The opinions or views expressed in this professional review are those of the authors and do not necessarily reflect the opinions or recommendations of the publisher or the companies that provided grants toward this process. This article is being published with the full knowledge and consent of the authors. This article may discuss pharmaceutical products and/or uses of products that have not been approved by the U.S. Food and Drug Administration or other regulatory authorities outside of the United States. For approved product information, consult the manufacturer's prescribing information or the applicable regulatory authority. Dosages, indications, and methods of use for compounds that are referred to in this article may be derived from the professional literature or other sources. In vitro and animal data may not correlate with clinical results and do not demonstrate clinical safety or efficacy in humans.We acknowledge the assistance of Lee Ann Chastain in the preparation of this article.
BackgroundEpidermal growth factor receptor inhibitors (EGFRI) produce various dermatologic side effects in the majority of patients, and guidelines are crucial for the prevention and treatment of these untoward events. The purpose of this panel was to develop evidence-based recommendations for EGFRI-associated dermatologic toxicities.MethodsA multinational, interdisciplinary panel of experts in supportive care in cancer reviewed pertinent studies using established criteria in order to develop first-generation recommendations for EGFRI-associated dermatologic toxicities.ResultsProphylactic and reactive recommendations for papulopustular (acneiform) rash, hair changes, radiation dermatitis, pruritus, mucositis, xerosis/fissures, and paronychia are presented, as well as general dermatologic recommendations when possible.ConclusionPrevention and management of EGFRI-related dermatologic toxicities is critical to maintain patients’ health-related quality of life and dose intensity of antineoplastic regimens. More rigorous investigation of these toxicities is warranted to improve preventive and treatment strategies.Electronic supplementary materialThe online version of this article (doi:10.1007/s00520-011-1197-6) contains supplementary material, which is available to authorized users.
Patients undergoing radiation therapy for the head and neck are susceptible to a significant and often abrupt deterioration in their oral health. The oral morbidities of radiation therapy include but are not limited to an increased susceptibility to dental caries and periodontal disease. They also include profound and often permanent functional and sensory changes involving the oral soft tissue. These changes range from oral mucositis experienced during and soon after treatment, mucosal opportunistic infections, neurosensory disorders, and tissue fibrosis. Many of the oral soft tissue changes following radiation therapy are difficult challenges to the patients and their caregivers and require life‐long strategies to alleviate their deleterious effect on basic life functions and on the quality of life. We discuss the presentation, prognosis, and management strategies of the dental structure and oral soft tissue morbidities resulting from the administration of therapeutic radiation in head and neck patient. A case for a collaborative and integrated multidisciplinary approach to the management of these patients is made, with specific recommendation to include knowledgeable and experienced oral health care professionals in the treatment team.
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