Treatment-induced mucositis: an old problem with new remedies.
Mucositis may be a painful, debilitating, dose-limiting side-effect of both chemotherapy and radiotherapy for which there is no widely accepted prophylaxis or effective treatment. The basis of management is pain relief, prevention of dehydration and adequate nutrition. When tested vigorously, most antiseptic mouthwashes and anti-ulcer agents are ineffective. Simple mechanical cleansing by saline is the most effective traditional measure. A variety of new agents are effective. Granulocyte macrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF) act outwith the haemopoeitic system and can reduce mucositis, but the best schedule, dosage and method of administration is not known or which is the best growth factor to prevent this side-effect. A placebo-controlled randomized trial of antibiotic pastilles has shown a significant reduction in mucositis and weight loss during radiotherapy for head and neck cancer. Another method to reduce radiation effects in normal tissue is to stimulate cells to divide before radiotherapy by silver nitrate or interleukin 1. These methods may be particularly effective when given along with hyperfractionated radiation treatment such as CHART.
Symonds
R P
RP
Beatson Oncology Centre, Western Infirmary, Glasgow, UK.
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects*; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D007249:Inflammation; D009059:Mouth Diseases / Q000628:therapy*; D009061:Mouth Mucosa / Q000187:drug effects* / Q000528:radiation effects*; D010608:Pharyngeal Diseases / Q000628:therapy*; D010862:Pilocarpine / Q000627:therapeutic use; D011878:Radiotherapy / Q000009:adverse effects*
D000900:Anti-Bacterial Agents; D000893:Anti-Inflammatory Agents; D000897:Anti-Ulcer Agents; D000970:Antineoplastic Agents; D010862:Pilocarpine; D016179:Granulocyte Colony-Stimulating Factor; D016178:Granulocyte-Macrophage Colony-Stimulating Factor