Oral Cryotherapy For High Dose Chemotherapy

description

D18.050, oral, cryotherapy, melphalan, chemotherapy

Policy Number

D18.050

Purpose

Administration of oral cryotherapy to prevent severe mucositis in patients receiving high dose chemotherapy infusions.

Equipment

 Ice Chips
 Ice Water

Policy

Oral cryotherapy will be administered to all patients receiving high dose Melphalan (>140mg/m2) and
Busulfan.

Procedure
A. Melphalan - The patient will put ice chips and/or ice cold water in their mouths 15 minutes before, during
and 30 minutes after the Melphalan infusion (total of 60 minutes).

B. Daily Busulfan - The patient will put ice chips and/or ice cold water in their mouths 90 minutes after the
infusion is initiated and for 30 minutes after the infusion completes (total of 120 minutes).

C. Q6 Hour Busulfan - The patient will put ice chips and/or ice water in their mouths one hour after the
initiation of Busulfan and continue for one hour after the infusion completes (total of 120 minutes).

D. The patient should continuously swirl ice chips around their mouth.

E. Patients should swallow ice cold water every 10-20 minutes throughout the period of oral cryotherapy.

F. Popsicles can be used during cryotherapy.

Reference Details

Asia, Y., Mori, T., Kudo, M., Yashima, T., Kondo, S., Yokoyama, A., Ideda, Y., Okamoto, S. (2005). Oral
cryotherapy for the prevention of high-dose Melphalan-induced stomatitis in allogeneic hematopoietic stem
cell transplant recipients. Support Care Cancer. 13:266-269

Gori, E. et al., (2007). Cryotherapy in the prevention of oral mucositis in patients receiving low-dose
methotrexate following myeloablative allogeneic stem cell transplantation: a prospective randomized study of
the Gruppo Italiano Trapianto di Midollo Osseo nurses group. Bone Marrow Transplantation. 39: 347-352

Karagozoglu, S., Ulusoy, M.F., (2004). Chemotherapy: the effect of oral cryotherapy on the development of
mucositis. Journal of Clinical Nursing. 14, 754-765

Lilleby, K., Gooley, T., McDonnell, P., Taber, R., Holmberg, L., Maloney, DG, Press, OW., & Bensinger, W.,
(2006). A prospective randomized study of cryotherapy during administration of high-dose Melphalan to
decrease the severity and duration of oral mucositis in patients with multiple myeloma undergoing autologous
peripheral blood stem cell transplantation. Bone Marrow Transplantation. 37:1031-1035

Mori, T., Asia, Y., Yamazaki, R., Mihara, A., Ideda, Y., & Okamoto, S. (2005). Brief oral cryotherapy for the
prevention of high-dose Melphalan-induced stomatitis in allogeneic hematopoietic stem cell transplan
recipients.

Support Care Cancer. 14:395-395.

Svanberg, A., Gunnar, B., & Ohrn, R. (2007). Oral cryotherapy reduces mucositis and opioid use after
myeloablative therapy-a randomized controlled trial. Support Care Cancer, 15:1155-1161

Tartarone, A., Matera, R., Romano, G., Vigliotti, ML., DiRenzo, N. (2005). Prevention of high-dose melphalan
induced mucositis by cryotherapy. Leukemia and Lymphoma. 46(4): 633-634.

Fishman, S., Ballantyne, J., Rathmell, J. (2010) Bonica's Management of Pain. Philadelphia, PA: Lippincott
Williams and Wilkins
 Issuing Authority

FMLH Professional Practice Council

Distribution

Froedtert Memorial Lutheran Hospital

Reference Type

Evidence Based Practice

category

8CFAC,