title: Prophylaxis for mucositis induced by ambulatory chemotherapy: systematic review.
abstract: OBJECTIVE
  The aim of this study was to perform a systematic review of clinical trials covering interventions used as prophylaxis for oral mucositis induced by ambulatory antineoplastic chemotherapy.
  
  
  BACKGROUND
  Oral mucositis in patients undergoing chemotherapy is a side effect that can impact the quality of treatment and can interfere with eating and therapeutic adherence.
  
  
  METHODS
  Quantitative systematic review.
  
  
  METHODS
  Relevant databases were searched, from January 2002-July 2013, by using the combination of the keywords mucositis, stomatitis, neoplasms, antineoplastic agents, drug therapy, prevention and control and chemotherapy.
  
  
  METHODS
  Two researchers independently read the titles and abstracts from every cross-reference. The quality of the included studies was analysed by the Jadad Scale and the Cochrane Collaboration Risk of Bias Tool. Data were extracted from the selected studies with a data collection form developed specifically for this purpose.
  
  
  RESULTS
  Of the 23 controlled clinical trials that were identified in this study, five articles evaluated the use of oral cryotherapy to prevent oral mucositis and three studies analysed the prophylactic use of glutamine. Interventions of protocols for oral care, palifermin, allopurinol and chlorhexidine were evaluated by two articles each. Interventions of zinc sulphate, amifostine, chewing gum, sucralfate, recombination human intestinal trefoil factor, kefir and vitamin E were evaluated by one article each.
  
  
  CONCLUSIONS
  There is strong evidence that cryotherapy can prevent oral mucositis arising from ambulatory treatment with 5-flurouracil chemotherapy. Other interventions, although showing positive results in preventing oral mucositis, require further study to confirm their conclusions.
authors.affiliation: University of Brasília (UnB), Brazil.
authors.forename: Natália de Melo
authors.initials: Nde M
authors.lastname: Manzi
authors.affiliation: School of Ribeirão Preto, University of São Paulo (USP), Ribeirão Preto (SP), Brazil.
authors.forename: Renata Cristina de Campos Pereira
authors.initials: RC
authors.lastname: Silveira
authors.affiliation: Nursing Department, School of Healthy Sciences, University of Brasília (UnB), Brazil.
authors.forename: Paula Elaine Diniz
authors.initials: PE
authors.lastname: dos Reis
mesh_terms: D000493:Allopurinol / Q000627:therapeutic use; D000553:Ambulatory Care; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002710:Chlorhexidine / Q000627:therapeutic use; D018849:Controlled Clinical Trials as Topic; D017679:Cryotherapy / Q000451:nursing; D051523:Fibroblast Growth Factor 7 / Q000627:therapeutic use; D005973:Glutamine / Q000627:therapeutic use; D006801:Humans; D009369:Neoplasms / Q000188:drug therapy / Q000451:nursing; D009910:Oral Hygiene / Q000451:nursing; D013280:Stomatitis / Q000139:chemically induced / Q000451:nursing / Q000517:prevention & control*
chemical_list: D000893:Anti-Inflammatory Agents; D000970:Antineoplastic Agents; D005973:Glutamine; D051523:Fibroblast Growth Factor 7; D000493:Allopurinol; D002710:Chlorhexidine
keywords: chemotherapy; clinical trial; mucositis; nursing; prevention and control; systematic review