Abstract
Oral mucositis and stomatitis are characterized by pain, inflammation, and redness in the oral cavity. In the case of mucositis, ulceration also occurs. Despite being understudied, these symptoms are some of the most troubling, and yet common, adverse effects associated with cancer treatment. The incidence of these toxicities is highly variable depending on treatment-related and patient-related risk factors. However, most cancer treatment regimens carry some risk of this toxicity. The presence of mucositis or stomatitis can result in a significant decrease in the patient’s quality of life due to severe pain and the inability to eat or drink. These toxicities can also negatively affect the overall outcome of cancer treatment, leading to dose reductions and delays in treatment. Although the mechanism is not yet understood, the rapid increase in the number of targeted anticancer therapies available on the market has increased the number of patients who experience oral toxicities. The toxicities caused by targeted agents are less severe than those caused by conventional anticancer agents, but due to prolonged dosing schedules, they can still lead to significant declines in quality of life. The pathobiology of oral mucositis is a complex five phase process. It involves injury, activation of enzymes and transcription factors, upregulation of cytokine genes, inflammation/damage to tissue, and healing. These processes not only involve cells in the oral mucosa, but also the surrounding fibroblasts and connective tissue cells. A better understanding of the mechanisms behind oral mucositis and stomatitis will facilitate the development of effective prediction, prevention, and treatment strategies.
Highlights
It is indisputable that the effective treatment of malignancies is often limited by the harm inflicted on normal, healthy cells [1]
Toxicities of the oral cavity, which include mucositis and stomatitis, are some of the most significant and unavoidable toxicities associated with cancer treatment [3]
Oral mucositis caused by cytotoxic chemotherapy is characterized by painful inflammation, erythema, swelling, and ulcerations of the oral mucosa in the oral cavity, oropharynx, and hypopharynx [8,9]
Summary
It is indisputable that the effective treatment of malignancies is often limited by the harm inflicted on normal, healthy cells [1]. Given their high rate of turnover, mucosal cells in the oral cavity are highly susceptible to the toxic effects of cancer treatment [2]. Toxicities of the oral cavity, which include mucositis and stomatitis, are some of the most significant and unavoidable toxicities associated with cancer treatment [3]. Cytotoxic chemotherapy has long been associated with a high risk of oral toxicity. The lack of effective treatments and prevention strategies may be attributed to the fact that research on oral toxicities has lagged behind research on other chemotherapy and radiation-related toxicities such as febrile neutropenia and nausea and vomiting [4]
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