Appearance
The broadening scope of oral mucositis and oral ulcerative mucosal toxicities of anticancer therapies.
Literature Information
| DOI | 10.3322/caac.21704 |
|---|---|
| PMID | 34714553 |
| Journal | CA: a cancer journal for clinicians |
| Impact Factor | 232.4 |
| JCR Quartile | Q1 |
| Publication Year | 2022 |
| Times Cited | 79 |
| Keywords | cancer, immune checkpoint inhibitors, immunotherapy, oral mucositis, stomatitis |
| Literature Type | Journal Article, Review |
| ISSN | 0007-9235 |
| Pages | 57-77 |
| Issue | 72(1) |
| Authors | Sharon Elad, Noam Yarom, Yehuda Zadik, Michal Kuten-Shorrer, Stephen T Sonis |
TL;DR
This article reviews the epidemiology, pathogenesis, assessment, and management strategies for oral mucositis (OM), a painful complication of cancer therapies that significantly impacts patient quality of life and treatment tolerance. It highlights the need for ongoing research into both traditional and novel therapies to address OM and related mucosal toxicities, which are increasingly relevant in the context of targeted and immune checkpoint inhibitor treatments.
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cancer · immune checkpoint inhibitors · immunotherapy · oral mucositis · stomatitis
Abstract
Oral mucositis (OM) is a common, highly symptomatic complication of cancer therapy that affects patients' function, quality of life, and ability to tolerate treatment. In certain patients with cancer, OM is associated with increased mortality. Research on the management of OM is ongoing. Oral mucosal toxicities are also reported in targeted and immune checkpoint inhibitor therapies. The objective of this article is to present current knowledge about the epidemiology, pathogenesis, assessment, risk prediction, and current and developing intervention strategies for OM and other ulcerative mucosal toxicities caused by both conventional and evolving forms of cancer therapy.
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Primary Questions Addressed
- What are the emerging trends in the epidemiology of oral mucositis among different cancer therapies?
- How do targeted therapies and immune checkpoint inhibitors specifically contribute to oral mucosal toxicities?
- What innovative intervention strategies are being developed to manage oral mucositis in cancer patients?
- How does the severity of oral mucositis correlate with treatment outcomes and overall patient survival rates?
- What role does patient education play in the prevention and management of oral mucositis during cancer treatment?
Key Findings
Key Insights
Research Background and Objectives
Oral mucositis (OM) is a prevalent and painful complication encountered by cancer patients undergoing various therapies, significantly impairing their quality of life, functional abilities, and treatment adherence. The severity of OM not only affects patients’ well-being but can also lead to increased mortality rates in certain populations. Despite its critical impact, comprehensive research on OM management remains inadequate. This article aims to synthesize current knowledge regarding the epidemiology, pathogenesis, assessment, and risk prediction of OM and similar oral ulcerative mucosal toxicities induced by both traditional and novel cancer treatment modalities, including targeted therapies and immune checkpoint inhibitors.Main Methods and Findings
The article reviews recent literature and clinical studies that examine the prevalence and severity of OM across various patient demographics and cancer types. It discusses the underlying mechanisms contributing to OM, which include inflammatory responses, cellular damage, and microbial infections. The assessment approaches for OM are evaluated, highlighting the need for standardized measurement tools to gauge symptom severity accurately. Furthermore, the review outlines risk factors associated with the development of OM and introduces both established and emerging intervention strategies, such as oral care protocols, pharmacological treatments, and supportive therapies aimed at mitigating the incidence and severity of mucosal toxicities.Core Conclusions
The findings underscore the multifaceted nature of oral mucositis as a significant adverse consequence of cancer therapies, necessitating a nuanced understanding of its epidemiology and pathophysiology. The review concludes that while advancements in cancer treatment have improved patient outcomes, they have concurrently expanded the spectrum of oral mucosal toxicities. Effective management requires a multidisciplinary approach, integrating preventive measures and therapeutic interventions tailored to individual patient needs and treatment contexts.Research Significance and Impact
This article contributes to the growing body of literature aimed at improving the understanding and management of oral mucositis and related toxicities in cancer patients. By consolidating current insights and emphasizing the importance of addressing oral health in oncology care, it highlights the necessity for ongoing research into innovative therapeutic strategies. The findings have the potential to inform clinical practice guidelines, enhance patient care, and improve overall treatment tolerability and outcomes, thus having a profound impact on the quality of life for cancer patients receiving various therapeutic regimens.
Literatures Citing This Work
- Natural Products for the Prevention and Treatment of Oral Mucositis-A Review. - Ana Sofia Ferreira;Catarina Macedo;Ana Margarida Silva;Cristina Delerue-Matos;Paulo Costa;Francisca Rodrigues - International journal of molecular sciences (2022)
- Protective Effects of Cannabidiol on Chemotherapy-Induced Oral Mucositis via the Nrf2/Keap1/ARE Signaling Pathways. - Lin Li;Yaowei Xuan;Biao Zhu;Xing Wang;Xiaoyu Tian;Lisheng Zhao;Yan Wang;Xiaoxia Jiang;Ning Wen - Oxidative medicine and cellular longevity (2022)
- Precision medicine for risk prediction of oral complications of cancer therapy-The example of oral mucositis in patients receiving radiation therapy for cancers of the head and neck. - Stephen T Sonis - Frontiers in oral health (2022)
- Clinicians' experience with topical benzydamine and morphine for the management of oral mucositis: adverse effects and barriers. - Ariel Blanchard;Noam Yarom;Lauren Levi;Karis Kin Fong Cheng;Paolo Bossi;Yehuda Zadik;Sharon Elad; - Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (2022)
- Characterization of a novel dual murine model of chemotherapy-induced oral and intestinal mucositis. - Ali I Mohammed;Antonio Celentano;Rita Paolini;Jun T Low;Michael J McCullough;Lorraine A O' Reilly;Nicola Cirillo - Scientific reports (2023)
- A novel DNA methylation-related gene signature for the prediction of overall survival and immune characteristics of ovarian cancer patients. - Sixue Wang;Jie Fu;Xiaoling Fang - Journal of ovarian research (2023)
- Multimodal Data Integration to Predict Severe Acute Oral Mucositis of Nasopharyngeal Carcinoma Patients Following Radiation Therapy. - Yanjing Dong;Jiang Zhang;Saikt Lam;Xinyu Zhang;Anran Liu;Xinzhi Teng;Xinyang Han;Jin Cao;Hongxiang Li;Francis Karho Lee;Celia Waiyi Yip;Kwokhung Au;Yuanpeng Zhang;Jing Cai - Cancers (2023)
- Pathogenesis of Oral Toxicities Associated with Targeted Therapy and Immunotherapy. - Alessandro Villa;Michal Kuten-Shorrer - International journal of molecular sciences (2023)
- Microneedle patches containing mesoporous polydopamine nanoparticles loaded with triamcinolone acetonide for the treatment of oral mucositis. - Xiaoying Qu;Xiaoli Guo;Tingting Zhu;Zhe Zhang;Wanchun Wang;Yuanping Hao - Frontiers in bioengineering and biotechnology (2023)
- Radiation-induced mucositis: A retrospective study of dexamethasone-lidocaine-vitamin B12 mouth rinse versus compound chlorhexidine mouthwash in nasopharyngeal carcinoma. - Kejie Li;Xiaolin Ren;Raoying Xie - Heliyon (2023)
... (69 more literatures)
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