{"entity":{"id":"oral-cryotherapy-mucositis","kind":"technology","name":"Oral cryotherapy (ice chips) to prevent mucositis","aka":[],"tldr":"Sucking ice chips for half an hour around a bolus dose of fluorouracil or high-dose melphalan roughly halves the risk of painful mouth ulcers. It costs nothing and is recommended in international mucositis guidelines.","summary":"Cooling the mouth constricts mucosal blood vessels during the short window when a bolus cytotoxic is at peak concentration, reducing the dose delivered to the oral epithelium. A 2015 Cochrane review of 14 randomised trials found that oral cryotherapy reduces the incidence of oral mucositis of any severity and of moderate to severe mucositis in adults receiving fluorouracil-based chemotherapy for solid cancers, and probably reduces it with high-dose melphalan before stem cell transplant. The 2020 MASCC/ISOO guidelines recommend 30 minutes of oral cryotherapy for patients receiving bolus 5-fluorouracil and for high-dose melphalan conditioning. It does not help with infusional 5-FU or capecitabine, whose exposure is prolonged. It is uncomfortable for some and unsuitable with oxaliplatin because cold triggers acute neuropathy.","status":"standard-of-care","asOf":"2026-09-10","wikipedia":"https://en.wikipedia.org/wiki/Oral_mucositis","links":[{"label":"Cochrane: oral cryotherapy for preventing oral mucositis in patients receiving cancer treatment (2015)","url":"https://doi.org/10.1002/14651858.CD011552.pub2"},{"label":"MASCC/ISOO clinical practice guidelines for mucositis (Cancer 2020)","url":"https://doi.org/10.1002/cncr.33100"}],"tags":["complementary","supportive-care","evidence:strong"],"related":[],"cancers":[],"sections":["supportive-care","chemotherapy","rejuvenation"],"technologies":["cytotoxic-chemotherapy","scalp-cooling","dry-mouth-teeth-after-head-neck-radiotherapy"],"targets":[],"drugs":["fluorouracil","melphalan"],"companies":[],"institutions":["mascc"],"pathways":[],"terms":["mucositis"],"trials":[],"people":[],"bottlenecks":["b-toxicity-qol"],"keyPapers":["paper-elad-cancer","paper-riley-cochrane-database-syst-rev"],"journals":[],"dependsOn":[],"notes":[],"principle":"Local vasoconstriction lowers drug delivery to the oral mucosa during the peak plasma phase of short-half-life cytotoxics.","strengths":["Cochrane and MASCC/ISOO recommendation","Free and immediate","Large effect for bolus 5-FU and melphalan"],"limitations":["Only for short-infusion drugs","Avoid with oxaliplatin (cold-induced neuropathy)","Discomfort"]},"route":"/technologies/oral-cryotherapy-mucositis/","neighbours":{"section":[{"id":"chemotherapy","kind":"section","name":"Chemotherapy","route":"/fronts/chemotherapy/"},{"id":"rejuvenation","kind":"section","name":"Recovery & Rejuvenation","route":"/fronts/rejuvenation/"},{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"technology":[{"id":"cytotoxic-chemotherapy","kind":"technology","name":"Cytotoxic chemotherapy","route":"/technologies/cytotoxic-chemotherapy/"},{"id":"dry-mouth-teeth-after-head-neck-radiotherapy","kind":"technology","name":"Dry mouth, teeth and taste after head and neck radiotherapy","route":"/technologies/dry-mouth-teeth-after-head-neck-radiotherapy/"},{"id":"honey-radiation-mucositis","kind":"technology","name":"Honey for radiation mucositis","route":"/technologies/honey-radiation-mucositis/"},{"id":"photobiomodulation-mucositis","kind":"technology","name":"Photobiomodulation (low-level laser) for oral mucositis","route":"/technologies/photobiomodulation-mucositis/"},{"id":"scalp-cooling","kind":"technology","name":"Scalp cooling (cold caps: DigniCap, Paxman)","route":"/technologies/scalp-cooling/"}],"drug":[{"id":"fluorouracil","kind":"drug","name":"Fluorouracil (5-FU)","route":"/drugs/fluorouracil/"},{"id":"melphalan","kind":"drug","name":"Melphalan (including hepatic delivery system)","route":"/drugs/melphalan/"}],"institution":[{"id":"mascc","kind":"institution","name":"Multinational Association of Supportive Care in Cancer","route":"/institutions/mascc/"}],"term":[{"id":"mucositis","kind":"term","name":"Mucositis and stomatitis","route":"/terms/mucositis/"}],"bottleneck":[{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}],"paper":[{"id":"paper-riley-cochrane-database-syst-rev","kind":"paper","name":"Interventions for preventing oral mucositis in patients with cancer receiving treatment: oral cryotherapy","route":"/key-papers/paper-riley-cochrane-database-syst-rev/"},{"id":"paper-elad-cancer","kind":"paper","name":"MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy","route":"/key-papers/paper-elad-cancer/"}]}}