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Management of oral and gastrointestinal mucosal injury: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up

Peterson DE, Boers-Doets CB, Bensadoun RJ, Herrstedt J, on behalf of the ESMO Guidelines Committee

Ann Oncol (2015) First published online: July 4, 2015;

doi: 10.1093/annonc/mdv202

Selected and commented by Dr. Ricardo Caponero

“Healthcare providers are often faced with difficult decisions and considerable uncertainty when treating patients. They rely on the scientific literature, in addition to their knowledge, skills, experience, and patient preferences, to inform their decisions. Guidelines are designed to support the decision-making processes in patient care. The content of a guideline based on a systematic review of clinical evidence and on standardised best practice, have been shown to be capable of supporting improvements in quality and consistency in healthcare. The ESMO Clinical Practice Guidelines about oral and gastrointestinal mucosal injury present updates from the older published versions and represent the state-of-the-science for mucositis management in patients receiving conventional chemotherapy and/or head and neck radiation. It also provides expert opinion on the management of mucosal injury caused by targeted cancer therapies such as vascular endothelial growth factor receptor inhibitors, epidermal growth factor receptor inhibitors, (multi-targeted) tyrosine kinase inhibitors, and mammalian target of rapamycin inhibitors.”

Oral and gastrointestinal mucositis caused by high-dose chemotherapy and/or radiation continues to be an important clinical problem. Fortunately, there have been strategic advances over the past decade in understanding the molecular basis of the injury, providing opportunities for the development of drugs and devices to manage toxicity. The guidelines detailed below represent updates from the version published in the 2011 Annals of Oncology [1], which were primarily based on the previous version of the guidelines produced by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO).

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