Modified oral cryotherapy is associated with lower oral mucositis pain in HSCT recipients: a retrospective study

To assess modified oral cryotherapy (OC) for pain management in hematopoietic stem cell transplant (HSCT) recipients with oral mucositis (OM).

A retrospective study included 361 HSCT patients (2023-2025) stratified into Conventional Nursing Practice (CNP) group (n=170) and optimized nursing protocol (ONP) group (n=191). The ONP protocol replaced saline ice slurry with Kangfuxin solution ice slurry and incorporated adjunctive bilateral cheek cryotherapy using ice packs. Outcomes compared OM severity and pain levels (Verbal Rating Scale).

Both groups showed comparable overall OM incidence (78.8% vs 78.0%, P = 0.851). The optimized protocol was associated with moderate-to-severe pain (Grade 2-3: 22.8% vs 39.6%, ARR = 16.8%, P = 0.004), with a 66% reduction in severe pain (Grade 3: 4.0% vs 11.9%). Multivariable analysis showed that age, alcohol use, and baseline oral pathology were independently associated with OM (all P < 0.05).

Modified OC incorporating Kangfuxin ice slurry and localized cheek cryotherapy was associated with OM-related pain severity without reducing overall incidence, suggesting a clinically feasible and effective strategy for pain control in HSCT recipients.