Melphalan Tedavisi Alan Otolog Kök Hücre Transplantasyonu Olan Hastalarda Mukozitten Korunmada Oral Buz Uygulamasının Etkisi: Randomize Kontrollü Bir Çalışma

Year 2023, Volume: 12 Issue: 3, 182 - 193, 29.12.2023

Solmaz Zeybekçi , Özlem Uğur , Gülay Şahin , Gülşah Bedez , Derya Ünsel , Tuba Ülgen , Boran Yavuz , Ahmet Şeyhanlı , İnci Alacacıoğlu , Hayri Özsan

https://doi.org/10.47493/abantmedj.1283992

Abstract

Amaç: Melfalan tedavisi alan otolog kök hücre transplantasyonu yapılan hastalarda mukozitten korunmada oral kriyoterapinin etkisini incelemektir.
Gereç ve Yöntemler: Çalışma prospektif, randomize kontrollü bir çalışmadır. Çalışmaya seçilme kriterlerine uyan 50 hasta alınmıştır. Girişim grubundaki hastalara buz uygulaması kemoterapi tedavisine başlamadan 5 dakika önce başlanmış, tedavi süresince ve ilaç bittikten sonraki 15 dk. boyunca devam etmiştir. Kontrol grubundaki hastalar standart bakım almışlardır.
Bulgular: Kriyoterapi uygulanan kolda oral mukozit sıklığı tüm zaman dilimlerinde daha düşük bulunmuştur. Her iki grupta Evre 2’deki mukozit varlığının bütün zaman dilimlerinde benzer olduğu, 7. günden itibaren de Evre 3 mukozit sıklığının kontrol grubunda göreceli olarak daha yüksek olduğu saptanmıştır (p<0.001). Girişim grubunda şiddetli ağrı varlığı kontrol grubuna göre daha düşük bulunmuştur. “Kötü” veya “Hiç tad almama” durumunun kontrol grubunda yüksek olduğu belirlenmiştir.
Sonuç: Bu çalışma ile melfalan tedavisi alan ve otolog kök hücre nakli yapılan hastalarda, kriyoterapi uygulamasının, oral mukozit derecesini ve ağızda ağrı oluşumunu azalttığı, tat alma durumunu iyileştirdiği gösterilmiştir.

Keywords

Kök hücre transplantasyonu, Oral mukozit, Buz uygulaması

Project Number

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The Effect of Oral Ice Application on Protection from Mucositis in Patients with Autologic Stem Cell Transplantation Requesting Melphelan Treatment: A Randomized Controlled Study

Abstract

Objective: To examine the effect of oral cryotherapy in the prevention of mucositis in patients with autologous stem cell transplantation receiving Melphelan therapy.
Materials and Methods: Ice application to patients in the intervention group started 5 minutes before the chemotherapy treatment and continued throughout the treatment and 15 minutes after it ended. Patients in the control group received standard care.
Results: The frequency of oral mucositis was found to be lower in the cryotherapy arm in all time periods. It was determined that the presence of Stage 2 mucositis was similar in all time periods in both groups, and the frequency of Stage 3 mucositis was relatively higher in the control group starting from the 7th day (p<0.001). The presence of severe pain was found to be lower in the intervention group than in the control group. It was determined that the "bad" or "no taste" status was higher in the control group.
Conclusion: This study showed that cryotherapy reduces the degree of oral mucositis and pain in the mouth and improves taste in patients receiving melphalan treatment and autologous stem cell transplantation.

Keywords

Stem cell tranplantation, oral mucositis, ıce application

Project Number

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References

• Vokurka S, Chvojkova I, Svoboda T, Brandejsova R, Jungova A., Bystricka E., et al.. The impact of oral cryotherapy and oral and gastrointestinal mucositis after autologous stem cell transplantation. Eur J Cancer Care. 2014; 18(2): 228- 229. doi: 10.1016/j.ejon.2013.11.001
• Karagözoğlu S, Filiz Ulusoy M. Chemotherapy: the effect of oral cryotherapy on the development of mucositis. J Clin Nurs. 2005; 14(6):754-65. doi: 10.1111/j.1365-2702.2005.01128.x
• Kazemıan A, Kamian S, Aghili M, Hashemi FA, Haddad P. Benzydamine for prophylaxis of radiation-induced oral mucositis in head and neck cancers: a double-blind placebo-controlled randomized clinical trial. Eur J Cancer Care. 2009;18: 174–178. doi: 10.1111/j.1365-2354.2008.00943.x.
• Kusiak A, Jereczek-Fossa BA, Cichońska D, Alterio D. Oncological- therapy related oral mucositis as an ınterdisciplinary problem- liture review. Int J Environ Res Public Health. 2020;17(7):2464. doi: 10.3390/ijerph17072464..
• Riley P, Glenny AM, Worthington HV, Littlewood A, Clarkson JE, McCabe MG. Interventions for preventing oral mucositis in patients with cancer receving treatment:oral cryotherapy. Cochrane Database Syst Rev. 2015;(12):CD011552. doi: 10.1002/14651858.CD011552.
• Lalla RV, Bowen J, Barasch, A, Elting L, Epstein J, Keefe DM. et al. MASCC/ ISOO clinical practice guidelines for the management of mucositis secondery to cancer therapy. Cancer. 2014; 120(10):1453- 1461. doi: 10.1002/cncr.28592
• Oken MM, Creech RH, Tormey DC, Horton J, Davis TE, McFadden ET. et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group. Am. J. Clin. Oncol. 1982; 5 (6): 649-55.
• Palmer MK. WHO Handbook for reporting results of cancer treatment. Br J Cancer.1982; 45(3):484-485.
• Al-Rudayni AHM, Gopinath D, Maharajan MK, Veettil SK, Menon RK. Efficacy of oral cryotherapy in the prevention of oral mucositis associated with cancer chemotherapy:Systematic review with meta- analysis and trial sequential analysis. Curr Oncol. 2021;28(4):2852-2867. doi: 10.3390/curroncol28040250.
• Marchesi F , Tendas A , Giannarelli D , Viggiani C , Gumenyuk S , Renzi 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.. 2017; 52(1):154-156. doi: 10.1038/bmt.2016.207
• Askarifar M., Lakdizaji S, Ramzi M, Rahmani A, Jabbarzadeh F. The effect of oral cryotherapy on chemotherapyy- induced oral mucositis in patients undergoing autologous transplantation of blood stem cells: a clinical trial. Iran Red Crescent Med.. 2016; 18(4):247-275. doi: 10.5812/ircmj.24775
• Wang L, Gu Z, Zhai R, Zhao S, Luo L, Li D. 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; 10(5): 1- 12. doi: 10.1371/journal.pone.0128763
• Wodzinsk A. Potential benefits of oral cryotherapy for chemotherapy-ınduced mucositis. Clin J Oncology Nurs. 2016; 20(5): 462- 465.
• Eilers J, Harris D, Henry K., Johnson L. Evidence- based interventions for cancer treatment related mucositis: putting evidence into practice. Clin J Oncology Nurs. 2014; 18, 80- 96. doi: 10.1188/14.CJON.S3.80-96
• Chen J, Seabrook J, Fulford A, Rajakumar I. Icing oral mucositis: oral cryotherapy in multiple myeloma patients undergoing autologous hematopoietic stem cell transplant. J Oncol Pharm Practice. 2017; 23(2): 116–120. doi: 10.1177/1078155215620920
• Idayu RMN, Lei PC, Wan WL, Hsien CC. Oral cryotherapy: Prevention of oral mucositis and pain among patients with colorectal cancer undergoing chemotherapy. Clin J Nurs. 2018; 22(5):555-560. doi: 10.1188/18.CJON.555-560. doi: 10.1188/18.CJON.555-560
• Marchesi F, Tendas A , Giannarelli D , Viggiani C , Gumenyuk S , Renzi 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. 2017; 52(1):154-156. doi: 10.1038/bmt.2016.207
• Erdem Ö, Güngörmüş Z. The effect of royal jelly on oral mucositis in patients undergoing radiotherapy and chemotherapy. Holist Nurs Pract. 2014; 28(4): 242- 246. doi: 10.1097/HNP.0000000000000033
• Arslan M., Özdemir L. Kemoterapiye bağlı gelişen bulantı- kusmanın yönetiminde kullanılan tamamlayıcı tedavi yöntemleri. Türk Onkoloji Dergisi. 2015; 30(2): 82- 80.
• Johansson JE, Bratel J, Hardling M, Heikki L, Mellqvist UH, Hasseus B. 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; 54:1482–1488. doi: 10.1038/s41409-019-0468-6
• Okamoto K., Ninomiya I, Yamaguchi T, Terai S, Nakanuma S, Kinoshita J. Takamura H. Oral criyotherapy for prophylaxis of oral mucositis caused by docetaxel, cisplatin and flouroucil chemotherapy for esophageal cancer. Esophagus. 2019; 16(2): 207- 213. doi: 10.1007/s10388-018-00655-8