Journal of Clinical Oncology | China's first anti-tumor treatment-induced acute oral mucositis diagnosis and prevention expert consensus released

On May 30, my country’s first "Expert Consensus on the Diagnosis and Prevention of Acute Oral Mucositis Caused by Anti-tumor Therapy" (hereinafter referred to as "OM Consensus") was published in the journal "Clinical Oncology".
The committee and the CSCO Cancer Support and Rehabilitation Therapy Expert Committee jointly initiated the formulation, which was formulated with the joint efforts of 38 well-known domestic clinical experts.

It aims to jointly promote the standardization of the whole-process management of oral mucositis (OM, Oral Mucositis), improve the quality of life of patients with OM, and support the normal progress of tumor treatment.

"Physician Daily" specially interviewed the two committee chairmen who participated in the formulation of the consensus, Professor Qin Shukui from the General Hospital of the Eastern Theater Command and Professor Wang Jiejun from the Shanghai Changzheng Hospital, and brought an introduction to the consensus.

Professor Qin Shukui Chief Physician and Doctoral Supervisor of the PLA Cancer Center, Eastern Theater General Hospital of the People’s Liberation Army, Nanjing University of Traditional Chinese Medicine and Nanjing Medical University Distinguished Professor, "Journal of Clinical Oncology" Editor-in-Chief, Chinese Society of Clinical Oncology (CSCO) Vice President, Beijing Sisco Oncology Clinic Vice Chairman of the Research Foundation Chairman of the Committee of Experts on the Safety Management of Anticancer Drugs of the Chinese Society of Clinical Oncology Chairman of the Committee of Cancer Rehabilitation and Palliative Care (CRPC) of the Chinese Anticancer Association Core Expert of the Advisory Committee of Hematology and Tumor Drugs of the National Food and Drug Administration National Health Commission Capacity building and continuing education Chairman of the Oncology Expert Committee The oral mucositis of patients with tumors needs urgent attention.
Like the bone marrow suppression and nausea and vomiting that clinicians know well at present, OM caused by tumor treatment is also one of the common complications in the process of tumor treatment.

Almost all head and neck cancer patients undergoing chemotherapy and radiotherapy, 80% of high-dose chemotherapy (such as hematopoietic stem cell transplantation pretreatment) and 20%-40% of conventional chemotherapy patients will develop oral mucositis; more molecules have been used in recent years Oral mucosal damage can also occur during targeted therapy and immune checkpoint inhibitor therapy.

Patients with OM often present with varying degrees of ulcers, oral pain, difficulty eating, dry mouth, and dysgeusia, etc.
When the symptoms are severe, it often leads to adjustments of drugs and radiotherapy doses or interruption of treatment, which brings difficulties to tumor treatment and has serious impacts.
The patient’s quality of life.

Although many countries in Europe and the United States have formulated and issued a number of OM prevention and treatment or oral care related guidelines, they have not yet attracted enough attention in clinical practice in my country.
Most of them are treated symptomatically after the appearance of oral mucositis, or treatment based on personal experience.

At present, there is also a lack of a comprehensive (including radiotherapy, chemotherapy, and immuno-targeted therapy) diagnosis and treatment specifications for OM that are in line with my country's national conditions.

Based on these clinical backgrounds and needs, the CSCO Anti-tumor Drug Safety Management Expert Committee and the CSCO Cancer Support and Rehabilitation Expert Committee jointly organized 38 multidisciplinary experts and scholars in related fields, referring to relevant domestic and foreign literature, and based on evidence-based medical evidence With their respective professional experience, combined with the actual clinical situation in China, they have carefully discussed and revised several times, and finally formed this expert consensus, which is provided to clinicians as an important reference.

Professor Qin Shukui said: "The first "Expert Consensus on the Diagnosis, Prevention and Treatment of Acute Oral Mucositis Caused by Anti-tumor Therapy" adheres to the principles of the CSCO guidelines and forms recommendations based on evidence-based medicine evidence and expert consensus.
I believe it can bring guidance to clinical oncologists.
And help.

With the release of the "OM Consensus", it is also hoped that more and more clinicians will pay more attention to OM, standardized and effective prevention and treatment of OM, so that the supportive treatment and overall management of cancer patients will be brought to a new level.

" Doctors, nurses, and patients work together to jointly promote the prevention and treatment of oral mucositis.
The release of the "OM Consensus" is the beginning, and will continue to be updated and improved based on new evidence-based evidence that has emerged one after another and China's clinical practice.

The management of OM not only requires the attention of clinicians, but also the concept and participation of nurses and patients.
It is also very important.

Especially the nursing work, from prevention and education to daily oral examination, to follow-up treatment, runs through the whole process of OM.

The joint attention and cooperation of medical care plays an important role in the standardized management of OM.

With the release of the "OM Consensus", the Association will actively carry out continuing education work on the "OM Consensus", so that the majority of frontline clinical oncologists and nurses can learn about the "OM Consensus", and at the same time, combined with the clinical reality, jointly promote the OM field Standardization of prevention and treatment.

On the other hand, it is necessary to strengthen the education of oral mucositis for cancer patients, so that patients can pay attention to and correctly face OM, and do basic daily oral care to effectively prevent the occurrence and development of OM.

Through the cooperation of doctors, nurses and patients, the three parties jointly promote the standardization of OM prevention and treatment.

Professor Wang Jiejun Deputy Chairman of the Expert Committee on Rational Use of Tumors of the National Health and Family Planning Commission Chairman of the Chinese Society of Clinical Oncology (CSCO) Tumor Rehabilitation and Supporting Therapy Committee Chairman of the Chinese Society of Clinical Oncology (CSCO) Tumor Nutrition Therapy Expert Committee Designated Member of the Chinese Society of Clinical Oncology (CSCO) Standing Committee Advisor, Chinese People's Liberation Army Oncology Committee Former Chairman, China Cancer Rehabilitation and Palliative Care Committee, Vice President, China Life Care Association, Vice President, Shanghai Anti-Cancer Association, Member of Drug Evaluation Committee, National Medical Products Administration, OM Needs Whole-process management focuses on prevention.
The "OM Consensus" emphasizes that OM prevention and treatment for cancer patients must run through the entire treatment, and the whole-process, standardized management, including risk assessment, prevention, diagnosis, grading, treatment, post-treatment care and follow-up.

Prevention of oral mucositis is important, so preventive measures are recommended in the "OM Consensus".

Including oral assessment, daily care, nutritional advice, etc.

In terms of oral assessment, it is recommended to conduct oral assessment during the anti-tumor treatment period.
Especially for patients with medium and high risk of OM risk, oral assessment and preventive treatment are recommended first.

For all treated patients, oral care measures are advocated to prevent OM, while paying attention to the nutritional status of patients and providing necessary nutritional support.

In addition, the "OM Consensus" also made some recommendations for the prevention of patients with moderate and high-risk OM risks, such as the use of mucosal protective agents (such as oral gel), which can form a thin protective coating on the mucosa.
Block pathogenic bacteria, relieve pain, and indirectly promote mucosal self-repair; use cryotherapy (such as taking ice cubes); use oral care solution, etc.

Relieve pain and improve the eating and nutritional status of patients.
For the treatment of OM, the principles and objectives of clinical treatment emphasized by the "OM Consensus" mainly include: control oral pain, cover the ulcer surface, and make it heal as soon as possible; keep the oral cavity clean and reduce multiple infections; Prevent oral mucositis from developing to grade 3 or 4; multidisciplinary cooperation in the treatment of oral mucositis caused by ulcer bleeding, multiple oral infections, malnutrition, dehydration and electrolyte disturbances and other complications.

In terms of drug treatment, it is emphasized that active control of symptoms is the key, and measures are mainly local symptomatic treatment, supplemented by systemic systemic treatment.

Among them, oral pain is one of the symptoms of OM and the main complaint of patients.
Patients often cannot speak, drink, or eat because of oral pain.

Severe patients need to use systemic analgesics and parenteral nutrition support.

It causes great harm to the quality of life of patients, and affects the normal progress of tumor treatment of tumor patients.

Therefore, for patients with oral mucositis, oral pain relief is a more important aspect.
It is necessary to carry out pain management in time and early, and it is particularly important to use local analgesia to relieve the pain of patients drinking and eating.

Among them, the mucosal protective agent-Yipushu® Oral Gel is an imported ready-to-use and portable preparation.
It is a lipid-based liquid without preservatives.
It can automatically gather and arrange when sprayed on the oral mucosa.
A protective film is quickly formed within minutes to cover the oral ulcer surface, which can relieve pain obviously, and can improve eating and promote wound healing by reducing the irritation of the ulcer surface.

And a number of clinical studies at home and abroad have proved that Yipushu® can effectively relieve pain, improve patients' eating and nutritional status, and improve the quality of life of patients.

Therefore, this consensus recommends Yipushu® to the standardized treatment of OM: Yipushu® can not only be used for the prevention of OM in high-risk patients, but also for the treatment of OM, effectively alleviating oral pain in patients with OM, improving eating conditions and Nutritional status.

Conclusion The release of the "OM Consensus" for the first time gave my country a standard for the prevention and treatment of OM caused by anti-tumor therapy.
In the future, the two special committees will be committed to the promotion and implementation of the consensus, and strengthen my country’s oncologists and patients on oral mucositis and its harm Pay attention and develop the awareness of actively preventing and treating OM in the process of anti-tumor treatment, so that it will no longer be a stumbling block that affects tumor treatment, and at the same time improve the quality of life of the majority of tumor patients.

The appendix is ​​a special thanks to the experts who participated in this consensus (in alphabetical order) Chen Jiayi, Cheng Yuan, Fu Weijun, Guo Ye, Han Baohui, Hu Chaosu, Huang Yan, Jiang Xin, Li Jin, Li Junling, Liang Xiaohua, Liu Tianshu, Luo Suxia, Ma Jun, Mai Hai Qiang, Pan Hongming, Shen Xuemin, Sun Yan, Tang Guoyao, Wang Mengzhao, Wang Zhehai, Wu Hui, Wu Shikai, Xia Zhongjun, Xie Bo, Xie Fangyun, Xun Chen, Xu Binghe, Yu Shiying, Zhang Jian, Zhang Li, Zhang Weimin, Zhang Weijun, Zhou Caicun , Zhu Guopei, Zhu Jun Typesetting: Li Hui Editor: Wang Lina Review: Wang Lina For more information, please click: Academician Wu Mengchao’s death | See how the father of Chinese liver surgery pioneered and promoted the development of Chinese liver surgery in his life.
Jing Jiumei finally met this doctor at the time of desperation of life and death, "Physician Daily" award-winning survey waiting for you to participate in "Physician Daily" submission Public email: yishibao2017@163.
com [Note] Some pictures are from the Internet and WeChat Moments Dear Hello, the author of the picture, the doctor’s newspaper has prepared the manuscript fee for you, please contact the editor on duty: 010-58302828-6808.
Currently 1130000+ doctors have been following to join us