Prevention and treatment of oropharyngeal mucositis following cancer therapy: are there new approaches?
Oropharyngeal mucositis is an acute and distressing toxic effect of chemotherapy and head and neck irradiation. This oral sequela significantly impairs the daily functioning and quality of life of patients. The biological basis of mucositis is quite complex, involving sequential interaction of chemotherapeutic drugs or irradiation on mitosis of proliferating epithelium, a number of cytokines, and elements of oral microbial environment. Various interventions based on biological attenuation have been tested for mucositis. Such interventions have been reviewed elsewhere; however, most reviews focus on biomedical outcomes. Little attention has been paid to mucositis outcomes with oral morbidity or psychosocial aspects. The purpose of this article is to review the current research studies on the prevention and treatment of oropharyngeal mucositis following chemotherapy, radiotherapy, and bone marrow transplantation with an emphasis on biomedical, oral symptomatic, and functional impairment outcomes. In addition, further avenues of mucositis management, including psychotherapeutic intervention and integrated and stage-based treatment approaches are discussed.
Kwong
Karis K F
KK
Faculty of Medicine, Nethersole School of Nursing, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong. kariskwong@cuhk.edu.hk
D000208:Acute Disease; D000493:Allopurinol / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects; D001205:Ascorbic Acid / Q000627:therapeutic use; D017679:Cryotherapy; D016166:Free Radical Scavengers / Q000627:therapeutic use; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000627:therapeutic use; D006801:Humans; D053685:Laser Therapy; D009061:Mouth Mucosa; D009369:Neoplasms / Q000150:complications* / Q000628:therapy; D009859:Oncology Nursing / Q000379:methods; D009910:Oral Hygiene / Q000379:methods* / Q000451:nursing; D010612:Pharyngitis / Q000209:etiology / Q000628:therapy*; D011322:Primary Prevention / Q000379:methods*; D011878:Radiotherapy / Q000009:adverse effects; D012107:Research Design; D013280:Stomatitis / Q000209:etiology / Q000628:therapy*; D013392:Sucralfate / Q000627:therapeutic use; D016896:Treatment Outcome
D000890:Anti-Infective Agents; D000970:Antineoplastic Agents; D016166:Free Radical Scavengers; D013392:Sucralfate; D000493:Allopurinol; D016178:Granulocyte-Macrophage Colony-Stimulating Factor; D001205:Ascorbic Acid