The oral microbiome of patients with acute lymphoblastic leukemia (ALL) undergoes changes caused by the neoplasia as well as the antimicrobial activity of chemotherapy (CTX), which promotes the development of oral mucositis (OM). This study aimed to analyze the oral microbiome dynamics and salivary cytokine production in pediatric ALL patients before and during CTX, comparing children who did and did not develop OM. We conducted a longitudinal, observational, and analytical study including 32 newly diagnosed pediatric ALL patients (ages 2–16 years) undergoing CTX. Oral rinse and non-stimulated saliva samples were collected at baseline (day 0), day 14, and day 21 of induction of CTX, with an additional sample taken during OM episodes when possible. Microbiome analysis was performed using 16S rRNA sequencing on an Illumina MiSeq platform, and salivary cytokines were measured using a Luminex multiplex assay. The most pronounced microbiome changes occurred on day 14, particularly in patients who developed OM, characterized by higher α diversity, increased abundance of opportunistic taxa, and elevated IL-6 concentrations. In contrast, patients who did not develop OM exhibited a more stable microbial composition. Overall, these findings indicate that temporal oral dysbiosis and increased IL-6 may serve as early markers and potential predictors of OM development during chemotherapy in pediatric ALL patients.

Objective: This study aimed to explore the relationships among family resilience, psychological resilience, psychological need satisfaction, and self-neglect, with a particular focus on analyzing the mediating roles of family resilience and psychological resilience between basic psychological need satisfaction and self-neglect. The purpose was to provide a theoretical basis and practical guidance for improving the psychological state of patients with oral mucositis (OM) after chemoradiotherapy (CRT) for head and neck cancer (HNC). Methods: This retrospective study selected OM-patients post-CRT for HNC from Affiliated Hospital of Jiangnan University between January 2022 and December 2024 as the research subjects. A total of 312 patients were surveyed using a general information questionnaire, the Basic Psychological Needs Scale (BPNS), the Scale of the Elderly Self-Neglect (SESN), the Family Resilience Questionnaire (FRQ), and the 10-item Connor-Davidson Resilience Scale (CD-RISC-10). Structural equation modeling and the Bootstrap method were used to test the mediating effects of family resilience and psychological resilience between psychological need satisfaction and self-neglect in these patients. Results: The scores of patients on the BPNS, SESN, FRQ, and CD-RISC-10 were 5.35 ± 1.05, 8.16 ± 5.607, 78.56 ± 12.50, and 23.45 ± 8.03, respectively. Statistically significant differences were found in BPNS, FRQ, and CD-RISC-10 scores based on residence, education, living situation, economic pressure, metastasis status, and complications (P < 0.05). SESN scores also showed significant differences across age, residence, education, living situation, economic pressure, metastasis, and complications (P < 0.05). Psychological need satisfaction negatively correlated with self-neglect (r = −0.462, P < 0.01) and positively with family and psychological resilience (r = 0.546 and 0.497, both P < 0.01). A structural equation model indicated good fit indices, revealing that basic psychological need satisfaction negatively impacted self-neglect, with family and psychological resilience serving as significant mediators. Conclusion: The satisfaction of basic psychological needs in OM-patients post-CRT for HNC can directly or indirectly affect their self-neglect through family resilience and psychological resilience. In daily nursing care, it is possible to avoid self-neglect in patients by meeting their basic psychological needs and enhancing their family resilience and psychological resilience.

ABSTRACT Oral mucositis (OM) is significant clinical problem for children receiving chemotherapy. This study was conducted to evaluate the effect of basic oral care (BOC) education given to children receiving chemotherapy and their mothers on the prevention and severity of oral mucositis. This study was a quasi-experimental, single-arm, pre–post intervention design conducted to evaluate the effect of basic oral care (BOC) education on the prevention and severity of oral mucositis in children undergoing chemotherapy. The study was carried out at the pediatric hematology and oncology unit of a university hospital in Trabzon, Türkiye, between January and December 2019. A total of 30 children aged 3—17 years who met the inclusion criteria and their parents were enrolled in the study. Data were collected using three instruments: the Information Form, the Basic Oral Care Follow-up Chart (BOCFC), and the World Health Organization Mucositis Assessment Scale (WHOMAS). Oral mucositis was assessed on days 1, 3, 5, 7, 14, and 21, while adherence to BOC practices was recorded daily using the follow-up chart. BOC education was delivered face-to-face by the same researcher to both children and their parents in two 25-minute sessions. The training included tooth brushing with the Bass technique, the use of oral care sponges, and sodium bicarbonate rinses. Data were analyzed using SPSS 24.0. Normality was tested with the Shapiro–Wilk test. For nonparametric data, the Wilcoxon Signed Rank Test was applied. A p-value < 0.05 was considered statistically significant. Data were analyzed for 30 children. In the post-training period, there was a significant increase in BOC practices, especially in the evening and at bedtime, compared to the pre-education group (p<0.05). The results showed that there was a significant difference in the degree of oral mucositis after BOC education planned for children receiving chemotherapy compared to the group before BOC education (p<0.05). In the pre-training period, the number of children who developed severe OM increased until day 14, improvement started after day 14, but severe OM was still detected in 3.3% of the children on day 21. After BOC training, children did not develop severe OM and mild mucositis decreased from 23.3% on day 14 to 3.3% on day 21. BOC education given to children receiving chemotherapy and their parents prevents the development of severe oral mucositis by increasing tooth brushing and mouth rinsing rates. BOC may be the best option to prevent OM and reduce the severity of OM in children receiving chemotherapy.

Efficacy of pumpkin seed oil on paclitaxel-induced tongue mucosal injury in rat: Structural and biochemical insights.

Longitudinal multi-compartment oral mucositis assessment in adults undergoing myeloablative allogeneic hematopoietic cell transplantation: a contemporary prospective cohort analysis.

Oral mucositis (OM) is a debilitating condition that typically results from chemotherapy or radiotherapy, causing painful ulceration and inflammation in the oral cavity. This work optimized and tested a dual-action mucoadhesive buccal film containing curcumin (CUR) with lidocaine (LID) for the localized targeting treatment of OM to develope an anti-inflammatory and analgesic effects and mucosal healing. Mucoadhesive buccal films were formulated using a solvent casting technique based on nanoemulsion. Buccal films were produced combining plasticizers (PEG 400), hydrophilic polymers (PVA, HPMC, PVP), and permeation enhancers (Tween 80, Transcutol). The optimized formula have high folding endurance (>300 folds), uniform thickness (1.0 ± 0.01 mm), pH compatibility (6.7), and excellent drug content homogeneity (∼97% for LID and ∼96% for CUR). In vitro, the film released 95% of LID and 90% of CUR within 13 minutes. Ex vivo studies showed higher permeation of LID (95 µg/cm2) compared to CUR (80 µg/cm2). In vivo, the CUR-LID film significantly enhanced ulcer healing (∼95–100% by day 5), with complete mucosal regeneration and normalization of inflammatory biomarkers to baseline levels. This work supports the CUR-LID buccal film as a prospective non-invasive platform for managing oral mucositis with better therapeutic outcomes, effective drug delivery, and prolonged mucosal contact.

A scalable natural language processing framework for drug repurposing in chemotherapy-induced adverse events from clinical narrative records.

Dual anti-inflammatory and analgesic effects of Xipayi Mouth Rinse on radiation-induced oral mucositis: ethnopharmacological and preclinical evidence.

Mold therapy using gold-198 grains (Au-mold therapy) is a radical treatment for early stage oral cancer owing to its localized delivery of radiation. Understanding the efficacy and limitations of Au-mold therapy is crucial for optimizing treatment protocols and enhancing outcomes. Thus, this study evaluated the treatment outcomes of Au-mold therapy in patients with hard palate and gingival cancer and assessed its feasibility as a therapeutic modality. This retrospective study analyzed data from 37 cases with hard palate and gingival cancer who received Au-mold therapy alone. Treatment outcomes and complications were evaluated, and the dose distribution of Au-mold therapy was simulated using clinically available calculation systems. A notable 5-year local control rate of approximately 80% was noted in primary cases, whereas recurrent cases exhibited lower local control rates. Severe oral mucositis was not observed, and late complications, such as osteoradionecrosis and oral ulceration, were infrequent following Au-mold therapy. This study provides insights into the use of Au-mold therapy for oral cancer. Promising outcomes in primary cases suggest its potential as a treatment option. Future research should focus on innovative strategies to enhance the efficacy of Au-mold therapy in oral cancer management.

Grid Spatially Fractionated Radiation Therapy for Bulky Tumors: A Large Single Institution Experience.

Therapeutic efficacy and mechanistic insights of umbilical cord mesenchymal stem cell-derived exosomes in chemotherapy-induced oral mucositis

Liquid crystalline structure affects drug release from Pluronic® gels.

A phase II study of the AKT inhibitor TAS-117 in patients with advanced solid tumors and germline PTEN mutations

Amivantamab is the first fully humanized bispecific antibody approved for the treatment of non-small cell lung cancer (NSCLC) in the world. Amivantamab can block epidermal growth factor receptor (EGFR) pathway and mesenchymal-epithelial transformation factor (MET) pathway simultaneously, trigger the internalization and degradation of EGFR and MET, and activate the antitumor immune response. Amivantamab has been approved by the National Medical Products Administration for the treatment of adult patients with locally advanced or metastatic NSCLC with EGFR exon 20 insertion mutation, EGFR exon 19 deletion or exon 21 L858R substitution mutation, and is expected to be widely used in clinical practice soon. How to reasonably manage the adverse reactions related to amivantamab and maximize its efficacy is an urgent problem to be solved. Based on the existing medical evidence, combined with clinical experience, the expert group of this consensus finally formulated this "Expert consensus on amivantamab clinical application and adverse reaction management (2025 edition)" after multiple discussions. The contents of the consensus include the clinical use and management of adverse reactions of amivantamab. The recommendations focus on the prevention of infusion-related reactions, skin adverse reactions, venous thromboembolism, peripheral edema, oral mucositis, ocular toxicity and interstitial lung disease, amivantamab dose adjustment and treatment when adverse events occur, in order to provide guidance for clinicians to correctly use amivantamab and manage related adverse reactions.

High-dose melphalan (MEL) combined with autologous stem cell transplantation (ASCT) effectively treats multiple myeloma (MM) but often causes oral mucositis (OM), affecting patient outcomes. This study aims to evaluate the effectiveness of an enhanced oral care model in preventing MEL-induced OM. This retrospective study reviewed the medical records of 87 patients with MM who underwent ASCT at the First Affiliated Hospital of Soochow University between December 2019 and February 2022. According to the oral care protocols that had been implemented during their hospitalization, patients were classified into 2 groups: a control group (n = 49) that had received routine oral care and an observation group (n = 38) that had received an enhanced oral care regimen. All patients had received cryotherapy during MEL infusion as part of standard supportive care. The enhanced oral care protocol included prolonged (30-second) gargling with oropharyngeal involvement, cheek puffing exercises, and nurse-supervised education to ensure proper technique and adherence. Relevant clinical data were extracted from medical records, including the incidence, severity, onset, and healing time of OM; pain scores; neutrophil counts; nutritional status; weight change; and length of hospital stay. Baseline characteristics were comparable between groups. The observation group experienced significantly shorter hospital stays and less weight loss (P < .05). OM onset was delayed, and fewer patients developed OM in the observation group (P < .05). At OM healing, the observation group had higher neutrophil counts and better nutritional scores (P < .05). No significant differences were observed in OM pain, severity, or healing duration. Overall, the enhanced regimen improved recovery and reduced OM incidence and impact. However, the retrospective single-center design and limited sample size may restrict the generalizability of these findings, which should be validated in larger prospective studies. Enhanced oral care – incorporating standardized gargling techniques, patient education, and cryotherapy – effectively reduces OM incidence and improves clinical outcomes in MM patients undergoing ASCT. Optimizing oral hygiene protocols may enhance quality of care during high-dose MEL therapy.

Oral mucositis is a significant side effect of chemotherapy, radiotherapy, or their combination in cancer patients. Current clinical management focuses primarily on symptom control, with few effective therapeutic agents. Understanding the factors influencing susceptibility to oral mucositis is essential for a comprehensive grasp of its pathophysiology. This study investigates sex as a biological variable in radiation-induced oral mucositis. Oral mucositis was induced via X-ray ionizing radiation using a fractionated dose of 8 Gy/d for 5 consecutive days, targeting only the head and neck area using male and female C57BL/6J mice aged 7 to 9 wk. Following sex-guided time points, we harvested tongues, stained with toluidine blue, and imaged to visualize mucosal damage. Histopathological analyses were performed using hematoxylin and eosin staining to assess mucositis severity and inflammatory infiltration. All irradiated groups showed a significant increase in mucositis severity versus controls, measured by the total number and area of ulcerative lesions as well as inflammatory cell infiltrate. Notably, there was a significant decrease in epithelial thickness in irradiated mice compared with nonirradiated controls, consistent with oral mucositis. Furthermore, female mice exhibited a greater area of ulcerative lesions and higher inflammatory cell infiltrate scores than males did. This study highlights the sexual dimorphism in the murine model of fractionated ionizing radiation-induced oral mucositis, demonstrating that female mice have an increased susceptibility to irradiation treatment.

Background: Oral mucositis (OM) is a significant complication after allogeneic stem cell transplantation. Objectives: This prospective, observational cohort study assessed the effectiveness of a polyvinylpyrrolidone-zinc gluconate and taurine (PVP-ZG-TAU) oral gel in managing OM. The primary objective was to determine whether the gel reduced the incidence and grade of OM and accelerated its resolution. Methods: The study enrolled 82 patients; 39 received the PVP-ZG-TAU gel, and 43 represented a historical control group. To prevent oral mucositis, both groups maintained good oral hygiene. In the experimental group, patients received three sprays of PVP-ZG-TAU gel, three times a day, from the start of conditioning chemotherapy until day +15 after allo-SCT. Results: In the PVP-ZG-TAU group, 79.1% patients experienced grade 1–2 OM and 20.9% experienced grade 3–4 OM. In the control group, 74.4% had grade 1–2 OM, and 25.6% had grade 3–4 OM (p = ns). Resolution occurred significantly faster in the PVP-ZG-TAU group, with an 84% resolution rate per 100 person-weeks, compared with 62% in the control group. Cox regression analysis revealed that treatment was associated with a 68% greater likelihood of earlier resolution (adjusted hazard ratio [HR], 1.68; 95% confidence interval [CI], 1.03–2.74; p = 0.036). Conclusions: These findings suggest that PVP-ZG-TAU can reduce OM duration and serve as a supportive intervention for allo-SCT patients.

Oral mucositis is an inflammatory toxic reaction that can affect up to 100% of patients undergoing radiotherapy for head and neck cancer. This study aimed to promote best practices for the assessment, prevention, and management of oral mucositis in patients undergoing radiotherapy for head and neck cancer. The study adhered to the seven-phase JBI Evidence Implementation Framework, which is grounded in an audit and feedback process. The study was conducted from October 2022 to August 2023 in the radiotherapy department of a university hospital in Brazil. Eight evidence-based criteria were established to assess compliance with recommendations before and after implementation. Data were analyzed using JBI PACES. Barriers, strategies, and resources were identified using the JBI GRiP approach and improvement strategies were implemented. A follow-up audit was conducted to measure changes in compliance. In the follow-up audit, six of the eight criteria achieved 100% compliance. These included standardized initial and follow-up oral cavity assessments, treatment of oral mucositis based on damage, education about oral mucositis, oral hygiene protocols, and standardized assessment for malnutrition. The criterion related to the involvement of a multidisciplinary team in treating oral mucositis reached 90% compliance, while the criterion for referring malnourished patients to a nutritionist showed 66.7% compliance. The high level of compliance with the best practice criteria demonstrates the feasibility of using evidence in clinical practice. The project highlights that strategies and resources can be used to overcome barriers, such as the active involvement of a multidisciplinary team, education, and systematizing the evaluation, prevention, and management of oral mucositis. http://links.lww.com/IJEBH/A442.

BackgroundAccurate diagnosis of oral mucositis (OM) is essential for effective management and plays a critical role in ensuring reliable outcomes in clinical trials evaluating OM-prevention and treatment strategies. Currently, no evidence-based guidelines specify which clinical profession should be primarily responsible for OM assessments in patients undergoing high-dose chemotherapy. In most Scandinavian countries, nurses perform daily OM assessments, while dentists specialized in orofacial medicine (considered the gold standard) conduct supplementary evaluations several times per week. However, the concordance between nurses’ assessments and those conducted by dentists specialized in orofacial medicine remains unclear. Therefore, this study aimed to evaluate the interrater reliability in of OM assessments between these two professions.MethodsThis study utilized data from a randomized, blinded, multicenter, parallel-group, phase 3 trial conducted at five university hospitals in Sweden and Norway. A total of 127 patients aged 18 years or older, diagnosed with multiple myeloma or lymphoma, and scheduled to receive high-dose conditioning chemotherapy in preparation for hematopoietic stem cell transplantation, were included. The primary objective was to evaluate the interrater reliability of OM assessments across all severity grades using the World Health Organization (WHO) oral toxicity scale (grades 0–4). The secondary objective was to evaluate the interrater reliability of OM assessments across all severity grades at each individual study site.ResultsOverall interrater reliability between nurses and dentists specialized in orofacial was found to be fair for OM of any grade (κ = 0.211, p < 0.001). However, agreement levels at individual study sites ranged from no agreement to fair agreement.ConclusionThe interrater reliability in the assessment of oral mucositis between dentists specialized in orofacial medicine and nurses ranged from no-, to fair agreement. This highlights the need for targeted interventions to improve nurses' assessment skills or to integrate a specialized dentist as a permanent member of the multidisciplinary team in oncology and hematology settings.Trial registration This study is based on data from a previously registered clinical trial (ClinicalTrials.gov; Identifier: NCT03203733, Registered on November 20, 2020).

BackgroundChemotherapy-induced gastrointestinal toxicity (CIGT) is a common and distressing adverse effect in cancer care, manifesting as nausea, vomiting, appetite loss, oral mucositis, constipation, and diarrhea. These symptoms severely impair patients’ quality of life, reduce treatment adherence, and may lead to premature therapy discontinuation. Aromatherapy, a complementary therapy using plant-derived essential oils, has shown potential benefits for alleviating CIGT symptoms; however, most existing systematic reviews focus solely on nausea and vomiting, leaving its effects on other CIGT symptoms under-studied. Moreover, the influence of essential oil types, intervention forms, and intervention durations on therapeutic outcomes remains unclear.ObjectiveThis systematic review and meta-analysis aims to comprehensively evaluate the efficacy and safety of aromatherapy for the full spectrum of CIGT symptoms in patients with cancer and to clarify how essential oil types, intervention forms, and intervention durations influence treatment outcomes.MethodsNine databases (PubMed, Cochrane Library, Web of Science, Embase, Cumulative Index to Nursing and Allied Health Literature, Chinese National Knowledge Infrastructure, Wanfang, Chinese Science and Technology Journal Database, and SinoMed); the World Health Organization (WHO) Trials Portal; and the Chinese Clinical Trial Registry will be searched from inception to August 2025 to identify randomized controlled trials focusing on aromatherapy for CIGT management in patients with cancer. Data on participant characteristics, interventions, comparisons, outcomes, and adverse effects will be extracted from included studies. Continuous outcomes will be synthesized using standardized mean differences with 95% CIs, and categorical outcomes will be summarized as odds ratios with 95% CIs. All analyses will adopt a random-effects model to account for expected clinical and methodological heterogeneity. Subgroup and meta-regression analyses will be conducted to examine differences across essential oil types, intervention forms, and intervention durations. The Hartung-Knapp-Sidik-Jonkman method will be used for random-effects estimation, and prediction intervals will be calculated where applicable to reflect real-world variation. Risk of bias will be assessed using the Cochrane Risk of Bias 2 tool, and evidence certainty will be graded using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach.ResultsThis study was funded in February 2024. As of August 2025, the literature search and study selection have been completed, and 20 eligible randomized controlled trials have been identified. Data extraction and quantitative synthesis are expected to be completed in December 2025, and the final results are anticipated to be submitted for publication in March 2026.ConclusionsThe anticipated findings will address key evidence gaps by evaluating aromatherapy’s therapeutic potential for CIGT beyond nausea and vomiting and clarifying parameter-specific effects on CIGT management. These findings will support the development of evidence-based, standardized aromatherapy interventions, guide future mechanism-based research, and inform clinical decision-making in supportive cancer care.