Oral mucositis induced by anticancer treatments: physiopathology and treatments

Abstract

Oral mucositis is a frequent and devastating side effect of anticancer treatments. It impairs the patient's quality of life and also can be life threatening because severe infections and delayed or incomplete anticancer treatments may result. This problem has been largely overlooked and underestimated in the past. However, recently studies have been performed to precisely identify the epidemiology, cost, consequences, physiopathology, and treatments of oral mucositis. Clinical guidelines have recently been published to help the daily management of this frequent complication. In addition, some innovative new drugs, including palifermin, have been developed to prevent and treat this major side effect of cancer treatments. In this paper we summarize the recent developments of oral mucositis management.

Prospective evaluation of clinical symptoms of chemotherapy‐induced oral mucositis in adult patients with acute leukemia: A preliminary study

“…The oral cavity is also affected as a result of local and/or systemic side effects of chemotherapy, whereby oral lesions are called chemotherapy-induced oral mucositis (CIOM; Chen et al, 2011). Oral mucositis is inflammation of the oral mucosa, occurring in 20-40% of patients receiving conventional chemotherapy (Lionel, Christophe, Marc, & Jean-Luc, 2006;Naidu et al, 2004;Scully, Sonis, & Diz, 2006). Chemotherapy causes inflammation and ulceration through tissue damage resulting from a sequence of chemical, metabolic, and biological events that occur in several stages (Lopez-Castano, Onate-Sanchez, Roldan-Chicano, & Cabrerizo-Merino, 2005).…”

“…Chemotherapy causes inflammation and ulceration through tissue damage resulting from a sequence of chemical, metabolic, and biological events that occur in several stages (Lopez-Castano, Onate-Sanchez, Roldan-Chicano, & Cabrerizo-Merino, 2005). Thus, CIOM usually begins within the first week after the initiation of treatment and peaks in the second week (Lionel et al, 2006;Naidu et al, 2004;Scully et al, 2006). Oral health plays an important role in the quality and life expectancy of an individual.…”

The Effect of Orally-Administered Zinc in the Prevention of Chemotherapy-Induced Oral Mucositis in Patients with Acute Myeloid Leukemia

“…Current treatments for oral mucositis in the clinics settings are local anesthetics, paliferin, glutamine, caphsol mouth rinse, amifostine and antimicrobial agents (4,5).…”

The efficacy of selenium in prevention of oral mucositis in patients undergoing hematopoietic SCT: a randomized clinical trial

“…Oral mucositis (OM), the consequence of injury to the epithelial cells of oral cavity, is a frequent complication of such an aggressive chemotherapy regimen, as patients receiving HDC have an approximately 76% risk of developing this complication. 1 OM usually manifests as diffuse, painful ulcerative lesions, which typically occurs within 2 weeks after the HDC regimen. Serious consequences of OM include pain, increased risk of infection, impaired nutritional intake and prolonged hospitalization.…”

“…3 On the other hand, production of pro-inflammatory cytokines including TNF-a, and the ILs (IL-1, IL2 and IL-6) seems to have a role in development of OM. 1,4 Hence, mechanistically, antioxidant and anti-inflammatory agents could be effective in prevention of this side effect. Several studies have shown that these agents have some benefits in prevention of OM induced by both chemotherapy and radiation therapy.…”