Prevention and treatment of chemo- and radiotherapy-induced oral mucositis.
The administration of many chemo-radiotherapy regimens in patients with cancer may be complicated by toxicities that limit the clinicians' abilities to deliver the most effective doses of active agents. Oral mucositis is a major dose-limiting toxic effect and the most important cause of morbidity in patients undergoing chemo-radiotherapy for head and neck cancers, in patients undergoing bone marrow transplantation and those receiving certain chemotherapeutic agents for a variety of human malignancies. The intent of this paper is to review preventive strategies and treatment approaches for patients with established oral mucositis. Many agents of differing mechanisms of action have been used in the prevention and treatment of oral mucositis induced by anticancer therapies. Currently, no intervention is completely successful at preventing or treating oral mucositis. The several solutions, drugs and methods used and studied in the prophylaxis and therapy of chemotherapy or radiotherapy-induced oral mucositis reflects the need of new, more efficient tools in the management of this complication. Current studies and our increasing understanding of the etiology and pathogenesis of oral mucositis will lead to new approaches to the management and improved quality of life for these patients.
Demarosi
F
F
Dipartimento di Medicina Chirurgia e Odontoiatria, Unità di Patologia e Medicina Orale, Università degli Studi, Milan, Italy. federica.demarosi@unimi.it
Bez
C
C
Carrassi
A
A
D000042:Absorption; D000779:Anesthetics, Local / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000493:pharmacokinetics; D001685:Biological Factors / Q000627:therapeutic use; D016026:Bone Marrow Transplantation; D018678:Cholinergic Agents / Q000627:therapeutic use; D017679:Cryotherapy; D016207:Cytokines / Q000627:therapeutic use; D006801:Humans; D053685:Laser Therapy; D009061:Mouth Mucosa / Q000187:drug effects / Q000528:radiation effects; D009369:Neoplasms / Q000188:drug therapy / Q000532:radiotherapy; D009748:Nutrition Disorders / Q000209:etiology / Q000517:prevention & control; D009910:Oral Hygiene; D011832:Radiation Injuries / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D011878:Radiotherapy / Q000009:adverse effects*; D013280:Stomatitis / Q000139:chemically induced / Q000209:etiology / Q000517:prevention & control* / Q000628:therapy; D019172:Transplantation Conditioning / Q000009:adverse effects
D000779:Anesthetics, Local; D000890:Anti-Infective Agents; D000893:Anti-Inflammatory Agents; D000970:Antineoplastic Agents; D001685:Biological Factors; D018678:Cholinergic Agents; D016207:Cytokines