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MASCC/ISOO Mucositis Guidelines, 2004, 2007, 2014

The first set of MASCC/ISOO Mucositis Guidelines was published in the journal Cancer in 2004, with updates published in 2007 and 2014. The 2014 guidelines were included in the National Guideline Clearinghouse™ (NGC) maintained by the US Agency for Healthcare Research and Quality (AHRQ) — a testament to their having met rigorous criteria, including a systematic literature review, systematically developed recommendations for optimal care, and assessment of benefits and harms of recommended treatments.

2014 MASCC/ISOO Clinical Practice Guidelines

English - MASCC/ISOO Clinical Practice Guidelines for the Management of Mucositis Secondary to Cancer Therapy
Rajesh V. Lalla, Joanne Bowen, Andrei Barasch, Linda Elting, Joel Epstein, Dorothy M. Keefe, Deborah B. McGuire, Cesar Migliorati, Ourania Nicolatou-Galitis, Douglas E. Peterson, Judith E. Raber-Durlacher, Stephen T. Sonis, Sharon Elad and The Mucositis Guidelines Leadership Group of the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO). Cancer. 2014 May 15;120(10):1453-61. Epub 2014 Feb 25. Free Access.

English - Erratum  in: Cancer. 2015 Apr 15;121(8):1339.

Guidelines Summary
English - MASCC/ISOO Guidelines Summary alt 

Guideline Translations 
Translation Policy   •  For more translation information please contact MASCC Study Group Coordinator, Leslie Johnson

Chinese alt - May 2016, Translation by Karis Cheng and E Cheng
French alt - Nov 2014
Greek alt - Nov 2014
Hindi alt - Jan 2017, Translation by Abhsihek Kandwal and Atul Batra 
Italian alt - Nov 2014
Japanese alt - Nov 2014
Portuguese alt - May 2016, Translation by Rui Amaral Mendes and Maria Elvira Correa
Spanish alt - May 2016, Translation by Rui Amaral Mendes, Pia Lopez Jornet
Turkish alt - Oct 2015, Translation by Elif Sozeri and Sevinc Kutluturkan

Publications Related to the 2014 Guidelines

The MASCC/ISOO Mucositis Guidelines Update: introduction to the first set of articles. Rajesh V. Lalla.

The MASCC/ISOO Mucositis Guidelines: dissemination and clinical impact. Rajesh V. Lalla, Fredrick D. Ashbury.

Methodology for the MASCC/ISOO Mucositis Clinical Practice Guidelines Update. J. M. Bowen, S. Elad, R. D. Hutchins, R. V. Lalla; for the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer and the International Society of Oral Oncology (MASCC/ISOO).

Development of the MASCC/ISOO Clinical Practice Guidelines for Mucositis: considerations underlying the process. Sharon Elad, Joanne Bowen, Yehuda Zadik, Rajesh V. Lalla; on behalf of the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer and the International Society of Oral Oncology (MASCC/ISOO).

Systematic review of basic oral care for the management of oral mucositis in cancer patients. Deborah B. McGuire, Janet S. Fulton, Jumin Park, Carlton G. Brown, M. Elvira P. Correa, June Eilers, Sharon Elad, Faith Gibson, loree K. Oberle-Edwards, Joanne Bowen, Rajesh V. Lalla; on behalf of the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer and the International Society of Oral Oncology (MASCC/ISOO).

Systematic Review of Anti-inflammatory Agents for the Management of Oral Mucositis in Cancer Patients. Ourania Nicolatou-Galitis, Triantafyllia Sarri, Joanne Bowen, Mario Di Palma, Vassilios E. Kouloulias, Pasquale Niscola, Dorothea Riesenbeck, Monique Stokman, Wim Tissing, Eric Yeoh, Sharon Elad, Rajesh V. Lalla; for the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer and the International Society of Oral Oncology (MASCC/ISOO).

Systematic Review of Antimicrobials, Mucosal Coating Agents, Anesthetics, and Analgesics, for the Management of Oral Mucositis in Cancer Patients. Deborah P. Saunders, Joel B. Epstein, Sharon Elad, Justin Allemano, Paolo Bossi, Marianne D. van de Wetering, Nikhil G. Rao, Carin Potting, Karis K. Cheng, Annette Freidank, Michael T. Brennan, Joanne Bowen, Kristopher Dennis, Rajesh V. Lalla; for the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer and the International Society of Oral Oncology (MASCC/ISOO).

Systematic review of natural agents for the management of oral mucositis in cancer patients. Noam Yarom, Anura Ariyawardana, Allan Hovan, Andrei Barasch, Virginia Jarvis, Siri Beier Jensen, Yehuda Zadik, Sharon Elad, Joanne Bowen, Rajesh V. Lalla; for the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer and the International Society of Oral Oncology (MASCC/ISOO).

Systematic review of miscellaneous agents for the management of oral mucositis in cancer patients. Siri Beier Jensen, Virginia Jarvis, Yehuda Zadik, Andrei Barasch, Anura Ariyawardana, Allan Hovan, Noam Yarom, Rajesh V. Lalla, Joanne Bowen, Sharon Elad; for the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer and the International Society of Oral Oncology (MASCC/ISOO).

Emerging Evidence on the Pathobiology of Mucositis. Noor Al-Dasooqi, Stephen T. Sonis, Joanne M. Bowen, Emma Bateman, Nicole Blijlevens, Rachel J. Gibson, Richard M. Logan, Raj G. Nair, Andrea M. Stringer, Roger Yazbeck, Sharon Elad, Rajesh V. Lalla; for the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer and the International Society of Oral Oncology (MASCC/ISOO).

Risk of Oral and gastrointestinal mucosal injury among patients receiving selected targeted agents: a meta-analysis. Elting LS, Chang YC, Parelkar P, Boers-Doets, CB, Michelet M, Hita G, Rouleau T, Cooksley C, Halm J, Vithala M, Bossi P, Escalante C, Brennan MT; On behalf of Mucositis Study Group of the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO).

Systematic review of agents for the management of gastrointestinal mucositis in cancer patients. RAchel J. Gibson, Dorothy M. K. Keefe, Rajesh V. Lalla, Emma Bateman, Nicole Blijlevens, Margot Fijlstra, Emily E. King, Andrea M. Stringer, Walter J. F. M. van der Velden, Roger Yazbeck, Sharon Elad, Joanne M. Bowen; for the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer and the International Society of Oral Oncology (MASCC/ISOO).

Systematic review of oral cryotherapy for management of oral mucositis caused by cancer therapy. Douglas E. Peterson, Kerstin Öhrn, Joanne Bowen, Monica Fliedner, Judith Lees, Charles Loprinzi, Takehiko Mori, Anthony Osaguona, Dianna S. Weikel, Sharon Elad, Rajesh V. Lalla; for the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer and the International Society of Oral Oncology (MASCC/ISOO).

Systematic review of laser and other light therapy for the management of oral mucositis in cancer patients. Cesar Migliorati, Ian Hewson, Rajesh V. Lalla, Heliton Spindola Antunes, Cherry L. Estilo, Brian Hodgson, Nilza Nelly Fontana Lopes, Mark M. Schubert, Joanne Bowen, Sharon Elad; for the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer and the International Society of Oral Oncology (MASCC/ISOO).

Systematic review of cytokines and growth factors for the management of oral mucositis in cancer patients. Judith E. Raber-Durlacher, Inger von Bültzingslöwen, Richard M. Logan, Joanne Bowen, Abdul Rahman Al-Azri, Hele Everaus, Rich Gerber, Jesùs Garcia Gomez, Bo G. Pettersson, Yoshihiko Soga, Fred K. L. Spijkervet, Wim J. E. Tissing, Joel B. Epstein, Sharon Elad, Rajesh V. Lalla; for the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer and the International Society of Oral Oncology (MASCC/ISOO).

Systematic review of amifostine for the management of oral mucositis in cancer patients. Ourania Nicolatou-Galitis, Triantafyllia Sarri, Joanne Bowen, Mario Di Palma, Vassilios E. Kouloulias, Pasquale Niscola, Dorothea Riesenbeck, Monique Stokman, Wim Tissing, Eric Yeoh, Sharon Elad, Rajesh V. Lalla; for the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer and the International Society of Oral Oncology (MASCC/ISOO).

2007 MASCC/ISOO Clinical Practice Guidelines

Updated clinical practice guidelines for the prevention and treatment of mucositis. Dorothy M. Keefe, Mark M. Schubert, Linda S. Elting, Stephen T. Sonis, Joel B. Epstein, Judith E. Raber-Durlacher, Cesar A. Migliorati, Deborah B. McGuire, Ronald D. Hutchins, Douglas E. Peterson; for the Mucositis Study Section of the Multinational Association of Supportive Care in Cancer (MASCC) and the International Society for Oral Oncology (ISOO). Cancer. 2007 Mar 1;109(5):820-31. Free Access.

Publications Related to the 2007 Guidelines

Alimentary mucositis: putting the guidelines into practice. Michael T. Brennan, Inger von Bültzingslöwen, Mark M. Schubert, Dorothy Keefe.

Mucositis guidelines: what have they achieved, and where to from here? Dorothy M. K. Keefe.

Developing evidence-based guidelines for management of alimentary mucositis: process and pitfalls. Dorothy M. Keefe, Douglas E. Peterson, Mark M. Schubert.

Alimentary tract mucositis in cancer patients: impact of terminology and assessment on research and clinical practice. Douglas E. Peterson, Dorothy M. Keefe, Ronald D. Hutchins, Mark M. Schubert.

Epidemiology of treatment-associated mucosal injury after treatment with newer regimens for lymphoma, breast, lung, or colorectal cancer. Jeffrey A. Jones, Elenir B. C. Avritscher, Catherine D. Cooksley, Marisol Michelet, B. Nebiyou Bekele, Linda S. Elting.

New thoughts on the pathobiology of regimen-related mucosal injury. Lowell Anthony, Joanne Bowen, Adam Garden, Ian Hewson, Stephen Sonis.

Growth factors and cytokines in the prevention and treatment of oral and gastrointestinal mucositis. Inger von Bültzingslöwen, Michael T. Brennan, Fred K. L. Spijkervet, Richard Logan, Andrea Stringer, Judith E. Raber-Durlacher, Dorothy Keefe.

Antimicrobials, mucosal coating agents, anesthetics, analgesics, and nutritional supplements for alimentary tract mucositis. Andrei Barasch, Sharon Elad, Arnold Altman, Kathryn Damato, Joel Epstein.

The role of alternative and natural agents, cryotherapy, and/or laser for management of alimentary mucositis. Cesar A. Migliorati, Loree Oberle-Edwards, Mark Schubert.

The role of basic oral care and good clinical practice principles in the management of oral mucositis. Deborah B. McGuire, Maria Elvira P. Correa, Judith Johnson, Patricia Wienandts.

Promulgation of guidelines for mucositis management: educating health care professionals and patients. Deborah B. McGuire, Judith Johnson, Cesar Migliorati.

Anti-inflammatory agents in the management of alimentary mucositis. Rajesh V. Lalla, Mark M. Schubert, Rene-Jean Bensadoun, Dorothy Keefe.

Amifostine in the management of radiation-induced and chemo-induced mucositis. Rene-Jean Bensadoun, Mark M. Schubert, Rajesh V. Lalla, Dorothy Keefe.

Palifermin for oral mucositis in the high-dose chemotherapy and stem cell transplant setting: the Royal Adelaide Hospital Cancer Centre experience. Dorothy Keefe, Jude Lees, Noemi Horvath.

2004 MASCC/ISOO Clinical Practice Guidelines and Related Publication

Clinical practice guidelines for the prevention and treatment of cancer therapy-induced oral and gastrointestinal mucositis. Edward B. Rubenstein, Douglas E. Peterson, Mark Schubert, Dorothy Keefe, Deborah McGuire, Joel Epstein, Linda S. Elting, Philip C. Fox, Catherine Cooksley, Stephen T. Sonis. Cancer. 100(59):2026-46. Free Access.

Perspectives on cancer therapy-induced mucosal injury: Pathogenesis, measurement, epidemiology, and consequences for patients. Stephen T. Sonis, Linda S. Elting, Dorothy Keefe, Douglas E. Peterson, Mark Schubert, Martin Hauer-Jensen, B. Nebiyou Bekele, Judith Raber-Durlacher, J. Peter Donnelly, Edward B. Rubenstein. Free Access.