Ice pack application

Suggested

2 studies · 1 recommendation

Last updated: February 14, 2026

Ice pack application – Oral Mucositis
Suggested2 studies

Ice chips during cancer treatment cut oral mucositis risk by 43%

Two Cochrane systematic reviews covering 27 trials and 945 patients confirm cryotherapy (ice chips) as one of the most effective preventive strategies for oral mucositis in cancer patients. Ice chip use reduced mucositis risk with a relative risk of 0.57 (95% CI 0.43–0.77), with no heterogeneity between studies (P=0.61). The number needed to treat was 4 (95% CI 3–7)—for every 4 patients using ice chips, one additional case of mucositis is prevented. Across patients with different cancer types undergoing various treatments including bone marrow transplant, cryotherapy ranked among only two interventions with the strongest evidence of benefit out of all evaluated strategies. Application involves holding ice chips in the mouth during chemotherapy infusion to constrict local blood vessels and reduce mucosal drug exposure.

Evidence

Authors: Abramoff, Adamietz, Adamietz, Adamietz, Ahmed, Ahn, Aisa, Altmann, Andersen, Anderson, Anderson, Andreassen, Antin, Antonadou, Antonadou, Apaydin, Aquino, Ardizzoni, Attal, Awada, Awada, Awidi, Awwad, Barasch, Barker, Baydar, Begg, Bellm, Bennett, Bensadoun, Bensadoun, Bensadoun, Bensadoun, Bensadoun, Bentzen, Biswal, Biswal, Bjarnason, Bleehen, Boer, Borowski, Bourhis, Bourhis, Bourhis, Braaksma, Brizel, Bubley, Buentzel, Buentzel, Buntzel, Buntzel, Buntzel, Calais, Calais, Calais, Cartee, Carter, Cascinu, Cassidy, Castagna, Castro, Cella, Cengiz, Cerchietti, Chang, Cheng, Cheng, Cheng, Cheng, Cheng, Cheng, Chi, Chi, Choi, Chor, Clarke, Clarkson, Clarkson, Clarkson, Clarkson, Clarkson, Coghlin Dickson, Colella, Collova, Colombat, Costa, Costa, Cowen, Cowen, Crawford, Crawford, Cunningham, Dai, Damon, Dazzi, Dazzi, Denham, Denning, Djuric, Dobrowsky, Dodd, Doroshow, Dose, Dose, Dozono, Dreicer, Dudjak, Duenas-Gonzalez, Duncan, Duncan, Edelman, Egger, Eilers, Eisen, El-Sayed, El-Sayed, El-Sayed, Elad, Elbourne, Epstein, Epstein, Epstein, Epstein, Epstein, Erkisi, Erlichman, Erlichman, Ertekin, Etiz, Etiz, Evensen, Ezzat, Fahlke, Falcone, Fay, Feber, Feber, Ferreira, Ferreira, Ferretti, Ferretti, Ferretti, Ferretti, Fidler, Fidler, Foncuberta, Foote, Franzen, Freytes, Gabison, Gandara, Gibson, Giles, Giles, Giles, Glenny, Glenny, Goldberg, Gordon, Grotz, Grotz, Grzegorczyk-Jazwinska, Gujral, Gujral, Gutierrez, Haddad, Hanson, Hanson, Harris, Hartmann, Hartmann, He, Henke, Hickey, Howell, Hu, Huang, Huang, Hwang, Ifrah, Ito, Jebb, Jebb, Jellema, Jham, Jham, Johnson, Ju, Kante, Karacetin, Karthaus, Kassab, Katano, Kaul, Kaul, Keefe, Kenny, Khouri, Klocke, Koning, Koukourakis, Labar, Labar, Labbate, Lanzos, Lavendag, Le, Leborgne, Lee, Lee, Lelie, Leong, Levi, Lievens, Lilleby, Lin, Lin, Lockhart, Loo, Lopez, Loprinzi, Lortholary, Lorusso, Lozada-Nur, Lugliè, Madero, Mahmoud HK, Mahood, Makkonen, Makkonen, Malaker, Mantovani, Marcial, Masucci, Matejka, McAleese, McGaw, McIlroy, Meropol, Merte, Mills, Mills, Minn, Moher, Nemunaitis, Nicolatou-Galitis, Niibe, Niibe, Nottage, Oberbaum, Oberbaum, Okuno, Okuno, Okuno, Okutomi, Panahi, Papadeas, Papas, Papas, Pauw, Penpattanagul, Peters, Peterson, Peterson, Peterson, Petit, Pfeiffer, Pfeiffer, Phillips, Piccirillo, Pillsbury, Pitten, Pouli, Prada, Prada, Puataweepong, Putwatana, Pyrhonen, Pytlik, Qin, Rabinovitch, Rades, Radmard, Raether, Rahn, Rahn, Robustelli della Cuna, Rocci, Rocke, Rojas de Morales, Rothwell, Rubestein, Rutkauskas, Saarilahti, Samaranayake, Sato, Savarese, Scarantino, Scarantino, Scarantino, Scherlacher, Schneider, Schuster, Schwerkoske, Shabanloei, Sharma, Shea, Shea, Shenep, Shidfar, Shieh, Simoes, Sonis, Sorensen, Spadaro, Spencer, Spielberger, Spielberger, Spijkervet, Stevens, Stokman, Stokman, Stokman, Su, Su, Su, Suc, Sutherland, Svanberg, Symonds, Symonds, Symonds, Tavender, Teshima, Thieblemont, Throuvalas, Toubai, Trotti, Trotti, Tu, Uchiyama, Vacha, Vacha, Vadhan-Raj, Valcarcel, Valcarcel, Valcárcel, Verdi, Verdi, Vesole, Villar, Vitello, Vokurka, Wagner, Wahlin, Wang, Wang, Ward, Warde, Watanabe, Weisdorf, Weiss, Whelan, White, Wijers, Wollina, Worthington, Worthington, Worthington, Worthington, Wright, Wu, Wu, Wu, Wymenga, Wymenga, Yokomizo, Yuen, Zaanen, Zanin

Published: January 1, 2010

A Cochrane systematic review evaluating interventions for preventing oral mucositis in cancer patients found that cryotherapy (ice chips) showed benefit in preventing mucositis. The review assessed multiple randomized controlled trials across patients with different cancer types undergoing various cancer treatments including bone marrow transplant. Cryotherapy was one of only two interventions (alongside keratinocyte growth factor) that demonstrated the strongest evidence of benefit among all strategies evaluated for mucositis prevention.

Authors: Bryan, Gemma, Clarkson, Jan E., Furness, Susan, Glenny, Anne-Marie, Khalid, Tasneem, Littlewood, Anne, McCabe, Martin G., Meyer, Stefan, Worthington, Helen V.

Published: January 1, 2003

Systematic review of 27 trials with 945 patients randomized for mucositis outcomes. Of eight prophylactic agents tested, only ice chips demonstrated effectiveness in preventing mucositis. Ice chips reduced mucositis risk with relative risk 0.57 (95% CI 0.43-0.77), showing statistical significance with no heterogeneity between studies (chi-square 0.26, df=1, P=0.61). The number needed to treat (NNT) was 4 (95% CI 3-7), meaning for every 4 patients using ice chips, one additional case of mucositis is prevented. When baseline mucositis incidence ranges from 50-80%, NNT ranges from 5 to 4 respectively.