Chapter 10 - Management of cancer treatment-induced oral mucositis

Abstract

Oral mucositis is a common complication and dose-limiting toxicity of cytotoxic radiotherapy and/or chemotherapy in cancer treatment. In particular, oral mucositis is frequently associated with chemotherapy followed by hematopoietic stem cell transplantation and head and neck radiotherapy or radio-chemotherapy. Oral mucositis is often accompanied by pain, odynophagia, xerostomia, and dysgeusia, and may lead to subsequent malnutrition and dehydration, which severely impair patients’ quality of life. A number of agents, including vitamin E, allopurinol, glutamine, zinc sucralfate, benzydamine, and palifermin, have been reported to be effective for preventing oral mucositis. A recent multiinstitutional randomized controlled study revealed that polaprezinc (zinc-l-carnosine) is effective for prophylaxis against oral mucositis associated with chemotherapy in patients undergoing hematopoietic stem cell transplantation without affecting hematopoietic stem cell transplantation outcomes. This review provides a comprehensive overview of cancer treatment-induced oral mucositis and the effectiveness of agents used to manage the condition.