Distinct shifts in the oral microbiota are associated with the progression and aggravation of mucositis during radiotherapy

Hou, Jin; Zheng, Huimin; Li, Pan; Liu, Haiyue; Zhou, Hongwei; Xiao-jun, Yang

doi:10.1016/j.radonc.2018.04.023

Cited by 82 publications

(90 citation statements)

References 41 publications

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“…Although recent antibiotic use was not significant when incorporated into a multivariable analysis (RR 1.88 [95% CI: 0.77‐4.63]; P = .168), such an association may imply a potential role for the microbiota in OM development. Preliminary results from patients with head and neck malignancies treated with radiation indicate that the oral microbiota shift in patients who develop mucositis . Whether this change is correlative or causative is an area of active investigation.…”

Section: Discussionmentioning

confidence: 99%

“…30 In a randomized, phase III study of patients undergoing autologous HSCT, the incidence of severe OM was reduced from 98% to 63% (P = .001). 31 33,34 Whether this change is correlative or causative is an area of active investigation. There is strong biological rationale to postulate that the microbiome affects mucositis development: Commensal bacteria facilitate metabolic, and immune responses 35,36 and the pathophysiology of OM involve oxidative stress, the release of inflammatory cytokines, and activation of the innate immune system.…”

Section: Discussionmentioning

confidence: 99%

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Risk factors and implications of oral mucositis in recipients of allogeneic hematopoietic stem cell transplantation

Shouval

Kouniavski

Fein

et al. 2019

European J of Haematology

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Background Oral mucositis (OM) is a common toxicity of stem cell transplantation (SCT). We sought to evaluate OM burden, risk factors, and implications in a cohort of allogeneic‐SCT recipients. Methods This was a single‐center study including 115 adult allogeneic‐SCT transplanted between 2016 and 2018 for various hematological conditions. Conditioning intensity was categorized as myeloablative (MAC, 39%), reduced intensity (34%), or reduced toxicity (RTC, 27%) in patients conditioned with fludarabine‐treosulfan. OM was prospectively graded using the Common Terminology Criteria for Adverse Events (v.4.0) system. Results Moderate‐to‐severe OM (grade 2‐4) was experienced by 60% of patients. In a univariate analysis, younger age (P = .023), lower body mass index (P = .01), recent smoking (P = .08), recent antibiotics exposure (P = .018), MAC (P < .001), and methotrexate (P = .009) were associated with moderate‐to‐severe OM. In a multivariable logistic regression model, conditioning and graft‐versus‐host disease prophylaxis remained significant. OM risk was lowest with RTC (RTC vs MAC: odd ratio [OR] 0.05, P < .001), and recent antibiotic exposure trended toward increased risk (OR 1.88, P = .168). OM was associated with longer hospitalization, delayed neutrophil engraftment, and gastrointestinal‐related infections. Conclusion Oral mucositis remains a leading SCT complication. Treosulfan‐based conditioning has low mucosal toxicity and is appealing given previous reports on its high efficacy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Risk factors and implications of oral mucositis in recipients of allogeneic hematopoietic stem cell transplantation

Shouval

Kouniavski

Fein

et al. 2019

European J of Haematology

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“…3,14 Three studies are from Asian countries, among them India, 15 China and Japan. 1,2,16 In addition, one study is from the American continent, more specifically Brazil. 5 The microbial analysis of OM articles…”

Section: Resultsmentioning

confidence: 99%

“…The studies selected had used different methodologies, both those of conventional culture with the microorganisms being analyzed by cultures in selective media, 3,5,[12][13][14][15] as microbial analysis by 16S sequencing. 1,2,11 Six studies have analyzed bacteria and two studies analyzed mainly fungi. [1][2][3][11][12][13][14][15] One study analyzed both microbiological groups.…”

Section: Resultsmentioning

confidence: 99%

“…Therefore, the side effects to these therapies are recurrent and worrying to the patient health, being oral mucositis (OM) the most common side effect to the antitumor treatment of the head and neck region. 1,2 The establishment of OM is related to a cascade of impactful events for the patient and the community, raising the costs of cancer treatment and the mortality. 1,3 Its development ranges from increasing number of proinflammatory cytokine receptors to damage of affected tissues by cell apoptosis and necrosis.…”

Section: Introductionmentioning

confidence: 99%

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Oral microbiota versus oral mucositis during cancer treatment: a review

Ribeiro¹,

Ferigatto²,

César³

et al. 2020

hu rev

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Introduction: Oral microbiota has been implicated on oral mucositis (OM) that occurs during cancer therapy, however without consensus. Objective: This study, aimed to establish, through a review, the association between oral microbiota and OM at head and neck cancer therapy (HNCT). Material and methods: The search of PubMed was performed considering 2008-2018 period, and the descriptors “oral mucositis” and “oral microbiota” in subheadings etiology and microbiology into the Medical Subject Heading (MeSH) “Head and Neck Neoplasms”. The conducting question was “Is there an oral dysbiosis during HNCT associated with OM?”. Results: 22 articles were selected under two steps of data extraction: articles that evaluated de oral microbiota during HNCT (n=13), and articles that also focused in OM (n=9). Conclusion: The evidence presented in the literature suggests associations of oral microbiota dysbiosis with the progression and worsening of radiation-induced OM. However, to define a microbial core for the disease, future standardized studies are required.

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Scheduling radiotherapy for patients with nasopharyngeal carcinoma in the corresponding time window can reduce radiation‐induced oral mucositis: A randomized, prospective study

Liao

et al. 2023

Cancer Medicine

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BackgroundTo explore a new method to reduce radiation‐induced oral mucositis by scheduling radiotherapy for patients with nasopharyngeal carcinoma (NPC) in the corresponding time window of the cycle of oral mucosal cells.MethodsEighty‐two NPC patients were randomly divided into a day group (n = 41) and a night group (n = 41). The radiotherapy was scheduled at noon (11:30–15:30) for the day group, while at night (19:00–23:00) for the night group. Oral mucositis and oral pain were recorded in both groups after each radiotherapy fraction. The short‐term efficacy of primary tumor regression, weight loss, and bone marrow suppression was recorded.ResultsThe incidence of Grade 2 oral mucositis was 87.8% (36/41) and 63.4% (26/41) in the night group and day group, respectively (p = 0.010). The incidence of Grade 3 oral mucositis was 65.9% (27/41) and 22.0% (9/41) in the night group and day group, respectively (p < 0.001). The mean number of radiotherapy for patients to develop Grade 2 oral mucositis was 15.67 ± 5.05 and 20.92 ± 6.21 in the night group and day group, respectively. The incidence of Grade 2 oral pain was 48.8% (20/41) and 22.0% (9/41) in the night group and day group, respectively (p = 0.011). There were no significant differences in tumor regression, weight loss, and bone marrow suppression between the two groups.ConclusionBy scheduling radiotherapy based on the corresponding time window of the cycle of oral mucosal cells, the severity of oral mucositis in NPC patients was reduced.

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Distinct shifts in the oral microbiota are associated with the progression and aggravation of mucositis during radiotherapy

Cited by 82 publications

References 41 publications

Risk factors and implications of oral mucositis in recipients of allogeneic hematopoietic stem cell transplantation

Risk factors and implications of oral mucositis in recipients of allogeneic hematopoietic stem cell transplantation

Oral microbiota versus oral mucositis during cancer treatment: a review

Scheduling radiotherapy for patients with nasopharyngeal carcinoma in the corresponding time window can reduce radiation‐induced oral mucositis: A randomized, prospective study

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