Guidelines for Complications of Cancer Treatment Vol VIII Part B

acceptable oral protocol include regular brushing withsoft bristle tooth brush, flossing, bland rinses andmoisturizers along with educating patient, family andhealth care team the importance of oral care.( level ofevidence, III; grade of recommendation, B). Dentalconsultation and treatment should be done prior to thestart of treatment.2. Cryotherapy with bolus doses of 5-FU.- The panelrecommends that patients receiving bolus 5-FUchemotherapy undergo 30 minutes of oral cryotherapyto prevent oral mucositis (level of evidence, II; grade ofrecommendation, A). It was hypothesized that placingice chips in the mouth, starting 5 minutes before 5-FUbolus injection and continuing for a total of 30 minutes,would cause cooling of the oral cavity, which would leadto vasoconstriction. It was suggested that thevasoconstriction would allow less 5-FU to reach the oralmucosa, thereby attenuating 5-FUinduced mucositis. Itshould be noted that oral cryotherapy is not expected tobe useful in preventing oral mucositis in patientsreceiving 5-FU by continuous infusion or in patientsundergoing administration of such agents asmethotrexate, doxorubicin, or other agents with a longserum half-lives.3. The panel does not recommend the use of systemicglutamine, acyclovir in the prevention of oral mucositis.(level of evidence, II; grade of recommendation, B)For prevention of mucositis caused by high dosechemotherapy with or without total body irradiation plushaematopoietic stem cell transplantation the panelrecommends1. Use of keratinocyte growth factor-1 (KGF1) (palifermin)at a dose of 60 mg/kg per day for 3 days prior to458