Skip to main content
Top
Published in: Current Oncology Reports 11/2015

01-11-2015 | Palliative Medicine (A Jatoi, Section Editor)

Management of Mucositis During Chemotherapy: From Pathophysiology to Pragmatic Therapeutics

Authors: Ysabella Z. A. Van Sebille, Romany Stansborough, Hannah R. Wardill, Emma Bateman, Rachel J. Gibson, Dorothy M. Keefe

Published in: Current Oncology Reports | Issue 11/2015

Login to get access

Abstract

Chemotherapy-induced mucositis is a common condition caused by the breakdown of the mucosal barrier. Symptoms can include pain, vomiting and diarrhoea, which can often necessitate chemotherapy treatment breaks or dose reductions, thus compromising survival outcomes. Despite the significant impact of mucositis, there are currently limited clinically effective pharmacological therapies for the pathology. New emerging areas of research have been proposed to play key roles in the development of mucositis, providing rationale for potential new therapeutics for the prevention, treatment or management of chemotherapy-induced mucositis. This review aims to address these new areas of research and to comment on the therapeutics arising from them.
Literature
1.
go back to reference Stein A, Voigt W, Jordan K. Chemotherapy-induced diarrhea: pathophysiology, frequency and guideline-based management. Ther Adv Med Oncol. 2010;2(1):51–63.PubMedCentralCrossRefPubMed Stein A, Voigt W, Jordan K. Chemotherapy-induced diarrhea: pathophysiology, frequency and guideline-based management. Ther Adv Med Oncol. 2010;2(1):51–63.PubMedCentralCrossRefPubMed
2.
go back to reference Sonis ST. Oral mucositis in cancer therapy. J Support Oncol. 2004;2(6 Suppl 3):3–8.PubMed Sonis ST. Oral mucositis in cancer therapy. J Support Oncol. 2004;2(6 Suppl 3):3–8.PubMed
3.
go back to reference Sonis ST. A biological approach to mucositis. J Support Oncol. 2004;2(1):21-32. discussion 35-6. Sonis ST. A biological approach to mucositis. J Support Oncol. 2004;2(1):21-32. discussion 35-6.
4.••
go back to reference Sonis ST. The pathobiology of mucositis. Nat Rev Cancer. 2004;4(4):277–84. This paper describes in detail the currently accepted 5-phase pathophysiological model of mucositis.CrossRefPubMed Sonis ST. The pathobiology of mucositis. Nat Rev Cancer. 2004;4(4):277–84. This paper describes in detail the currently accepted 5-phase pathophysiological model of mucositis.CrossRefPubMed
5.
go back to reference Cirillo M et al. Clinician versus nurse symptom reporting using the National Cancer Institute-Common Terminology Criteria for Adverse Events during chemotherapy: results of a comparison based on patient’s self-reported questionnaire. Ann Oncol : Off J Eur Soc Med Oncol / ESMO. 2009;20(12):1929–35.CrossRef Cirillo M et al. Clinician versus nurse symptom reporting using the National Cancer Institute-Common Terminology Criteria for Adverse Events during chemotherapy: results of a comparison based on patient’s self-reported questionnaire. Ann Oncol : Off J Eur Soc Med Oncol / ESMO. 2009;20(12):1929–35.CrossRef
6.
go back to reference Sonis S. et al. Unanticipated frequency and consequences of regimen-related diarrhea in patients being treated with radiation or chemoradiation regimens for cancers of the head and neck or lung. Support Care Cancer : Off J Multinatl Assoc Support Care Cancer. 2014. Sonis S. et al. Unanticipated frequency and consequences of regimen-related diarrhea in patients being treated with radiation or chemoradiation regimens for cancers of the head and neck or lung. Support Care Cancer : Off J Multinatl Assoc Support Care Cancer. 2014.
7.
go back to reference Foote M. The importance of planned dose of chemotherapy on time: do we need to change our clinical practice? Oncologist. 1998;3(5):365–8.PubMed Foote M. The importance of planned dose of chemotherapy on time: do we need to change our clinical practice? Oncologist. 1998;3(5):365–8.PubMed
8.
go back to reference Di Fiore F, Van Cutsem E. Acute and long-term gastrointestinal consequences of chemotherapy. Best Pract Res Clin Gastroenterol. 2009;23(1):113–24.CrossRefPubMed Di Fiore F, Van Cutsem E. Acute and long-term gastrointestinal consequences of chemotherapy. Best Pract Res Clin Gastroenterol. 2009;23(1):113–24.CrossRefPubMed
9.
go back to reference Gibson RJ, Stringer AM. Chemotherapy-induced diarrhoea. Curr Opin Support Palliat Care. 2009;3(1):31–5.CrossRefPubMed Gibson RJ, Stringer AM. Chemotherapy-induced diarrhoea. Curr Opin Support Palliat Care. 2009;3(1):31–5.CrossRefPubMed
10.
go back to reference Benson 3rd AB et al. Recommended guidelines for the treatment of cancer treatment-induced diarrhea. J Clin Oncol Off J Am Soc Clin Oncol. 2004;22(14):2918–26.CrossRef Benson 3rd AB et al. Recommended guidelines for the treatment of cancer treatment-induced diarrhea. J Clin Oncol Off J Am Soc Clin Oncol. 2004;22(14):2918–26.CrossRef
11.
go back to reference Carlotto A et al. The economic burden of toxicities associated with cancer treatment: review of the literature and analysis of nausea and vomiting, diarrhoea, oral mucositis and fatigue. PharmacoEconomics. 2013;31(9):753–66.CrossRefPubMed Carlotto A et al. The economic burden of toxicities associated with cancer treatment: review of the literature and analysis of nausea and vomiting, diarrhoea, oral mucositis and fatigue. PharmacoEconomics. 2013;31(9):753–66.CrossRefPubMed
12.
go back to reference Elting LS et al. The burdens of cancer therapy. Clinical and economic outcomes of chemotherapy-induced mucositis. Cancer. 2003;98(7):1531–9.CrossRefPubMed Elting LS et al. The burdens of cancer therapy. Clinical and economic outcomes of chemotherapy-induced mucositis. Cancer. 2003;98(7):1531–9.CrossRefPubMed
13.••
go back to reference Lalla RV et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer. 2014;120(10):1453–61. This paper reviewed the available literature and produced evidence based guidelines for the management of patients with mucositis, impacting clinical practice.PubMedCentralCrossRefPubMed Lalla RV et al. MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer. 2014;120(10):1453–61. This paper reviewed the available literature and produced evidence based guidelines for the management of patients with mucositis, impacting clinical practice.PubMedCentralCrossRefPubMed
14.
go back to reference Keefe DM. Gastrointestinal mucositis: a new biological model. Support Care Cancer. 2004;12(1):6–9.CrossRefPubMed Keefe DM. Gastrointestinal mucositis: a new biological model. Support Care Cancer. 2004;12(1):6–9.CrossRefPubMed
15.
go back to reference Gibson RJ et al. Irinotecan causes severe small intestinal damage, as well as colonic damage, in the rat with implanted breast cancer. J Gastroenterol Hepatol. 2003;18(9):1095–100.CrossRefPubMed Gibson RJ et al. Irinotecan causes severe small intestinal damage, as well as colonic damage, in the rat with implanted breast cancer. J Gastroenterol Hepatol. 2003;18(9):1095–100.CrossRefPubMed
16.•
go back to reference Al-Dasooqi N et al. Emerging evidence on the pathobiology of mucositis. Support Care Cancer. 2013;21(11):3233–41. This paper provided recent and emerging research directions, to drive new clinical research.CrossRefPubMed Al-Dasooqi N et al. Emerging evidence on the pathobiology of mucositis. Support Care Cancer. 2013;21(11):3233–41. This paper provided recent and emerging research directions, to drive new clinical research.CrossRefPubMed
17.
go back to reference Lalla RV, Ashbury FD. The MASCC/ISOO Mucositis Guidelines: dissemination and clinical impact. Support Care Cancer : Off J Multinatl Assoc Support Care Cancer. 2013;21(11):3161–3.CrossRef Lalla RV, Ashbury FD. The MASCC/ISOO Mucositis Guidelines: dissemination and clinical impact. Support Care Cancer : Off J Multinatl Assoc Support Care Cancer. 2013;21(11):3161–3.CrossRef
18.
go back to reference Davila M, Bresalier RS. Gastrointestinal complications of oncologic therapy. Nat Clin Pract Gastroenterol Hepatol. 2008;5(12):682–96.CrossRefPubMed Davila M, Bresalier RS. Gastrointestinal complications of oncologic therapy. Nat Clin Pract Gastroenterol Hepatol. 2008;5(12):682–96.CrossRefPubMed
19.
go back to reference Mehdipour M et al. A comparison between zinc sulfate and chlorhexidine gluconate mouthwashes in the prevention of chemotherapy-induced oral mucositis. Daru. 2011;19(1):71–3.PubMedCentralPubMed Mehdipour M et al. A comparison between zinc sulfate and chlorhexidine gluconate mouthwashes in the prevention of chemotherapy-induced oral mucositis. Daru. 2011;19(1):71–3.PubMedCentralPubMed
20.
go back to reference Arbabi-kalati F et al. Evaluation of the efficacy of zinc sulfate in the prevention of chemotherapy-induced mucositis: a double-blind randomized clinical trial. Arch Iran Med. 2012;15(7):413–7.PubMed Arbabi-kalati F et al. Evaluation of the efficacy of zinc sulfate in the prevention of chemotherapy-induced mucositis: a double-blind randomized clinical trial. Arch Iran Med. 2012;15(7):413–7.PubMed
21.
go back to reference Mansouri A et al. The effect of zinc sulfate in the prevention of high-dose chemotherapy-induced mucositis: a double-blind, randomized, placebo-controlled study. Hematol Oncol. 2012;30(1):22–6.CrossRefPubMed Mansouri A et al. The effect of zinc sulfate in the prevention of high-dose chemotherapy-induced mucositis: a double-blind, randomized, placebo-controlled study. Hematol Oncol. 2012;30(1):22–6.CrossRefPubMed
22.•
go back to reference Raber-Durlacher JE et al. Systematic review of cytokines and growth factors for the management of oral mucositis in cancer patients. Support Care Cancer. 2013;21(1):343–55. This paper provided evidence based guidelines for the use of growth factors, including palifermin, in patients with mucositis.CrossRefPubMed Raber-Durlacher JE et al. Systematic review of cytokines and growth factors for the management of oral mucositis in cancer patients. Support Care Cancer. 2013;21(1):343–55. This paper provided evidence based guidelines for the use of growth factors, including palifermin, in patients with mucositis.CrossRefPubMed
23.
go back to reference Goldberg JD et al. Palifermin is efficacious in recipients of TBI-based but not chemotherapy-based allogeneic hematopoietic stem cell transplants. Bone Marrow Transplant. 2013;48(1):99–104.PubMedCentralCrossRefPubMed Goldberg JD et al. Palifermin is efficacious in recipients of TBI-based but not chemotherapy-based allogeneic hematopoietic stem cell transplants. Bone Marrow Transplant. 2013;48(1):99–104.PubMedCentralCrossRefPubMed
24.
go back to reference Blijlevens N et al. In a high-dose melphalan setting, palifermin compared with placebo had no effect on oral mucositis or related patient’s burden. Bone Marrow Transplant. 2013;48(7):966–71.CrossRefPubMed Blijlevens N et al. In a high-dose melphalan setting, palifermin compared with placebo had no effect on oral mucositis or related patient’s burden. Bone Marrow Transplant. 2013;48(7):966–71.CrossRefPubMed
25.
go back to reference Vadhan-Raj S et al. Single-dose palifermin prevents severe oral mucositis during multicycle chemotherapy in patients with cancer: a randomized trial. Ann Intern Med. 2010;153(6):358–67.CrossRefPubMed Vadhan-Raj S et al. Single-dose palifermin prevents severe oral mucositis during multicycle chemotherapy in patients with cancer: a randomized trial. Ann Intern Med. 2010;153(6):358–67.CrossRefPubMed
26.
go back to reference Bouma G, Strober W. The immunological and genetic basis of inflammatory bowel disease. Nat Rev Immunol. 2003;3(7):521–33.CrossRefPubMed Bouma G, Strober W. The immunological and genetic basis of inflammatory bowel disease. Nat Rev Immunol. 2003;3(7):521–33.CrossRefPubMed
27.
go back to reference Shanahan F. Inflammatory bowel disease: immunodiagnostics, immunotherapeutics, and ecotherapeutics. Gastroenterology. 2001;120(3):622–35.CrossRefPubMed Shanahan F. Inflammatory bowel disease: immunodiagnostics, immunotherapeutics, and ecotherapeutics. Gastroenterology. 2001;120(3):622–35.CrossRefPubMed
28.
go back to reference Holmberg J et al. EphB receptors coordinate migration and proliferation in the intestinal stem cell niche. Cell. 2006;125(6):1151–63.CrossRefPubMed Holmberg J et al. EphB receptors coordinate migration and proliferation in the intestinal stem cell niche. Cell. 2006;125(6):1151–63.CrossRefPubMed
29.
go back to reference Bhanja P et al. Protective role of R-spondin1, an intestinal stem cell growth factor, against radiation-induced gastrointestinal syndrome in mice. PLoS One. 2009;4(11), e8014.PubMedCentralCrossRefPubMed Bhanja P et al. Protective role of R-spondin1, an intestinal stem cell growth factor, against radiation-induced gastrointestinal syndrome in mice. PLoS One. 2009;4(11), e8014.PubMedCentralCrossRefPubMed
30.
go back to reference Zhao J et al. R-Spondin1 protects mice from chemotherapy or radiation-induced oral mucositis through the canonical Wnt/beta-catenin pathway. Proc Natl Acad Sci U S A. 2009;106(7):2331–6.PubMedCentralCrossRefPubMed Zhao J et al. R-Spondin1 protects mice from chemotherapy or radiation-induced oral mucositis through the canonical Wnt/beta-catenin pathway. Proc Natl Acad Sci U S A. 2009;106(7):2331–6.PubMedCentralCrossRefPubMed
32.
go back to reference Kim KA et al. Mitogenic influence of human R-spondin1 on the intestinal epithelium. Science. 2005;309(5738):1256–9.CrossRefPubMed Kim KA et al. Mitogenic influence of human R-spondin1 on the intestinal epithelium. Science. 2005;309(5738):1256–9.CrossRefPubMed
33.•
go back to reference Zhou WJ, Zhou WJ, et al. Induction of intestinal stem cells by R-spondin 1 and Slit2 augments chemoradioprotection. Nature. 2013;501(7465):107–11. This paper provided evidence of the protective role of R-spondin1 in chemoradiation-induced mucositis.CrossRefPubMed Zhou WJ, Zhou WJ, et al. Induction of intestinal stem cells by R-spondin 1 and Slit2 augments chemoradioprotection. Nature. 2013;501(7465):107–11. This paper provided evidence of the protective role of R-spondin1 in chemoradiation-induced mucositis.CrossRefPubMed
34.
go back to reference Kazemian A et al. Benzydamine for prophylaxis of radiation-induced oral mucositis in head and neck cancers: a double-blind placebo-controlled randomized clinical trial. Eur J Cancer Care (Engl). 2009;18(2):174–8.CrossRef Kazemian A et al. Benzydamine for prophylaxis of radiation-induced oral mucositis in head and neck cancers: a double-blind placebo-controlled randomized clinical trial. Eur J Cancer Care (Engl). 2009;18(2):174–8.CrossRef
35.
go back to reference Logan RM et al. Characterisation of mucosal changes in the alimentary tract following administration of irinotecan: implications for the pathobiology of mucositis. Cancer Chemother Pharmacol. 2008;62(1):33–41.CrossRefPubMed Logan RM et al. Characterisation of mucosal changes in the alimentary tract following administration of irinotecan: implications for the pathobiology of mucositis. Cancer Chemother Pharmacol. 2008;62(1):33–41.CrossRefPubMed
36.
go back to reference Keefe DM et al. Updated clinical practice guidelines for the prevention and treatment of mucositis. Cancer. 2007;109(5):820–31.CrossRefPubMed Keefe DM et al. Updated clinical practice guidelines for the prevention and treatment of mucositis. Cancer. 2007;109(5):820–31.CrossRefPubMed
37.•
go back to reference Sheibani KM et al. Efficacy of benzydamine oral rinse in prevention and management of radiation-induced oral mucositis: a double-blind placebo-controlled randomized clinical trial. Asia Pac J Clin Oncol. 2015;11(1):22–7. This paper provided evidence on the efficacy of benzydamine HCl in the prevention of radiation induced oral mucositis.CrossRefPubMed Sheibani KM et al. Efficacy of benzydamine oral rinse in prevention and management of radiation-induced oral mucositis: a double-blind placebo-controlled randomized clinical trial. Asia Pac J Clin Oncol. 2015;11(1):22–7. This paper provided evidence on the efficacy of benzydamine HCl in the prevention of radiation induced oral mucositis.CrossRefPubMed
38.
go back to reference Epstein JB et al. Benzydamine HCl for prophylaxis of radiation-induced oral mucositis: results from a multicenter, randomized, double-blind, placebo-controlled clinical trial. Cancer. 2001;92(4):875–85.CrossRefPubMed Epstein JB et al. Benzydamine HCl for prophylaxis of radiation-induced oral mucositis: results from a multicenter, randomized, double-blind, placebo-controlled clinical trial. Cancer. 2001;92(4):875–85.CrossRefPubMed
39.
go back to reference Osterlund P et al. Lactobacillus supplementation for diarrhoea related to chemotherapy of colorectal cancer: a randomised study. Br J Cancer. 2007;97(8):1028–34.PubMedCentralCrossRefPubMed Osterlund P et al. Lactobacillus supplementation for diarrhoea related to chemotherapy of colorectal cancer: a randomised study. Br J Cancer. 2007;97(8):1028–34.PubMedCentralCrossRefPubMed
40.
go back to reference Abd El-Atti S et al. Use of probiotics in the management of chemotherapy-induced diarrhea: a case study. JPEN J Parenter Enteral Nutr. 2009;33(5):569–70.CrossRefPubMed Abd El-Atti S et al. Use of probiotics in the management of chemotherapy-induced diarrhea: a case study. JPEN J Parenter Enteral Nutr. 2009;33(5):569–70.CrossRefPubMed
41.
go back to reference Mego M et al. Prevention of irinotecan induced diarrhea by probiotics: a randomized double blind, placebo controlled pilot study. Complement Ther Med. 2015;23(3):356–62.CrossRefPubMed Mego M et al. Prevention of irinotecan induced diarrhea by probiotics: a randomized double blind, placebo controlled pilot study. Complement Ther Med. 2015;23(3):356–62.CrossRefPubMed
44.
go back to reference Stringer AM et al. Irinotecan-induced mucositis manifesting as diarrhoea corresponds with an amended intestinal flora and mucin profile. Int J Exp Pathol. 2009;90(5):489–99.PubMedCentralCrossRefPubMed Stringer AM et al. Irinotecan-induced mucositis manifesting as diarrhoea corresponds with an amended intestinal flora and mucin profile. Int J Exp Pathol. 2009;90(5):489–99.PubMedCentralCrossRefPubMed
45.
go back to reference Stringer AM et al. Chemotherapy-induced diarrhea is associated with changes in the luminal environment in the DA rat. Exp Biol Med (Maywood). 2007;232(1):96–106. Stringer AM et al. Chemotherapy-induced diarrhea is associated with changes in the luminal environment in the DA rat. Exp Biol Med (Maywood). 2007;232(1):96–106.
46.
go back to reference Bowen JM et al. VSL#3 probiotic treatment reduces chemotherapy-induced diarrhea and weight loss. Cancer Biol Ther. 2007;6(9):1449–54.CrossRefPubMed Bowen JM et al. VSL#3 probiotic treatment reduces chemotherapy-induced diarrhea and weight loss. Cancer Biol Ther. 2007;6(9):1449–54.CrossRefPubMed
47.
go back to reference Prisciandaro LD et al. Probiotic factors partially improve parameters of 5-fluorouracil-induced intestinal mucositis in rats. Cancer Biol Ther. 2011;11(7):671–7.CrossRefPubMed Prisciandaro LD et al. Probiotic factors partially improve parameters of 5-fluorouracil-induced intestinal mucositis in rats. Cancer Biol Ther. 2011;11(7):671–7.CrossRefPubMed
48.
go back to reference Ciorba MA et al. Lactobacillus probiotic protects intestinal epithelium from radiation injury in a TLR-2/cyclo-oxygenase-2-dependent manner. Gut. 2012;61(6):829–38.PubMedCentralCrossRefPubMed Ciorba MA et al. Lactobacillus probiotic protects intestinal epithelium from radiation injury in a TLR-2/cyclo-oxygenase-2-dependent manner. Gut. 2012;61(6):829–38.PubMedCentralCrossRefPubMed
49.
go back to reference Wardill HR, Bowen JM, Gibson RJ. New pharmacotherapy options for chemotherapy-induced alimentary mucositis. Expert Opin Biol Ther. 2014;14(3):347–54.CrossRefPubMed Wardill HR, Bowen JM, Gibson RJ. New pharmacotherapy options for chemotherapy-induced alimentary mucositis. Expert Opin Biol Ther. 2014;14(3):347–54.CrossRefPubMed
50.
go back to reference Bossi P et al. Prevention and treatment of oral mucositis in patients with head and neck cancer treated with (chemo) radiation: report of an Italian survey. Support Care Cancer. 2014;22(7):1889–96.PubMed Bossi P et al. Prevention and treatment of oral mucositis in patients with head and neck cancer treated with (chemo) radiation: report of an Italian survey. Support Care Cancer. 2014;22(7):1889–96.PubMed
51.
go back to reference Sorensen JB et al. Double-blind, placebo-controlled, randomized study of chlorhexidine prophylaxis for 5-fluorouracil-based chemotherapy-induced oral mucositis with nonblinded randomized comparison to oral cooling (cryotherapy) in gastrointestinal malignancies. Cancer. 2008;112(7):1600–6.CrossRefPubMed Sorensen JB et al. Double-blind, placebo-controlled, randomized study of chlorhexidine prophylaxis for 5-fluorouracil-based chemotherapy-induced oral mucositis with nonblinded randomized comparison to oral cooling (cryotherapy) in gastrointestinal malignancies. Cancer. 2008;112(7):1600–6.CrossRefPubMed
52.
go back to reference Orvain C et al. Miconazole mucoadhesive buccal tablet in high-dose therapy with autologous stem cell transplantation (HDT/ASCT)-induced mucositis. Support Care Cancer. 2015;23(2):359–64.CrossRefPubMed Orvain C et al. Miconazole mucoadhesive buccal tablet in high-dose therapy with autologous stem cell transplantation (HDT/ASCT)-induced mucositis. Support Care Cancer. 2015;23(2):359–64.CrossRefPubMed
53.
go back to reference Lin JX et al. A comparison of dioctahedral smectite and iodine glycerin cream with topical mouth rinse in treatment of chemotherapy induced oral mucositis: a pilot study. Eur J Oncol Nurs. 2015;19(2):136–41.CrossRefPubMed Lin JX et al. A comparison of dioctahedral smectite and iodine glycerin cream with topical mouth rinse in treatment of chemotherapy induced oral mucositis: a pilot study. Eur J Oncol Nurs. 2015;19(2):136–41.CrossRefPubMed
54.
go back to reference Rao NG et al. Effect of prophylactic fluconazole on oral mucositis and candidiasis during radiation therapy for head-and-neck cancer. Pract Radiat Oncol. 2013;3(3):229–33.CrossRefPubMed Rao NG et al. Effect of prophylactic fluconazole on oral mucositis and candidiasis during radiation therapy for head-and-neck cancer. Pract Radiat Oncol. 2013;3(3):229–33.CrossRefPubMed
55.
go back to reference Bensadoun RJ et al. Comparison of the efficacy and safety of miconazole 50-mg mucoadhesive buccal tablets with miconazole 500-mg gel in the treatment of oropharyngeal candidiasis: a prospective, randomized, single-blind, multicenter, comparative, phase III trial in patients treated with radiotherapy for head and neck cancer. Cancer. 2008;112(1):204–11.CrossRefPubMed Bensadoun RJ et al. Comparison of the efficacy and safety of miconazole 50-mg mucoadhesive buccal tablets with miconazole 500-mg gel in the treatment of oropharyngeal candidiasis: a prospective, randomized, single-blind, multicenter, comparative, phase III trial in patients treated with radiotherapy for head and neck cancer. Cancer. 2008;112(1):204–11.CrossRefPubMed
56.
go back to reference Moslehi A et al. N-acetyl cysteine for prevention of oral mucositis in hematopoietic SCT: a double-blind, randomized, placebo-controlled trial. Bone Marrow Transplant. 2014;49(6):818–23.CrossRefPubMed Moslehi A et al. N-acetyl cysteine for prevention of oral mucositis in hematopoietic SCT: a double-blind, randomized, placebo-controlled trial. Bone Marrow Transplant. 2014;49(6):818–23.CrossRefPubMed
57.
go back to reference Tsujimoto T et al. L-glutamine decreases the severity of mucositis induced by chemoradiotherapy in patients with locally advanced head and neck cancer: a double-blind, randomized, placebo-controlled trial. Oncol Rep. 2015;33(1):33–9.PubMedCentralPubMed Tsujimoto T et al. L-glutamine decreases the severity of mucositis induced by chemoradiotherapy in patients with locally advanced head and neck cancer: a double-blind, randomized, placebo-controlled trial. Oncol Rep. 2015;33(1):33–9.PubMedCentralPubMed
58.
go back to reference Chattopadhyay S et al. Role of oral glutamine in alleviation and prevention of radiation-induced oral mucositis: a prospective randomized study. South Asian J Cancer. 2014;3(1):8–12.PubMedCentralCrossRefPubMed Chattopadhyay S et al. Role of oral glutamine in alleviation and prevention of radiation-induced oral mucositis: a prospective randomized study. South Asian J Cancer. 2014;3(1):8–12.PubMedCentralCrossRefPubMed
59.
go back to reference Gibson RJ et al. Systematic review of agents for the management of gastrointestinal mucositis in cancer patients. Support Care Cancer. 2013;21(1):313–26.CrossRefPubMed Gibson RJ et al. Systematic review of agents for the management of gastrointestinal mucositis in cancer patients. Support Care Cancer. 2013;21(1):313–26.CrossRefPubMed
60.
go back to reference Blijlevens NM et al. A randomised, double-blinded, placebo-controlled, pilot study of parenteral glutamine for allogeneic stem cell transplant patients. Support Care Cancer. 2005;13(10):790–6.CrossRefPubMed Blijlevens NM et al. A randomised, double-blinded, placebo-controlled, pilot study of parenteral glutamine for allogeneic stem cell transplant patients. Support Care Cancer. 2005;13(10):790–6.CrossRefPubMed
61.
go back to reference Sornsuvit C et al. Pilot Study: effects of parenteral glutamine dipeptide supplementation on neutrophil functions and prevention of chemotherapy-induced side-effects in acute myeloid leukaemia patients. J Int Med Res. 2008;36(6):1383–91.CrossRefPubMed Sornsuvit C et al. Pilot Study: effects of parenteral glutamine dipeptide supplementation on neutrophil functions and prevention of chemotherapy-induced side-effects in acute myeloid leukaemia patients. J Int Med Res. 2008;36(6):1383–91.CrossRefPubMed
62.
go back to reference Li Y et al. Oral glutamine ameliorates chemotherapy-induced changes of intestinal permeability and does not interfere with the antitumor effect of chemotherapy in patients with breast cancer: a prospective randomized trial. Tumori. 2006;92(5):396–401.PubMed Li Y et al. Oral glutamine ameliorates chemotherapy-induced changes of intestinal permeability and does not interfere with the antitumor effect of chemotherapy in patients with breast cancer: a prospective randomized trial. Tumori. 2006;92(5):396–401.PubMed
63.
go back to reference Leenstra JL et al. Doxepin rinse versus placebo in the treatment of acute oral mucositis pain in patients receiving head and neck radiotherapy with or without chemotherapy: a phase III, randomized, double-blind trial (NCCTG-N09C6 [Alliance]). J Clin Oncol. 2014;32(15):1571–7.PubMedCentralCrossRefPubMed Leenstra JL et al. Doxepin rinse versus placebo in the treatment of acute oral mucositis pain in patients receiving head and neck radiotherapy with or without chemotherapy: a phase III, randomized, double-blind trial (NCCTG-N09C6 [Alliance]). J Clin Oncol. 2014;32(15):1571–7.PubMedCentralCrossRefPubMed
64.
go back to reference Epstein JB et al. Doxepin rinse for management of mucositis pain in patients with cancer: one week follow-up of topical therapy. Spec Care Dentist. 2008;28(2):73–7.CrossRefPubMed Epstein JB et al. Doxepin rinse for management of mucositis pain in patients with cancer: one week follow-up of topical therapy. Spec Care Dentist. 2008;28(2):73–7.CrossRefPubMed
65.
go back to reference Guo SP et al. Transdermal fentanyl for pain due to chemoradiotherapy-induced oral mucositis in nasopharyngeal cancer patients: evaluating efficacy, safety, and improvement in quality of life. Drug Des Devel Ther. 2014;8:497–503.PubMedCentralPubMed Guo SP et al. Transdermal fentanyl for pain due to chemoradiotherapy-induced oral mucositis in nasopharyngeal cancer patients: evaluating efficacy, safety, and improvement in quality of life. Drug Des Devel Ther. 2014;8:497–503.PubMedCentralPubMed
66.
go back to reference Vokurka S et al. The effect of polyvinylpyrrolidone-sodium hyaluronate gel (Gelclair) on oral microbial colonization and pain control compared with other rinsing solutions in patients with oral mucositis after allogeneic stem cells transplantation. Med Sci Monit. 2011;17(10):CR572–6.PubMedCentralCrossRefPubMed Vokurka S et al. The effect of polyvinylpyrrolidone-sodium hyaluronate gel (Gelclair) on oral microbial colonization and pain control compared with other rinsing solutions in patients with oral mucositis after allogeneic stem cells transplantation. Med Sci Monit. 2011;17(10):CR572–6.PubMedCentralCrossRefPubMed
67.
go back to reference Velez I et al. MuGard, an oral mucoadhesive hydrogel, reduces the signs and symptoms of oral mucositis in patients with lichen planus: a double-blind, randomized, placebo-controlled pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;118(6):657–64e2.CrossRefPubMed Velez I et al. MuGard, an oral mucoadhesive hydrogel, reduces the signs and symptoms of oral mucositis in patients with lichen planus: a double-blind, randomized, placebo-controlled pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;118(6):657–64e2.CrossRefPubMed
68.
go back to reference Hadjieva T et al. Treatment of oral mucositis pain following radiation therapy for head-and-neck cancer using a bioadhesive barrier-forming lipid solution. Support Care Cancer. 2014;22(6):1557–62.PubMedCentralCrossRefPubMed Hadjieva T et al. Treatment of oral mucositis pain following radiation therapy for head-and-neck cancer using a bioadhesive barrier-forming lipid solution. Support Care Cancer. 2014;22(6):1557–62.PubMedCentralCrossRefPubMed
69.
go back to reference Yarom N et al. Systematic review of natural agents for the management of oral mucositis in cancer patients. Support Care Cancer. 2013;21(11):3209–21.CrossRefPubMed Yarom N et al. Systematic review of natural agents for the management of oral mucositis in cancer patients. Support Care Cancer. 2013;21(11):3209–21.CrossRefPubMed
70.
go back to reference Carvalho PA et al. Evaluation of low-level laser therapy in the prevention and treatment of radiation-induced mucositis: a double-blind randomized study in head and neck cancer patients. Oral Oncol. 2011;47(12):1176–81.CrossRefPubMed Carvalho PA et al. Evaluation of low-level laser therapy in the prevention and treatment of radiation-induced mucositis: a double-blind randomized study in head and neck cancer patients. Oral Oncol. 2011;47(12):1176–81.CrossRefPubMed
71.
go back to reference Silva GB et al. The prevention of induced oral mucositis with low-level laser therapy in bone marrow transplantation patients: a randomized clinical trial. Photomed Laser Surg. 2011;29(1):27–31.CrossRefPubMed Silva GB et al. The prevention of induced oral mucositis with low-level laser therapy in bone marrow transplantation patients: a randomized clinical trial. Photomed Laser Surg. 2011;29(1):27–31.CrossRefPubMed
72.
go back to reference Schubert MM et al. A phase III randomized double-blind placebo-controlled clinical trial to determine the efficacy of low level laser therapy for the prevention of oral mucositis in patients undergoing hematopoietic cell transplantation. Support Care Cancer. 2007;15(10):1145–54.CrossRefPubMed Schubert MM et al. A phase III randomized double-blind placebo-controlled clinical trial to determine the efficacy of low level laser therapy for the prevention of oral mucositis in patients undergoing hematopoietic cell transplantation. Support Care Cancer. 2007;15(10):1145–54.CrossRefPubMed
73.
go back to reference Cowen D et al. Low energy Helium-Neon laser in the prevention of oral mucositis in patients undergoing bone marrow transplant: results of a double blind randomized trial. Int J Radiat Oncol Biol Phys. 1997;38(4):697–703.CrossRefPubMed Cowen D et al. Low energy Helium-Neon laser in the prevention of oral mucositis in patients undergoing bone marrow transplant: results of a double blind randomized trial. Int J Radiat Oncol Biol Phys. 1997;38(4):697–703.CrossRefPubMed
74.
go back to reference Jaguar GC et al. Low-energy laser therapy for prevention of oral mucositis in hematopoietic stem cell transplantation. Oral Dis. 2007;13(6):538–43.CrossRefPubMed Jaguar GC et al. Low-energy laser therapy for prevention of oral mucositis in hematopoietic stem cell transplantation. Oral Dis. 2007;13(6):538–43.CrossRefPubMed
75.
go back to reference Whelan HT et al. NASA light-emitting diodes for the prevention of oral mucositis in pediatric bone marrow transplant patients. J Clin Laser Med Surg. 2002;20(6):319–24.CrossRefPubMed Whelan HT et al. NASA light-emitting diodes for the prevention of oral mucositis in pediatric bone marrow transplant patients. J Clin Laser Med Surg. 2002;20(6):319–24.CrossRefPubMed
76.
go back to reference Barasch A et al. Helium-neon laser effects on conditioning-induced oral mucositis in bone marrow transplantation patients. Cancer. 1995;76(12):2550–6.CrossRefPubMed Barasch A et al. Helium-neon laser effects on conditioning-induced oral mucositis in bone marrow transplantation patients. Cancer. 1995;76(12):2550–6.CrossRefPubMed
77.
go back to reference Silva GB et al. Effect of low-level laser therapy on inflammatory mediator release during chemotherapy-induced oral mucositis: a randomized preliminary study. Lasers Med Sci. 2015;30(1):117–26.CrossRefPubMed Silva GB et al. Effect of low-level laser therapy on inflammatory mediator release during chemotherapy-induced oral mucositis: a randomized preliminary study. Lasers Med Sci. 2015;30(1):117–26.CrossRefPubMed
78.
go back to reference Antunes HS et al. Low-power laser in the prevention of induced oral mucositis in bone marrow transplantation patients: a randomized trial. Blood. 2007;109(5):2250–5.CrossRefPubMed Antunes HS et al. Low-power laser in the prevention of induced oral mucositis in bone marrow transplantation patients: a randomized trial. Blood. 2007;109(5):2250–5.CrossRefPubMed
79.
go back to reference Bensadoun RJ, Nair RG. Low-level laser therapy in the prevention and treatment of cancer therapy-induced mucositis: 2012 state of the art based on literature review and meta-analysis. Curr Opin Oncol. 2012;24(4):363–70.CrossRefPubMed Bensadoun RJ, Nair RG. Low-level laser therapy in the prevention and treatment of cancer therapy-induced mucositis: 2012 state of the art based on literature review and meta-analysis. Curr Opin Oncol. 2012;24(4):363–70.CrossRefPubMed
80.
go back to reference Migliorati C et al. Systematic review of laser and other light therapy for the management of oral mucositis in cancer patients. Support Care Cancer. 2013;21(1):333–41.CrossRefPubMed Migliorati C et al. Systematic review of laser and other light therapy for the management of oral mucositis in cancer patients. Support Care Cancer. 2013;21(1):333–41.CrossRefPubMed
Metadata
Title
Management of Mucositis During Chemotherapy: From Pathophysiology to Pragmatic Therapeutics
Authors
Ysabella Z. A. Van Sebille
Romany Stansborough
Hannah R. Wardill
Emma Bateman
Rachel J. Gibson
Dorothy M. Keefe
Publication date
01-11-2015
Publisher
Springer US
Published in
Current Oncology Reports / Issue 11/2015
Print ISSN: 1523-3790
Electronic ISSN: 1534-6269
DOI
https://doi.org/10.1007/s11912-015-0474-9

Other articles of this Issue 11/2015

Current Oncology Reports 11/2015 Go to the issue

Breast Cancer (B Overmoyer, Section Editor)

Treatment of Breast Cancer in the Elderly

Breast Cancer (B Overmoyer, Section Editor)

Ductal Carcinoma In Situ: Treatment Update and Current Trends

Sarcomas (SR Patel, Section Editor)

Immunotherapy in Sarcoma: Future Horizons

Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine