Oral microbiota versus oral mucositis during cancer treatment: a review

Abstract

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.

Waldeyer ring microbiome in relation to chemoradiation‐induced oral mucositis in patients with nasopharyngeal carcinoma

“…12,13,16,17 Although the translocation and dysbiosis of oral and gut microbiota have been implicated in the modification of OM risk during CCRT for head and neck cancers, [18][19][20] no consensus has been reached on specific genera associated with the protection, progression, and/or worsening of CCRT-induced OM. 21 Neither topical or systemic antibiotic interventions nor prophylactic antimicrobial strategies are effective for treating or attenuating CCRT-induced OM. 7,9,[22][23][24] Thus, the contribution of host microbiome, which may ameliorate or promote CCRT-induced OM throughout not just the oral cavity and gastrointestinal tract but also other organs, including the irradiated tumor and its surrounding connective stroma or organs, remains to be further elucidated.…”

“…Since the inception of the National Institute of Health Human Microbiome Project in 2007, increasing evidence has linked different sites of the host microbiome with the initiation, development, promotion, and amelioration of local radiation‐ and systemic chemotherapy‐induced toxicities, including oral and gastrointestinal mucositis, via the modulation of specific metabolic activities and broad inflammatory and immunological properties 12,13,16,17 . Although the translocation and dysbiosis of oral and gut microbiota have been implicated in the modification of OM risk during CCRT for head and neck cancers, 18–20 no consensus has been reached on specific genera associated with the protection, progression, and/or worsening of CCRT‐induced OM 21 . Neither topical or systemic antibiotic interventions nor prophylactic antimicrobial strategies are effective for treating or attenuating CCRT‐induced OM 7,9,22–24 .…”