This PACULit episode reviews a prospective, single-center randomized controlled trial evaluating oral cryotherapy (ice or lollies) during intravenous methotrexate–based chemotherapy to prevent oral mucositis in children with hematolymphoid malignancies. Key findings show a significant reduction in oral mucositis incidence (22.2% with cryotherapy vs 63.4% with standard care; RR 0.35, p ≤ 0.001), with fewer severe cases and shorter duration, and no notable cryotherapy-related adverse events. The discussion outlines the timing, adherence considerations, and potential integration into pediatric oncology protocols as a simple, low-cost preventive strategy, alongside limitations like single-center design and moderate sample size. The episode also situates the study within broader evidence and ongoing trials in pediatric mucositis prevention, and highlights practical implications for clinical practice, including patient/caregiver education, coordination among care teams, and the role of cryotherapy within a comprehensive oral care protocol.
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