Radiation mucositis: a new approach to prevention and treatment

Abstract

Mucosal reactions in patients receiving radiation treatment for head and neck cancer are regarded as unavoidable side-effects. The degree of mucositis experienced is determined by the treatment dose, radiation field size and fractionation schedules prescribed for individual patients. This article reviews a double-blind placebo-controlled trial of an antibiotic pastille which was aimed at reducing the more extreme effects of radiation mucositis. It identifies the role of oral care and hygiene, oral assessment and nursing support within a clinical trial setting. The results showed that the active pastille had a beneficial effect on the degree of mucositis experienced. Patients had a reduction in their weight loss in the active arm of the trial and the amount of yeast bacteria present in the oral cavity of those patients also diminished. It is worth noting that those patients in the placebo arm of the trial received both physical and psychological support from the nursing staff which may not have been available as frequently if they had not been in the trial.

Prophylaxis of Mucosal Toxicity by Oral Propantheline and Cryotherapy in Children with Malignancies Undergoing Myeloablative Chemo-Radiotherapy

“…Oral care by nursing stuff, which was effective for the prevention of oral mucositis (McIlroy 1996), was performed every day until the engraftment was achieved. Granulocyte-colony stimulating factor was administrated in all patients.…”

Prevention of radiation-induced mucositis

“…The patients treated with the AD film reportedly had better pain relief while eating with fewer cases of secondary bacterial or fungal infections. Similarly, preliminary results suggest that administration of an antibioticcontaining pastille (polymyxin, tobramycin, and amphotericin topical) may reduce incidence and severity of mucositis [23]. Other investigations have offered similar approaches [24].…”

Microbial Analysis of Obturators During Maxillofacial Prosthodontic Treatment Over an 8-Year Period

“…For patients requiring adjuvant chemotherapy and/or radiation therapy, the presence of microorganisms, especially gramnegative bacteria, and fungal species may be responsible for the development of indirect mucositis. 18,[67][68][69][70][71] Oral mucositis can result in pain and discomfort and an inability to tolerate food or fluids and may also limit a patient's ability to tolerate either chemotherapy or radiation therapy, resulting in doselimiting toxicity and drastically affecting cancer treatment and outcome. [70][71][72][73] Other oral effects of radiotherapy include alteration in taste and olfaction, [74][75][76][77][78][79] edema, 16,80,81 and salivary output.…”

“…For patients requiring adjuvant chemotherapy and/or radiation therapy, the presence of microorganisms, especially gram-negative bacteria, and fungal species may be responsible for the development of indirect mucositis. 18,67–71 Oral mucositis can result in pain and discomfort and an inability to tolerate food or fluids and may also limit a patient's ability to tolerate either chemotherapy or radiation therapy, resulting in dose-limiting toxicity and drastically affecting cancer treatment and outcome. 70–73 Other oral effects of radiotherapy include alteration in taste and olfaction, 74–79 edema, 16,80,81 and salivary output.…”