Late and Acute Effects of Pediatric Cancer Therapy on the Oral Cavity

Abstract

Pediatric cancer therapy has advanced to become curative for many types of cancer. The overall survival of patients treated for childhood cancer is now in the range of 90%. The May 2009 issue of the Journal of Clinical Oncology reported improved survival from about 30% in 1960 to 80% in 2004. An epidemiologic study (Mariotto et al. 2009) estimated that in the United States alone, there are more than 300,000 survivors of childhood cancer. However, this success has not come without a price. Pediatric cancer therapy is given during a time of growth, and late effects in the oral cavity can alter the growth and development of teeth and bones and affect overall health for the duration of a patient’s life. The severity of these clinical and anatomical complications depends on tumor diagnosis, therapy exposure (chemotherapy, radiation, hematopoietic stem cell transplantation or a combination of several therapies), patient age and developmental status at the time of therapy and the resulting toxicity. In this chapter we will discuss some of the most important oral complications in pediatric oncology, with a focus on late effects of cancer and its treatment. Early complications will also be briefly described. Although the emphasis of this book is neurologic malignancy, oral complications occur in association with such malignancies because of the type of cancer therapy used. The prevention and management of these complications will be discussed, as well as the need for collaboration between dental providers and the oncology team for the improvement of outcomes.KeywordsSalivary GlandOral HealthHematopoietic Stem Cell TransplantationPeriodontal DiseaseOral CavityThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.