not conclusive and requires more high-quality randomized controlled trials. |
| first_indexed | 2024-03-10T08:01:16Z |
| format | Article |
| id | doaj.art-a9e75706fa5540a4a0b46dae9409b02b |
| institution | Directory Open Access Journal |
| issn | 1198-0052 1718-7729 |
| language | English |
| last_indexed | 2024-03-10T08:01:16Z |
| publishDate | 2021-07-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Current Oncology |
| spelling | doaj.art-a9e75706fa5540a4a0b46dae9409b02b2023-11-22T11:29:08ZengMDPI AGCurrent Oncology1198-00521718-77292021-07-012842852286710.3390/curroncol28040250Efficacy of Oral Cryotherapy in the Prevention of Oral Mucositis Associated with Cancer Chemotherapy: Systematic Review with Meta-Analysis and Trial Sequential AnalysisAli Hatem Manfi Al-Rudayni0Divya Gopinath1Mari Kannan Maharajan2Sajesh Kalkandi Veettil3Rohit Kunnath Menon4School of Postgraduate Studies, International Medical University, Kuala Lumpur 57000, MalaysiaDepartment of Oral Diagnostics & Surgical Sciences, School of Dentistry, International Medical University, Kuala Lumpur 57000, MalaysiaDepartment of Pharmacy Practice, School of Pharmacy, International Medical University, Kuala Lumpur 57000, MalaysiaDepartment of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT 84112, USADepartment of Restorative Dentistry, School of Dentistry, International Medical University, Kuala Lumpur 57000, MalaysiaBackground: This review aimed to evaluate the efficacy of oral cryotherapy in the prevention of chemotherapy-induced oral mucositis using meta-analysis and trial sequential analysis, as well as to assess the quality of the results by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Methods: A comprehensive search of three databases including Medline, Embase and Central was performed to identify randomized controlled trials that used oral cryotherapy for the prevention of chemotherapy-induced oral mucositis. The primary outcome was the incidence of oral mucositis for trials employing oral cryotherapy as the intervention for the prevention of oral mucositis. The meta-analysis was performed using the random-effects model and random errors of the meta-analyses were detected by trial sequential analysis. Results: A total of 14 RCTs with 1577 participants were included in the present meta-analysis. Patients treated with oral cryotherapy were associated with a significantly lower risk of developing oral mucositis of any grade (risk ratio (RR), 0.67 (95% CI: 0.56–0.81, <i>p</i> < 0.05)). Findings from the subgroup analyses showed that oral cryotherapy significantly reduced the risk of oral mucositis in patients undergoing bone marrow transplantation (RR 0.69, CI: 0.54–0.89, <i>p</i> < 0.05) as well as chemotherapy (RR 0.66, CI: 0.58–0.75, <i>p</i> < 0.05). Findings from the trial sequential analysis suggested that the evidence on oral cryotherapy as a preventive intervention for oral mucositis in patients with solid malignancies receiving conventional chemotherapy was conclusive. Conclusion: Oral cryotherapy is effective in preventing oral mucositis in patients undergoing chemotherapy for the management of solid malignancies. The use of oral cryotherapy in preventing oral mucositis in bone marrow transplantation settings showed promising efficacy, but the evidence is not conclusive and requires more high-quality randomized controlled trials.https://www.mdpi.com/1718-7729/28/4/250oral cryotherapyoral mucositischemotherapyadverse effectsmeta-analysis |
| spellingShingle | Ali Hatem Manfi Al-Rudayni Divya Gopinath Mari Kannan Maharajan Sajesh Kalkandi Veettil Rohit Kunnath Menon Efficacy of Oral Cryotherapy in the Prevention of Oral Mucositis Associated with Cancer Chemotherapy: Systematic Review with Meta-Analysis and Trial Sequential Analysis Current Oncology oral cryotherapy oral mucositis chemotherapy adverse effects meta-analysis |
| title | Efficacy of Oral Cryotherapy in the Prevention of Oral Mucositis Associated with Cancer Chemotherapy: Systematic Review with Meta-Analysis and Trial Sequential Analysis |
| title_full | Efficacy of Oral Cryotherapy in the Prevention of Oral Mucositis Associated with Cancer Chemotherapy: Systematic Review with Meta-Analysis and Trial Sequential Analysis |
| title_fullStr | Efficacy of Oral Cryotherapy in the Prevention of Oral Mucositis Associated with Cancer Chemotherapy: Systematic Review with Meta-Analysis and Trial Sequential Analysis |
| title_full_unstemmed | Efficacy of Oral Cryotherapy in the Prevention of Oral Mucositis Associated with Cancer Chemotherapy: Systematic Review with Meta-Analysis and Trial Sequential Analysis |
| title_short | Efficacy of Oral Cryotherapy in the Prevention of Oral Mucositis Associated with Cancer Chemotherapy: Systematic Review with Meta-Analysis and Trial Sequential Analysis |
| title_sort | efficacy of oral cryotherapy in the prevention of oral mucositis associated with cancer chemotherapy systematic review with meta analysis and trial sequential analysis |
| topic | oral cryotherapy oral mucositis chemotherapy adverse effects meta-analysis |
| url | https://www.mdpi.com/1718-7729/28/4/250 |
| work_keys_str_mv | AT alihatemmanfialrudayni efficacyoforalcryotherapyinthepreventionoforalmucositisassociatedwithcancerchemotherapysystematicreviewwithmetaanalysisandtrialsequentialanalysis AT divyagopinath efficacyoforalcryotherapyinthepreventionoforalmucositisassociatedwithcancerchemotherapysystematicreviewwithmetaanalysisandtrialsequentialanalysis AT marikannanmaharajan efficacyoforalcryotherapyinthepreventionoforalmucositisassociatedwithcancerchemotherapysystematicreviewwithmetaanalysisandtrialsequentialanalysis AT sajeshkalkandiveettil efficacyoforalcryotherapyinthepreventionoforalmucositisassociatedwithcancerchemotherapysystematicreviewwithmetaanalysisandtrialsequentialanalysis AT rohitkunnathmenon efficacyoforalcryotherapyinthepreventionoforalmucositisassociatedwithcancerchemotherapysystematicreviewwithmetaanalysisandtrialsequentialanalysis |