Table 5 Mucositis analysis for each study

Anirudhan 2008 [29]

70

WHO criteria

antibiotics/steroids usage in previous two weeks

Initial treatment included topical analgesics, oral antifungals or acyclovir. Amphotericin B was started if persisted beyond 5 days of fluconazole or antibiotics.

T1: chemotherapy induction

T2: chemotherapy intensification

T3: 18 months of maintenance phase

T1: 41 episodes

T2: 39 episodes

T3: 20 episodes

47,6%

Bardellini 2017 [30]

1

WHO criteria

Twice weekly Cotrimoxazole prophylaxis

Antibiotic combination therapy with Amikacin and Ceftazidime for 8 days

T1: Before initiation of cancer therapy

T2: During II cycle of cancer therapy

T2b Phase II (consolidation);

T2c Phase III (delayed intensification);

T2d Phase IV (maintenance)

T3: Post-treatment (disease-free)

T4: Relapse cases

Tx: Un-sp

Not specified

Costa 2020 [31]

26

Modified OAG

Not specified

Not specified

T0: before cancer therapy

T1: after 2 weeks of treatment

T2: after 5 weeks of treatment

T3: after 10 weeks of treatment

T1: n = 4 cases

T2: n = 7 cases

T3: n = 5 cases

20,5%

De Oliveira 2019 [32]

9

WHO criteria

Not specified

Not specified

D0/1, D8, D15, D35 of pre-phase and induction phase; D1, D15, D29, D50 of consolidation phase

0 cases

Gandhi 2017 [33]

62

WHO criteria

Not specified

Not specified

First phases of chemotherapy

58.1%

58,1%

Juarez-Lopez 2018 [34]

103

Clinical evaluation

Not specified

Not specified

Not specified

98% at starting of chemotherapy. Induction phase stricly related with mucositis incidence (OR = 7,6, IC 95% p = 0,0001)

98%

Levy-Polack 1998 [35]

96

NCI Grading scale

Mouthwash with sodium bicarbonate and water after every meal; a mouthwash with a nonalcoholic solution of chlorhexidine (0.12%) twice a day (midmorning and evening); cleaning of mucosa with gauze soaked in iodopovidone, four times a day prior to the use of nystatin. The children “swishing and swallowing” with nystatin 500,000 units, oral suspension four times a day and a daily rinse with sodium fluoride 0.05% (nonalcoholic solution).

Not specified

T1: diagnosis;

T2: chemotherapy starting

T3: evaluation at D7 and D14 of treatment

The overall difference between the two groups was not statistically significant but a decrease after the protocol application was found in the study group

Group I: 30%

Group II: 21.9%

26,05%

Mendonca 2012 [36]

71

NCI Grading scale

Not specified

In some cases, use of Acyclovir

T1: beginning of treatment

T2: D14

T3: D56

Day 14 (71 pz) n(%): GRADE 0: 6 (8.3) GRADE I: 47 (65.3) GRADE II: 10 (13.9) GRADEIII: 8 (11) Day 56 (67 pz) n(%) GRADE 0: 29 (43.3) GRADE I: 25 (37.4) GRADE II: 7 (10.5) GRADE III: 6 (8.8)

24,3%

Olczak-Kowalczyk 2012 [37]

45

Common Terminology Criteria Adverse Events (CTCAE),

Not specified

Not specified

T1: patient enrollement

GROUP B: 14 patients had mucositis (its severity was assessed according to the CTCAE scale: I = 6, II = 3, III = 5)

31,1%

Pinto 2018 [38]

71

Clinical evaluation

Chlorhexidine 0.12%

Lasertherapy and chlorhexidine

Not specified

44/71—72%

72%

Sixou 1998 [39]

32

Clinical evaluation

Mouth washing three times a day with an alchool-free 2% chlorhexidine solution

-

D0 (before chemotherapy), D7, D14, D21 of treatment

8/16—50%

50%

Soares 2011 [40]

17

Clinical evaluation

Mouth washes wiht 0.12% chlorhexidine gluconate solution twice a day, 30 min after breakfast and after the last meal for 10 days

-

Daily during the period of hospitalization of the patient for chemotherapy

5/17—29,4%

29,4%

Ye 2013

75

WHO criteria

Single 2.5 mg/mL benzydamine-based mouth rinse for the period of chemotherapy

Not specified

25/37

67,6%

Mean prevalence of mucositis:

57,6%