Kanserli Çocuklarda Oral Mukozit İçin Kullanılan Kanıta Dayalı Yöntemler: Sistematik Derleme

GİRİŞ ve AMAÇ: Bu çalışma, kanserli çocuklarda gelişen oral mukozitin (OM) önlenmesi ve tedavi edilmesi için kanıta dayalı uygulamaların kullanıldığı araştırmaların incelenmesi amacıyla yapılmıştır. YÖNTEM ve GEREÇLER: Taramalar Ankara Üniversitesi Kütüphane ve Dökümantasyon Daire Başkanlığı’nın veri tabanları (Medline, OVID, EBSECOhost, Science Direct, Ulakbim Ulusal Veri Tabanları) üzerinden Ağustos 2017- Şubat 2018 tarihleri arasında yapılmış, araştırmalar hemşirelik ve sağlık bakım hizmetlerinde kanıt temelli uygulama rehberi kanıt listesi kullanılarak değerlendirilmiştir. BULGULAR: Kanserli çocuklarda OM’nin önlenmesi ve tedavisinde kullanılan 14 farklı yöntemi inceleyen 32 çalışmaya rastlanmış ve bu çalışmaların %62,5’inin randomize kontrollü, %21,8’inin ise randomizasyonun olmadığı deney kontrollü yöntemle yapıldığı saptanmıştır. İncelenen makalelerin, çoğunda kullanılan yöntemlerin OM semptomlarının yönetiminde etkili olduğu bulunmuş, bazı yöntemlerin çalışma sonuçlarının birbirini desteklemediği görülmüştür.  TARTIŞMA ve SONUÇ: Kanserli çocuklarda gelişen OM’nin önlenmesi ve tedavi edilmesi için çok sayıda yöntem kullanılmaktadır. Ancak, kanıt oluşturacak çalışma sayısının az olması ve kanıtların tutarsız olması OM için standart bir ağız bakım protokolü oluşturulmasını engellemektedir.                                                                                     

Evidence Based Methods for Oral Mucositis in Children with Cancer: Systematic Review

INTRODUCTION: This study aims to investigate the studies using evidence-based practice for the prevention and treatment of oral mucositis (OM) in children with cancer.METHODS: Literature searches were conducted between August 2017 and February 2018 through the databases of the University of Ankara Library and Documentation Department (Medline, OVID, EBSCOhost, Science Direct, Ulakbim National Databases). Studies were evaluated using the evidence-based practice in nursing and healthcare: a guide to best practice.RESULTS: There were 14 different methods for prevention and treatment of OM in children with cancer. 62.5% of them were randomized controlled studies and 21.8%, not randomized experimental studies. Plans have been found to be useful in symptom management in most of the examined articles, but some ways have been found inconsistent. DISCUSSION and CONCLUSION: Numerous methods are used for the prevention and treatment of OM in children with cancer. However, the limited number of the studies and inconsistency of the results prevents the establishment of a standard oral care protocol for OM.

___

  • 1. Fabricant DS, Farnsworth NR. The value of plants used in traditional medicine for drug discovery. Environ Health Perspect 2001;109:69-75.
  • 2. Resmi Gazete Geleneksel ve Tamamlayıcı Tıp Uygulamaları Yönetmeliği, http://www.resmigazete.gov.tr /eskiler/2014/ 10/20141027.pdf/ Avaliable Date: 1 October 2017
  • 3. Genç RE, Senol S, Turgay AS, Kantar M. Complementary and alternative medicine used by pediatric patients with cancer in western Turkey. Oncol Nurs Forum 2009; 36:159-64.
  • 4. Gözüm S, Arikan D, Büyükavci M. Complementary and alternative medicine use in pediatric oncology patients in eastern Turkey. Cancer Nurs 2007;30(1):38-44.
  • 5. Karalı Y, Demirkaya M, Sevinir B. Use of complementary and alternative medicine in children with cancer: effect on survival. J Pediatr Hematol Oncol 2012;29(4):335-44.
  • 6. Italia S, Wolfenstetter SB, Teuner CM. Patterns of complementary and alternative medicine (CAM) use in children: a systematic review. Eur J Pediatr 2014;173(11):1413-28.
  • 7. National Center for Complemantary and Integrative Health Complementary Alternative, or Integrative Health: What’s In a Name?, https://nccih.nih.gov/health/integrative-health/ Avaliable Date: 12 September, 2017
  • 8. Diorio C, Lam CG, Ladas EJ, Njuguna F, Afungchwi GM, Taromina K, et al. Global use of traditional and complementary medicine in childhood cancer: a systematic review. J Glob Oncol 2017;3:791-800.
  • 9. Öztürk C, Karataş H, Längler A, Schütze T, Bailey R, Zuzak TJ. Complementary and alternative medicine in pediatrics in Turkey. World J Pediatr 2014;10(4):299-305.
  • 10. Koç Z, Tural E, Gudek E. Determining complementary and alternative medicine methods used by paediatric haematology–oncology patients. J Nurs Healthc Chronic Illn 2011;3(4):361-71.
  • 11. Magi T, Kuehni CE, Torchetti L, Wengenroth L, Lüer S, Frei-Erb M. Use of complementary and alternative medicine in children with cancer: a study at a Swiss University Hospital. PLoS One 2015;10(12):1-13.
  • 12. Çavuşoğlu H. Oral mukozit yönetiminde kanıta dayalı hemşirelik. Turkiye Klinikleri J Med Sci 2007;27(3):398-406.
  • 13. Hashemi A, Bahrololoumi Z, Khaksar Y, Saffarzadeh N, Neamatzade H, Foroughi E. Mouth-rinses for the prevention of chemotherapy induced oral mucositis in children: a systematic review. Iran J Ped Hematol Oncol 2015;15(2):106-12.
  • 14. Oncology Nursıng Socıety Mucositis Topic, https://www.ons.org/practice-resources/pep/mucositis/ Avaliable Date: 1 October, 2017
  • 15. Fineout-Overholt E, Melnyk BM, Stillwell SB, Williamson KM. Evidence-based practice step by step: critical appraisal of the evidence: part I. Am J Nurs 2010;110(7):47-52.
  • 16. Amadori F, Bardellini E, Conti G, Pedrini N, Schumacher RF, Majorana A. Low-level laser therapy for treatment of chemotherapy-induced oral mucositis in childhood: a randomized double-blind controlled study. Lasers Med Sci 2016;31(6):1231-6.
  • 17. Castro JFL, Abreu EGF, Correia AVL, Mota Vasconcelos Brasil C, Cruz Perez DE,Paula Ramos Pedrosa F. Low-level laser in prevention and treatment of oral mucositis in pediatric patients with acute lymphoblastic leukemia. Photomed Laser Surg 2013;31(12):613-8.
  • 18. Cauwels RG, Martens LC. Low level laser therapy in oral mucositis: a pilot study. Eur Arch Paediatr Dent 2011;12(2):118-23.
  • 19. Eduardo FP, Bezinelli LM, Carvalho DL, Lopes RM, Fernandes JF, Brumatti M, et al. Oral mucositis in pediatric patients undergoing hematopoietic stem cell transplantation: clinical outcomes in a context of specialized oral care using low-level laser therapy. Pediatr Transplant 2015;19(3):316-25.
  • 20. Kuhn A, Porto FA, Mıraglıa P, Brunetto AL. Low-level infrared laser therapy in chemotherapy-induced oral mucositis: a randomized placebo-controlled trial in children. J Pediatr Hematol Oncol 2009;31(1):33-7.
  • 21. Silva VCR, Motta Silveira FM, Lima GS, Cruz MMD, Júnior ADFC, Godoy GP. Photodynamic therapy for treatment of oral mucositis: pilot study with pediatric patients undergoing chemotherapy. Photodiagnosis Photodyn Ther 2018;21:115-20.
  • 22. Cheng KK, Chang AM. Palliation of oral mucositis symptoms in pediatric patients treated with cancer chemotherapy. Cancer Nurs 2003;26:476-84.
  • 23. Cheng KK, Chang AM, Yuen MP. Prevention of oral mucositis in pediatric patients treated with chemotherapy: a randomised crossover trial comparing two protocols of oral care. Eur J Cancer 2004;40:1208-16.
  • 24. Costa EM, Fernandes MZ, Quinder LB, de Souza LB, Pinto LP. Evaluation of an oral preventive protocol in children with acute lymphoblastic leukemia. Pesqui Odontol Bras 2003;17:147-50.
  • 25. Pinto LP, De Souza LB, Gordón-Núñez MA, Soares RC, de Brito Costa EMM, de Aquino ARL, et al. Prevention of oral lesions in children with acute lymphoblastic leukemia. Int J Pediatr Otorhinolaryngol 2006;70(11):1847-51.
  • 26. Vadhan‐Raj S, Goldberg JD, Perales MA, Berger DP, Brink MR. Clinical applications of palifermin: amelioration of oral mucositis and other potential indications. J Cell Mol Med 2013;17(11):1371-84.
  • 27. Gholizadeh N, Mehdipoor M, Sajadi H, Moosavi MS. Palifermin and hlorhexidine mouthwashes in prevention of chemotherapy-ınduced mucositis in children with acute lymphocytic leukemia: a randomized controlled trial. J Dent 2016;17(4):343-7.
  • 28. Lauritano D, Petruzzı M, Dı Stasıo D, Lucchese A. Clinical effectiveness of palifermin in prevention and treatment of oral mucositis in children with acute lymphoblastic leukaemia: a case–control study. Int J Dent Oral Sci 2014;6(1):27-30.
  • 29. Morris J, Rudebeck M, Neudorf S, Moore T, Graham M, Aquino V, et al. Safety, pharmacokinetics, and efficacy of palifermin in children and adolescents with acute leukemias undergoing myeloablative therapy and allogeneic hematopoietic stem cell transplantation: a pediatric blood and marrow transplant consortium trial. Biol Blood Marrow Transplant 2016;22(7):1247-56.
  • 30. Vitale KM, Violago L, Cofnas P, Bishop J, Jin Z, Bhatia M, et al. Impact of palifermin on incidence of oral mucositis and healthcare utilization in children undergoing autologous hematopoietic stem cell transplantation for malignant diseases. Pediatr Transplant 2014;18(2):211-6.
  • 31. Abdulrhman M, Samır Elbarbary N, Ahmed Amın D, Saeıd Ebrahım R. Honey and a mixture of honey, beeswax, and olive oil–propolis extract in treatment of chemotherapy-ınduced oral mucositis: a randomized controlled pilot study. J Pediatr Hematol Oncol 2012;29(3):285-92.
  • 32. Al Jaouni SK, Al Muhayawi MS, Hussein A, Elfiki I, Al-Raddadi R, Al Muhayawi SM, et al. Effects of honey on oral mucositis among pediatric cancer patients undergoing chemo/radiotherapy treatment at King Abdulaziz University Hospital in Jeddah. Evid Based Complement Alternat Med 2017; doi: 10.1155/2017/5861024.
  • 33. Bulut HK, Tüfekçi FG. Honey prevents oral mocositis in children undergoing chemotherapy: A quasi-experimental study with a control group. Complement Ther Med 2016;29:132-40.
  • 34. El–Housseiny A, Saleh S, El–Masry A, Allam A. The effectiveness of vitamin" E" in the treatment of oral mucositis in children receiving chemotherapy. J Clin Pediatr Dent 2007;31(3):167-70.
  • 35. Khurana H, Pandey Rk, Saksena Ak, Kumar A. An evaluation of vitamin e and pycnogenol in children suffering from oral mucositis during cancer chemotherapy. Oral Dis 2013;19(5):456-64.
  • 36. Sung L, Tomlınson GA, Greenberg ML, Koren G, Judd P, Ota S, et al. Serial controlled N-of-1 trials of topical vitamin E as prophylaxis for chemotherapy-induced oral mucositis in paediatric patients. Eur J Cancer 2007;43(8):1269-75.
  • 37. Chang YH, Yu MS, Wu KH, Hsu MC, Chiou YH, Wu HP, et al. Effectiveness of parenteral glutamine on methotrexate-induced oral mucositis in children with acute lymphoblastic leukemia. Nutr Cancer 2017;69(5):746-51.
  • 38. Ward E, Smıth M, Henderson M, Reıd U, Lewıs I, Kınsey S, et al. The effect of high-dose enteral glutamine on the incidence and severity of mucositis in paediatric oncology patients. Eur J Clin Nutr 2009;63(1):134-40.
  • 39. Gori E, Arpinati M, Bonifazi F, Errico A, Mega A, Alberani F, et al.Cryotherapy in the prevention of oral mucositis in patients receiving low-dose methotrexate following myeloablative allogeneic stem cell transplantation: a prospective randomized study of the gruppo Italiano trapianto di midollo osseo nurses group. Bone Marrow Transplant 2007;39(6):347.
  • 40. Sato A, Saisho-Hattori T, Koizumi Y, Minegishi M, Iinuma K, Imaizumi M. Prophylaxis of mucosal toxicity by oral propantheline and cryotherapy in children with malignancies undergoing myeloablative chemo-radiotherapy. Tohoku J Exp Med 2006;210: 315–20.
  • 41. Eghbali A, Taherkhanchi B, Bagheri B, Sedeh BS. Effect of chewing gum on oral mucositis in children undergoing chemotherapy: a randomized controlled study. Iran J Ped Hematol Oncol 2015;6(1):9-14.
  • 42. Gandemer V, Le Deley MC, Dollfus C, Auvrıgnon A, Bonnaure-Mallet M, Duval M, et al. Multicenter randomized trial of chewing gum for preventing oral mucositis in children receiving chemotherapy. J Pediatr Hematol Oncol 2007;29(2):86–94.
  • 43. Oberbaum M, Yaniv I, Ben-Gal Y, Stein J, Ben-Zvi N, Freedman LS et al. A randomized, controlled clinical trial of the homeopathic medication TRAUMEEL S in the treatment of chemotherapy-induced mucositis in children undergoing stem cell transplantation. Cancer 2001;92:684–90.
  • 44. Sencer SF, Zhou T, Freedman LS, Ives JA, Chen Z, Wall D, et al. Traumeel S in preventing and treating mucositis in young patients undergoing sct: a report of the children's oncology group. Bone Marrow Transplant 2012;47(11):1409-14.
  • 45. Mujica V, Orrego R, Pérez J, Romero P, Ovalle P, Zúñiga-Hernández J, et al. The role of propolis in oxidative stress and lipid metabolism: a randomized controlled trial. Evid Based Complement Alternat Med 2017;11 pages, Article ID 4272940.
  • 46. Tomaževıč T, Jazbec J. A double blind randomised placebo controlled study of propolis (bee glue) effectiveness in the treatment of severe oral mucositis in chemotherapy treated children. Complement Ther Med 2013;21(4):306-12.
  • 47. Eren M, Akyüz C, Yalçın B, Varan A, Kutluk T, Büyükpamukçu M. Çocukluk çağı kanserlerinde kemoterapi ile ilişkili mukozit tedavisinde granülosit makrofaj koloni stimülan faktörün ağız bakımındaki yeri. UHOD 2007;2(17):70-8.
  • 48. Chermetz M, Gobbo M, Ronfani L, Ottaviani G, Zanazzo GA, Verzegnassi F, et al. Class IV laser therapy as treatment for chemotherapy‐induced oral mucositis in onco‐haematological paediatric patients: a prospective study. Int J Paediatr Dent 2014;24(6):441-9.
  • 49. Quınn B. Efficacy of a supersaturated calcium phosphate oral rinse for the prevention and treatment of oral mucositis in patients receiving high-dose cancer therapy: a review of current data. Eur J Cancer 2013;22:564-79.
  • 50. Raphael MF, Den Boer AM, Kollen W, Mekelenkamp H, Abbınk H, Kaspers L, et al. Caphosol, a therapeutic option in case of cancer therapy-induced oral mucositis in children? Support Care in Cancer 2014;22(1):3-6.