About Oral Mucositis
Oral Mucositis (OM) is the inflammation and ulceration of the oral mucosa
and submucosa.1,2 It is a common and
dose-limiting side effect of chemotherapy and radiation therapy in cancer treatment.3
Oral mucositis can occur in up to 100% of patients receiving high-dose chemotherapy
and/or hematopoetic stem-cell transplantation (HSCT) and in up to 80% of those receiving radiation therapy
for head and neck malignancies.4 Its
overall incidence for patients receiving cancer therapy is 30%-40%.5
Oral mucositis can cause significant pain and greatly reduce a patient’s
quality of life. In fact, patients often report it as the most debilitating
side effect of their treatment.3,4,5,6 The
pain and swelling associated with OM can interfere with the patient’s
ability to eat, drink and talk.1 Pediatric patients
with severe OM present the additional risk of airway compromise.7 Oral
mucositis greatly increases the patient’s
risk of infection by breaching the protective mucosal barrier, and immunosuppressed
patients are especially vulnerable to this risk.2,1 Perhaps
the most significant effect of OM is the potential for treatment delays,
interruptions or dose reductions that could reduce treatment efficacy and patient
survival.6,3
There is no effective prophylaxis for OM, and there are few tools for controlling
its severity.2,3 Current treatment and prevention
strategies stress extensive oral assessment and oral care as well as
thorough palliative oral care and pain management during cancer treatment.1,4
Oral or dental disease at the outset of treatment is a significant risk factor
for the development of OM, which is why pretreatment assessment and intervention
are paramount.1
Historically, little has been known about the etiology of OM. Recent clinical
investigations, however, have provided new information on the Causes, Consequences and Prevalence,
and are resulting in new strategies for Preventing and Managing Oral Mucositis.7
References
- Brown, CG,Wingard, J Clinical consequences of oral mucositis. Semin
Oncol Nurs 2004. 20(1):16-21.
- Sonis, ST. The pathobiology of mucositis. Nat Rev Cancer, 2004. 4(4):277-84.
- Epstein, JB, Schubert, MM. Oropharyngeal mucositis in cancer therapy.
Review of pathogenesis, diagnosis, and management. Oncology (Huntingt) 2003.
17(12):1767-79.
- Rubenstein, EB, et al., Clinical practice guidelines for the prevention
and treatment of cancer therapy-induced oral and gastrointestinal mucositis. Cancer 2004;
100(9 Suppl): 2026-46.
- Sonis, ST, A biological approach to mucositis. J Support Oncol 2004.
2(1): 21-32.
- Avritscher, EB, CD Cooksley, Elting, LS. Scope and epidemiology of cancer
therapy-induced oral and gastrointestinal mucositis. Semin Oncol Nurs 2004.
20(1):3-10.
- Sonis, ST, et al., Perspectives on cancer therapy-induced mucosal injury:
pathogenesis, measurement, epidemiology, and consequences for patients.
Cancer, 2004. 100(9 Suppl):1995-2025.
