UICC World Cancer Congress 2006

Objective:The Mucosisits Study Group (MSG) of The Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO) was formed in 1998 to produce evidence-based guidelines for the management of mucositis. It was during the process of producing the first guidelines that it became clear that the problem was more than oral mucositis and so gastrointestinal mucositis was included in the project. The original guidelines were published in May 2004 as a supplement to the Journal CANCER, and became almost immediately out of date with the publishing of the Palifermin Phase 3 study in stem cell transplantation.

Methods:The guidelines were therefore updated in 2005, and the new guidelines have been published on the web at www.mascc.org. Members of the MSG guidelines working group have written a suite of 13 papers covering all areas of the project, which have been published in the June 2006 edition of the MASCC journal, the Journal of Supportive Care in Cancer. The process involved a literature search conducted with the help of a specialist medical librarian, review and scoring of all manuscripts and finally presentation of scores to the entire panel for crafting of the final evidence based guidelines.

Results:The important issues in management of mucositis are good oral hygiene and basic oral care; patient, caregiver and staff education; appropriate use of oral rinses, ice-chips, palifermin; appropriate use of analgesics, proton-pump inhibitors and anti-diarrhoeal agents; the avoidance of agents for which there is no evidence.

This presentation will focus on the current guidelines and on the problems of dissemination and changing practice.