Objectives: To assess the effectiveness of interventions for the treatment of oral mucositis or its associated pain for patients with cancer receiving chemotherapy and or radiotherapy. Methods: Computerised MEDLINE, EMBASE, CCTR and the Cochrane Oral Health Group Specialised Register were searched. Date of most recent searches: May 2001 (CCTR 2001, issue 2). Randomised trials were selected if they met the following criteria: design - random allocation of participants; participants - anyone receiving chemotherapy and or radiotherapy for cancer, with mucositis; interventions - agents prescribed to treat oral mucositis; outcomes - oral mucositis, oral pain, dysphagia, systemic infection, amount of analgesia, length of hospitalisation, cost and patient quality of life. Information regarding methods, participants, interventions, outcome measures and results were independently extracted, in duplicate, by two reviewers. Authors were also contacted for details of randomisation blindness and withdrawals and a quality assessment was carried out on these three criteria. Results: 15 trials involving 876 patients satisfied the inclusion criteria. Only two agents each in single trials were found to be effective for improving (allopurinol RR=0.63 95%CI 0.42 to 0.96) or eradicating mucositis (allopurinol RR=0.59 95%CI 0.42 to 0.84; vitamin E RR=0.38 95%CI 0.14, 0.97). Three trials compared patient controlled analgesia (PCA) to the continuous infusion method (CI) for controlling pain, and there was no evidence of a difference. However there was evidence that less opiate is used per hour for PCA . Conclusions: There is weak evidence that allopurinol mouthwash and vitamin E may be beneficial in improving or eradicating mucositis. There is no evidence that PCA is better than CI for controlling pain, however there is evidence that less opiate is used per hour. There is a need for more well designed trials including a placebo control, assessing the effectiveness of allopurinol mouthwash, vitamin E and new interventions for treating mucositis.

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