Local prostaglandin E2 in patients with oral malignancies undergoing chemo- and radiotherapy

Porteder, H; Rausch, Elisabeth; Kment, G.; Watzek, Georg; Matĕjka, M; Sinzinger, H.

doi:10.1016/s1010-5182(88)80082-9

Cited by 28 publications

(15 citation statements)

References 6 publications

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“…Two small studies comparing its topical use with placebo in patients undergoing simultaneous chemoradiation and the therapeutic potency of PGE 2 in chemotherapy-induced oral mucositis, respectively, found the substance to be effective in reducing oral discomfort as well as the duration of reepithelialization. 131,132 Another prophylactic pilot study enrolling patients undergoing radiotherapy found an impressive reduction of severe cases of radiotherapy-induced mucositis. 133 In contrast, a randomized study that used lower doses of PGE 2 as compared with the previously mentioned trials did not note any benefit in patients who were undergoing bone marrow transplantation, but observed a higher incidence of herpes virus reactivation and severe mucositis in patients using PGE 2 .…”

Section: Prostaglandin Ementioning

confidence: 99%

Oral Mucositis Complicating Chemotherapy and/or Radiotherapy: Options for Prevention and Treatment

Köstler

Hejna

Wenzel

et al. 2001

CA: A Cancer Journal for Clinicians

294

252

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The incidence and severity of oral mucositis is influenced by the type of antineoplastic treatment administered and by patient-related factors. Severe courses of oral mucositis are observed during simultaneous radiochemotherapy, which Oral Mucositis Complicating Chemotherapy and/or Radiotherapy: Options for Prevention and TreatmentWolfgang J. Köstler, MD; Michael Hejna, MD; Catharina Wenzel, MD; and Christoph C. Zielinski, MD 290 CA A Cancer Journal for Clinicians ABSTRACT Chemotherapy-and radiotherapy-induced oral mucositis represents a therapeutic challenge frequently encountered in cancer patients. This side effect causes significant morbidity and may delay the treatment plan, as well as increase therapeutic expenses.The pathogenesis of this debilitating side effect can be attributed to the direct mucosal toxicity of cytotoxic agents and ionizing radiation and to indirect mucosal damage caused by a concomitant inflammatory reaction exacerbated in the presence of neutropenia, and the emergence of bacterial, mycotic, and viral infections. affects virtually all patients with head and neck cancer who receive this therapeutic modality. 8 However, up to 40% of patients treated with conventional chemotherapy and the more than 70% of patients undergoing conditioning therapy for bone marrow transplantation also experience oral treatment-related complications. 9,10The pathogenesis of oral mucositis is not fully understood, yet it is thought to involve direct and indirect mechanisms. Direct mucosal injury by radiation and chemotherapy interfere with the average 5-to 14-day turnover time of the oral epithelium 11 and induce apoptosis. Indirect stomatotoxic effects that result from the release of inflammatory mediators, loss of protective salivary constituents, and therapyinduced neutropenia have been postulated to contribute to the development of oral mucositis and also promote the emergence of bacteria, fungi, and viruses on damaged mucosa.12 Although a linear relationship among the occurrence of oral mucositis, oral and systemic granulocyte counts, and a coincidence of resolution of mucositis with neutrophil recovery, has been demonstrated, 10,[13][14][15] significant mucositis can occur in the absence of myelotoxicity. 16,17 In addition, the prophylactic or therapeutic elimination of the pathogenic mucosal flora frequently observed in patients developing oral mucositis by various antiseptic and antimicrobial agents can at most alleviate the course of oral mucositis (see Antimicrobal Agents p. 302).Based upon these considerations, newer pathophysiologic concepts have emerged characterizing oral mucositis as having an initial inflammatory/vascular phase, an epithelial phase, a (pseudomembraneous) ulcerative/bacteriological phase and a healing phase.18 During the inflammatory phase, tissue injury induces release of free radicals, modified proteins and proinflammatory cytokines including interleukin-1β, prostaglandins and tumor necrosis factor-α (TNF-α) by epithelial, endothelial, and connective tissue cells. These ...

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Section: Prostaglandin Ementioning

confidence: 99%

Oral Mucositis Complicating Chemotherapy and/or Radiotherapy: Options for Prevention and Treatment

Köstler

Hejna

Wenzel

et al. 2001

CA: A Cancer Journal for Clinicians

294

252

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“…[80][81][82] Prostaglandins and pentoxifylline were investigated, and have a marginal effect on oral mucositis. [83][84][85] These agents may even be hazardous due to a reported increase of infections. [86][87][88][89] Topical azelastine seems to improve clinical symptoms in patients with aphtous ulceration and Behcets disease; however, the effect in oral mucositis is only accessible from one study.…”

Section: Mouthrinses With Anti-infective and Anesthetic Propertiesmentioning

confidence: 99%

Prophylaxis and treatment of chemo- and radiotherapy-induced oral mucositis – are there new strategies?

Karthaus

Rosenthal

Ganser

1999

Bone Marrow Transplant

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Summary:Oral mucositis is a major dose-limiting toxic effect of intensive cancer chemotherapy. Oral complications may lead to dose reduction or delay in further cancer treatment. Mucositis can be caused directly by cytotoxic effects and indirectly by sustained neutropenia after cytostatic therapy. An impaired mucosal barrier predisposes to life-threatening septic complications during aplasia. The prevalence of an oral focus in febrile neutropenia has been reported in up to 30% of cases and also reduces quality of life. The basic strategies aim at pain relief and prevention of bacterial and fungal infectious complications. However, no effective causal prophylaxis or treatment of oral mucositis is widely accepted. The introduction of cytokines, eg granulocytemacrophage colony-stimulating factor (GM-CSF) and granulocyte colony-stimulating factor (G-CSF) for oral mucositis may be particularly effective and offer a new and hopeful approach. At present, the optimal growth factor, best schedule, effective dosage and best mode of application is not known.

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“…Disappointingly, betamethasone, prednisolone, and anti-inflammatory prostaglandins E1 (misoprostol) and E2 (Prostin, Pfizer, NY, NY) did not reduce HN RIM or chemotherapy stomatitis in clinical trials (43)(44)(45)(46).…”

Section: Anti-inflammatory Agentsmentioning

confidence: 99%

Management of oral mucositis

Mota¹,

Brasil²,

Ribeiro³

et al. 2012

Arch Oncol

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Oral mucositis is one of the most common oral complications of cancer treatment. Studies have shown some interventions that reduce the severity of this condition, but there is not a specific treatment proved that really prevents or treats mucositis efficiently. The aim of this paper was to provide a literature review for better understanding of the management of oral mucositis. Pubmed and Scopus were used in order to identify research articles published between 2005 and 2012 in English language. A search term combination that included stomatitis, mucositis, lasers, complimentary therapies, amino acids, antioxidants, vitamins, minerals, plant extracts, and cryotherapy was conducted. A large number of therapeutic strategies to prevent and treat oral mucositis have been shown in studies and growth factors, including palifermin, appear as one of the most innovative drugs used in the management of oral mucositis. Understanding the physiopathological basis of mucositis can lead to the development of target drugs’ therapies. In addition, clinical trials should be conducted in order to determine an efficient protocol of treatment

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Local prostaglandin E2 in patients with oral malignancies undergoing chemo- and radiotherapy

Cited by 28 publications

References 6 publications

Oral Mucositis Complicating Chemotherapy and/or Radiotherapy: Options for Prevention and Treatment

Oral Mucositis Complicating Chemotherapy and/or Radiotherapy: Options for Prevention and Treatment

Prophylaxis and treatment of chemo- and radiotherapy-induced oral mucositis – are there new strategies?

Management of oral mucositis

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