A systematic review including 55 studies of acceptable methodological quality, and a further 46 papers of lower quality was abstracted in DARE. There was no evidence that any oral care protocol is effective in preventing or reducing mucositis. The use of allopurinol mouthwash is supported to prevent mucositis from 5-fluorouracil, although there was heterogeneity between studies (SMD = -0.40, 95% CI -0.76 to -0.04). Cryotherapy is a cheap and effective method of minimizing mucositis, but patients may develop aversion to the ice. There was no evidence supporting chlorhexidine, antifungals, sucralfate, or vitamins. Patient-controlled morphine administration is safe and effective for managing mucositis pain in cancer patients undergoing bone marrow transplantation.
Comment: The quality of evidence is downgraded by study quality (limited data of original studies) and by imprecise results (limited study size).