Non-prescription supportive care interventions for anticancer therapy-induced oral mucositis: protocol for a systematic review and meta-analysis

Abstract Background Oral mucositis (OM) is a common and debilitating complication of anticancer therapies, frequently resulting in pain, nutritional impairment, and potential treatment interruption. While several pharmacologic and device-based interventions have been evaluated, less attention has been given to non-prescription supportive care (NSC) strategies that are accessible, self-administered, and feasible in resource-limited or home-based settings. Existing reviews rarely distinguish between prescription-based therapies and patient-led, non-prescription interventions. A comprehensive synthesis focusing specifically on NSC interventions is therefore warranted. Methods This protocol outlines a systematic review and meta-analysis designed to evaluate the efficacy of non-prescription supportive care interventions for cancer therapy–induced oral mucositis. Randomized controlled trials involving adult patients receiving chemotherapy, radiotherapy, chemoradiotherapy, or hematopoietic stem cell transplantation will be included. Eligible interventions will be defined as supportive oral care or self-management strategies that do not require a medical prescription, can be self-administered by patients or caregivers, and do not require specialized medical equipment or professional clinical administration. Searches will be conducted in PubMed, MEDLINE via Ovid, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and Scopus, supplemented by Google Scholar, clinical trial registries, and reference-list screening. The primary outcome will be the incidence of severe oral mucositis (Grade ≥ 3). Secondary outcomes will include any-grade mucositis, pain intensity, treatment interruption, quality of life, and adverse events. Risk of bias will be assessed using RoB 2, and certainty of evidence will be assessed using the GRADE approach. Random-effects meta-analyses will be conducted where appropriate, with pre-specified subgroup and sensitivity analyses. Systematic review registration PROSPERO CRD420251178696