Oral Mucositis Induced By Anticancer Therapies

Abstract

Oral mucositis induced by conventional cytotoxic cancer therapies is a common and significant clinical problem in oncology. Mucositis symptoms, which include severe pain, may lead to dose reductions and unplanned interruptions of chemotherapy and/or radiotherapy, and often affect patients' quality of life. In addition, ulcerative mucositis represents a risk factor for local or systemic infectious complications that may be life-threatening in immunosuppressed patients. The development of biologically based targeted cancer therapies, which aim to block the growth, spread, and survival of tumors by interfering with specific molecular targets, may have reduced mucosal injury, but did not eliminate it. This article will review the epidemiology, pathobiology, and management of oral mucositis associated with conventional cytotoxic therapies for malignant diseases and will briefly summarize emerging information on oral mucosal injury associated with targeted therapies. Considerations for future research aimed at the development of more efficient and effective supportive care approaches will be presented, with emphasis on the contribution of dental researchers and clinicians in these efforts.

Keywords: Chemotherapy; Cytotoxic cancer therapy; Mucositis management; Oral mucositis; Radiation therapy; Stomatitis; Targeted therapies.

Fig. 1

Clinical differences in onset, severity, and resolution of chemotherapy- and radiation-induced oral mucositis. In some patients treated with radiotherapy, oral mucositis may last for longer periods and may become chronic. Hyperfractionated radiotherapy, combined chemoradiation regimens, or radiotherapy combined with a targeted agent may lead to increased mucositis severity (not depicted)