Cryotherapy as A Prophylaxis of Mucositis in Children with Cancer Undergoing Chemotherapy at Dr. M. Djamil General Hospital
Background: Mucositis is one of the side effects of chemotherapy, which can be a severe problem for children with cancer. Cryotherapy can cause vasoconstriction and decrease blood flow to the oral mucosa, resulting in lower concentrations of chemotherapy agents to prevent mucositis. This study aims at determining the effectiveness of oral cryotherapy as prophylaxis mucositis in children with cancer undergoing chemotherapy.
Methods: This quasi-experiment study with a pretest-posttest control-group design involved 45 respondents (22 in the intervention group and 23 in the control group) selected using consecutive sampling. The data collection instrument was the WHO mucositis scale.
Results: Of the 45 children undergoing chemotherapy, 24 (53.3%) were of school age, 25 (55.6%) were male, 33 (73.3%) had good nutritional status, and 17 (37.8%) had mild neutropenia before undergoing chemotherapy. All respondents (100%) did not experience mucositis, but after chemotherapy, 9 children (40.9%) in the intervention group had mucositis, and 19 children (82.6%) experienced mucositis in the control group. The data were analyzed using the Wilcoxon test to see the difference between the intervention group and the control group and the Chi-Square test with Yates’s correction to see the effect of cryotherapy on the prevention of mucositis. The results showed that there was a difference in the incidence of mucositis between before and after intervention in the intervention group (p = 0.003) and the control group (p = 0.000), and cryotherapy was effective in preventing mucositis (p = 0.01).
Conclusions: Cryotherapy is effective against the prevention of mucositis. Nurses and families need to be able to apply oral cryotherapy and other evidence-based treatment as a method to prevent mucositis
Whitehead TP, Metayer C, Wiemels JL, et al. Childhood leukemia and primary prevention. Curr Probl Pediatr Adolesc Heal Care. 2016;46(10):317–52.
Qutob AF, Gue S, Revesz T, et al. Prevention of oral mucositis in children receiving cancer therapy: A systematic review and evidence-based analysis. Oral Oncol. 2013;49(2):102–7.
Elad S, Raber-durlacher JE, Brennan MT, et al. Basic oral care for hematology – oncology patients and hematopoietic stem cell transplantation recipients : a position paper from the joint task force of the Multinational Association of Supportive Care in Cancer / International Society of Oral Oncology. Support Care Cancer. 2015;223–36.
Belver L, Ferrando A. The genetics and mechanisms of T cell acute lymphoblastic leukaemia. Nat Rev Cancer. 2016;16(8):494–507.
Mack JW, Evan EE, Duncan J, Wolfe J. Palliative Care in Pediatric Oncology. 1 ed. Wolfe J, L. Jones Barbara, Ulrika Kreicbergs, Momcilo Jankovic, editors. Oncology of Infancy and Childhood. Sweden; 2018. P. 1177–1202.
Sakamoto B, Paiva R, Barroso EM, et al. The Children’s International Mucositis Evaluation Scale (ChIMES) is valid and reliable for the assessment of mucositis among Brazilian children with cancer. J Pain Symptom Manage. 2018;56(5):774-80.e2
Johansson JE, Bratel J, Hardling M, et al. Cryotherapy as prophylaxis against oral mucositis after high-dose melphalan and autologous stem cell transplantation for myeloma: a randomised, open-label, phase 3, non-inferiority trial. Bone Marrow Transplant. 2019;54(9):1482–8.
Park S-H, Lee HS. Meta ‐ analysis of oral cryotherapy in preventing oral mucositis associated with cancer therapy. Int J Nurs Pract. 2019;(February 2018):1–13.
Vanhoecke B, De Ryck T, Stringer A, et al. Microbiota and their role in the pathogenesis of oral mucositis. Oral Dis. 2015;21(1):17–30.
Gandhi K, Datta G, Ahuja S, et al. Prevalence of oral complications occurring in a population of pediatric cancer patients receiving chemotherapy. Int J Clin Pediatr Dent. 2017;166–71.
Cheng KKF. Prevention of gastrointestinal side-effects in paediatric oncology: what are the guidelines?. Curr Opin Support Palliat Care. 2017;11(2):120-124.
Parra JJ, Alvarado MC, Monsalve P, et al. Oral health in children with acute lymphoblastic leukaemia: before and after chemotherapy treatment. Eur Arch Paediatr Dent. 2020 Feb;21(1):129-36.
Riley P, Glenny AM, Worthington HV, et al. Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy. Cochrane Database Syst Rev. 2015;(12):CD011552.
Askarifar M, Lakdizaji S, Ramzi M, et al. The effects of oral cryotherapy on chemotherapy-induced oral mucositis in patients undergoing autologous transplantation of blood stem cells: a clinical trial. Iran Red Crescent Med J. 2016;18(4):e24775.
Cheng KKF, Goggins WB, Thompson DR, Lee VWS. Risk factors for oral mucositis in children undergoing chemotherapy: A matched case-control study q. Oral Oncol. 2008;44(11):1019–25.
Mazhari F, Shirazi AS, Shabzendehdar M. Management of oral mucositis in pediatric patients receiving cancer therapy: A systematic review and meta-analysis. Pediatr Blood Cancer. 2018;(July):1–9.
Henke YC, Wujcik D, Holmes GB. Cancer nursing: principles and practice. 7th ed. Sudbury: Jones and Bartlett Publishers; 2011.
Mahood DJ, Dose AM, Loprinzi CL, et al. Inhibition of fluorouracil-induced stomatitis by oral cryotherapy. J Clin Oncol. 1991;9(3):449–52.
Okamoto K, Ninomiya I, Yamaguchi T, et al. Oral cryotherapy for prophylaxis of oral mucositis caused by docetaxel, cisplatin, and fluorouracil chemotherapy for esophageal cancer. Esophagus. 2019;(0123456789).
Baysal E, Sari D. Complementary Therapies in Clinical Practice E ff ects of cryotherapy in preventing oral mucositis in hematopoietic stem cell transplantation patients: Literature review. Complement Ther Clin Pract. 2019;35(March):342–7.
Lu Y, Zhu X, Ma Q, et al. Oral cryotherapy for oral mucositis management in patients receiving allogeneic hematopoietic stem cell transplantation: a prospective randomized study. Support Care Cancer. 2019;5–8.
Marchesi F, Tendas A, Giannarelli D, et al. Cryotherapy reduces oral mucositis and febrile episodes in myeloma patients treated with high-dose melphalan and autologous stem cell transplant: a prospective, randomized study. Bone Marrow Transplant. 2016;15;52:154.
Kamsvag T, Svanberg A, Legert KG, et al. Prevention of oral mucositis with cryotherapy in children undergoing hematopoietic stem cell transplantations — a feasibility study and randomized controlled trial. Suportive Care Cancer. 2020;28(10):4869-79.
Al Jaouni SK, Al Muhayawi MS, Hussein A, et al. Effects of honey on oral mucositis among pediatric cancer patients undergoing chemo/radiotherapy treatment at King Abdulaziz University Hospital in Jeddah, Kingdom of Saudi Arabia. Kuropatnicki AK, editor. Evidence-Based Complement Altern Med. 2017;2017:5861024.
Ritwik P. Dental care for patients with childhood cancers. Ochsner J. 2018;18(4):351–7.
Konuk Sener D, Aydin M, Cangur S, Guven E. The effect of oral care with chlorhexidine, vitamin e and honey on mucositis in pediatric intensive care patients: a randomized controlled trial. J Pediatr Nurs. 2019;1–7.
Wang L, Gu Z, Zhai R, et al. Efficacy of oral cryotherapy on oral mucositis prevention in patients with hematological malignancies undergoing hematopoietic stem cell transplantation : a meta-analysis of randomized controlled trials. PLoS One. 2015;1–12.
Ribeiro ILA, Limeira RRT, Dias de Castro R, Ferreti Bonan PR, Valença AMG. Oral mucositis in pediatric patients in treatment for acute lymphoblastic leukemia. Int J Environ Res Public Health. 2017;14(12):1468.
Yarbro CH, Wujcik D, Gobel BH. Cancer Symptom Management. 4th ed. Burlington, MA: Jones and Bartlett Learning; 2014.
Sato A, Hattori TS, Koizumi Y, et al. 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.
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