OBJECTIVE To update the clinical practice guidelines for the management of oral mucositis (OM) that were developed by the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). This part focuses on honey, herbal compounds, saliva stimulants, probiotics, and miscellaneous agents. METHODS A systematic review was conducted by the Mucositis Study Group of MASCC/ISOO. The body of evidence for each intervention, in each clinical setting, was assigned an evidence level. The findings were added to the database used to develop the 2014 MASCC/ISOO clinical practice guidelines. Based on the evidence level, one of the following guidelines were determined: Recommendation, Suggestion, No Guideline Possible. RESULTS A total of 78 papers were identified within the scope of this section, of which 49 were included in this review and merged with nine publications that were reported in the previous guidelines update. A new Suggestion was made for honey (combined topical and systemic delivery) for the prevention of OM in head and neck cancer patients receiving radiotherapy with or without chemotherapy. A new Suggestion clarified that chewing gum is not effective for the prevention of OM in pediatric patients with hematological or solid cancer treated with chemotherapy. No guideline was possible for other interventions. CONCLUSIONS Numerous natural products and herbal remedies were studied for the management of OM. Of the agents reviewed in this systematic review, a guideline in favor was made for honey (combined topical and systemic), while a guideline against was made for chewing gum. Additional research is warranted to clarify the potential of other interventions.

中文翻译：

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用于治疗癌症患者口腔粘膜炎的天然和其他药物的系统评价和临床实践指南-第2部分：蜂蜜，草药化合物，唾液兴奋剂，益生菌和其他药物。

目的更新由多国癌症支持治疗协会/国际口腔肿瘤学会（MASCC / ISOO）制定的口腔粘膜炎（OM）管理的临床实践指南。本部分重点介绍蜂蜜，草药化合物，唾液兴奋剂，益生菌和其他药物。方法MASCC / ISOO黏膜炎研究小组进行了系统的审查。在每种临床情况下，为每种干预措施的证据体系指定了证据等级。研究结果已添加到用于制定2014 MASCC / ISOO临床实践指南的数据库中。根据证据水平，确定了以下准则之一：建议，建议，无准则。结果在本节的范围内，总共鉴定出78篇论文，其中49篇被纳入本评价，并与先前指南更新中报告的9篇出版物合并。蜂蜜（局部和全身联合给药）的新建议被用于预防接受或不接受化疗的放疗的头颈癌患者的OM。一项新的建议澄清说，口香糖对儿童接受化学疗法治疗的血液病或实体癌患者的OM预防无效。没有其他干预措施的指导方针。结论研究了多种天然产物和草药用于OM的管理。在本系统综述中，对蜂蜜（局部和全身结合使用）制定了指导方针，而对口香糖制定了反对指导方针。