Mucositis In Cancer Research Articles

Cryotherapy for oral mucositis in cancer: review of systematic reviews and meta-analysis

BackgroundOne of the most common side effects of cancer treatment is oral mucositis. Although studies have shown that oral cryotherapy has a favourable effect on oral mucositis, the reliability of...

Oral Mucositis in Cancer and Potential Use of Omega-3 Free Fatty Acids in Its Management: A Review.

Oral mucositis (OM) is a painful condition caused by chemotherapeutic or radiotherapeutic cancer treatments, occurring in patients with different tumour characteristics and locations. OM greatly impacts a patient’s quality of life and cancer recovery. Current OM management strategies are not providing sufficient prevention and treatment; new approaches to injury management are needed. Studies on the benefit of omega-3 free fatty acids (FFA) in human health have increased significantly in recent years. FFA properties have been studied extensively, including their potential therapeutic use in inflammatory conditions. However, omega-3 FFA’s use as a supplementary treatment for OM has not been clinically tested. Preliminary evidence suggests that utilising FFA to manage OM could be a useful strategy for lesion management, assisting with healthy oral mucosa recovery. This review will describe the incidence, risk factors, biology of OM and the current treatment strategies, leading to a discussion of the utility of omega-3 FFA as a novel therapeutic agent for OM.

Evidence based complementary and alternative methods used in the prevention and treatment of oral mucositis in cancer:Literature review

Cancer patients frequently face symptoms that result from the treatment process and affect their life quality adversely. The most important one of these symptoms is oral mucositis. For the solution of this complication, complementary and alternative methods are used by patients in addition to medical treatment. However, in order for these methods to be successful, it is extremely important that health care team members are informed of these practices, patients are protected against any kind of harm and they are guided to choose the evidence-based methods among the complementary and alternative methods. The present study was carried out to examine the efficiency of complementary and alternative methods in the prevention and treatment of the chemotherapy-induced oral mucositis. The population of the study consists of the articles reached through the research on the data bases “Medline”, “Ebscohost”, “Pubmed”, “Science Direct” and “Google Scholar” using the keywords “cancer patients”, oral mucositis” ,“oral care” and “complementary and alternative methods” in between February and April 2017. Randomized controlled studies that have been published in the last ten years in Turkish and English languages and that had their full texts were included in the examinations. 19 articles complying with the research criteria composed the sample of the compiled study. It was seen that the most commonly used complementary and alternative methods in the prevention and treatment of oral mucositis are cryotherapy (n= 9 articles), honey (n=3), propolis (n=2), chewing gum (n=1), coffee and honey mixture (n=1), kefir (n=1), Liquid C recutita extract (n=1) and cloves-based mouthwash (n=1) in the studies included in the compilation. Complementary and alternative methods are significant recourses for decreasing the incidence and severity of oral mucositis due to their ease of use, tolerability and having no side effects.

Systematic review of antimicrobials, mucosal coating agents, anesthetics, and analgesics for the management of oral mucositis in cancer patients

The aim of this project was to develop clinical practice guidelines on the use of antimicrobials, mucosal coating agents, anesthetics, and analgesics for the prevention and management of oral mucositis (OM) in cancer patients. A systematic review of the available literature was conducted. The body of evidence for the use of each agent, in each setting, was assigned a level of evidence. Based on the evidence level, one of the following three guideline determinations was possible: recommendation, suggestion, or no guideline possible. A recommendation was developed in favor of patient-controlled analgesia with morphine in hematopoietic stem cell transplant (HSCT) patients. Suggestions were developed in favor of transdermal fentanyl in standard dose chemotherapy and HSCT patients and morphine mouth rinse and doxepin rinse in head and neck radiation therapy (H&N RT) patients. Recommendations were developed against the use of topical antimicrobial agents for the prevention of mucositis. These included recommendations against the use of iseganan for mucositis prevention in HSCT and H&N RT and against the use of antimicrobial lozenges (polymyxin-tobramycin-amphotericin B lozenges/paste and bacitracin-clotrimazole-gentamicin lozenges) for mucositis prevention in H&N RT. Recommendations were developed against the use of the mucosal coating agent sucralfate for the prevention or treatment of chemotherapy-induced or radiation-induced OM. No guidelines were possible for any other agent due to insufficient and/or conflicting evidence. Additional well-designed research is needed on prevention and management approaches for OM.

Systematic review of anti-inflammatory agents for the management of oral mucositis in cancer patients

The aim of this project was to review the available literature and define clinical practice guidelines for the use of anti-inflammatory agents for the prevention and treatment of oral mucositis in cancer patients. A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology. The body of evidence for use of each intervention, in each cancer treatment setting, was assigned an evidence level. Based on the evidence level, one of the following three guideline determinations was possible: recommendation, suggestion, and no guideline possible. Forty-one papers were reviewed. There was sufficient evidence to recommend the use of benzydamine mouthwash for the prevention of oral mucositis in head and neck cancer patients receiving moderate-dose radiation therapy (up to 50 Gy), without concomitant chemotherapy. A new suggestion was developed against the use of misoprostol mouthwash for the prevention of oral mucositis in head and neck cancer patients receiving radiation therapy. Positive results were reported for some other anti-inflammatory agents. However, no guidelines were able to be developed for any other agents due to insufficient and/or conflicting evidence. The use of anti-inflammatory agents continues to be a promising strategy for the prevention and treatment of oral mucositis. Additional well-designed studies are needed to examine the use of this class of agents for oral mucositis.

Severe mucositis: how can nutrition help?

To review the recent evidence on the effect of nutrition on the incidence and severity of mucositis following anticancer treatment. There have been many recent publications on mucositis and on nutrition in cancer, but very few on nutrition and mucositis in cancer. It is difficult to establish a definite link between nutritional status, nutritional interventions and mucositis. Malnutrition is probably a risk factor for mucositis, however, and some of the interventions that improve nutrition in cancer patients and reduce the risk of cancer in the general population work via mechanisms that might positively affect the development and course of mucositis. Whilst it can be tempting to extrapolate these findings to suggest that nutritional support can reduce the incidence and severity of mucositis, this would be premature. There may well be a link between nutritional status, nutritional supplementation, anticancer treatment and mucositis, but it is not yet proven; and mechanism-based, prospective, randomized studies are required to answer the question. This is likely to be an area of increased study in the future.