Mucosal Injury during Anti-Cancer Treatment: From Pathobiology to Bedside

Basile, Debora; Nardo, Paola Di; Corvaja, Carla; Garattini, S.; Pelizzari, Giacomo; Lisanti, C.; Bortot, L.; Ros, Lucia Da; Bartoletti, Michele; Borghi, M.O.; Gerratana, Lorenzo; Lombardi, Davide; Puglisi, Fabio

doi:10.3390/cancers11060857

Cited by 97 publications

(87 citation statements)

References 140 publications

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“…Also, the use of preventive agents has a significant positive effect on the quality of life of patients, which has been recorded, both in our study and in similar studies devoted to the prevention and treatment of OM [2,3]. Given that this complication is frequent and significantly affects patients, the prevention and treatment of OM is an important aspect of concomitant treatment of oncohematologic patients.…”

Section: Discussionsupporting

confidence: 77%

“…At the same time, inadequate oral hygiene, neutropenia, the elderly, progression of the underlying disease was among the aggravating factors contributing to exacerbation of OM [2,8]. Accordingly, at the cellular level, factors of impaired OM development were damage to epithelial cells, development of local inflammation with induction of apoptosis of cells of different layers of the mucosa [1,10].…”

Section: Introductionmentioning

confidence: 99%

“…Ulcerative mucositis. Active ulcer, perifocal inflammation with a large number of segmented neutrophils, tissue detritus (1), dyskeratotic phenomena in desquamated epithelium(2). Severe submucosal edema (3).…”

mentioning

confidence: 99%

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Pharmacological correction of various morphological forms of oral mucositis in patients with leukemia

et al. 2019

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Oral mucositis (OM) is a common complication against the background of modern leukemia therapy, which significantly impairs patients’ quality of life. The purpose of the study was to evaluate the effectiveness of the use of local Cyanocobalamin and Decamethoxine therapy for the prevention and treatment of OM. The study was conducted on the basis of the hematology department of Vinnytsia Regional Clinical Hospital n.a. M.I. Pirogov in 2013-2019 (58 patients were studied with standard combination chemotherapy with Cytarabine, Methotrexate and anthracycline antibiotics). In addition to the standard clinical and laboratory study, dental examination was performed before treatment, at 7 and 14 days of treatment with determination of the degree of mucositis according to the NCI-CTC criteria and determination of quality of life indicators. At the same time, a sample incisional biopsy of the oral mucosa was performed with photo-fixation of histopreparations. In a group of 28 patients, 7 days orally administered a combination of Septefril (Decamethoxine) 0.2 mg 4-6 times daily, and Cyanocobalamin 500 mg 3 times daily. Statistical processing of the obtained results was carried out in the license package “STATISTICA 6.1” using non-parametric methods of evaluation of the obtained results. Prior to the onset of cytostatic therapy, no signs of inflammatory lesions were reported. However, patients with pre-established signs of caries, periodontal disease and lack of teeth subsequently experienced OM, even with the use of Cyanocobalamin and Septefril. Thus, after 7 days in 8 patients on the background of medication correction I-II degree of OM according to NCI-CTC was recorded, and only in 2 – III degree, unlike the group without correction. In the group where this combination of drugs was used, OM was recorded after 7 days in 12 patients, in contrast to the indices where the correction was not performed and the development of OM had a more pronounced course and was present in all patients. According to the morphological study, several degrees of OM were observed in patients. Initially, catarrhal stomatitis with pronounced plethora and swelling of the mucous membrane was detected. During the transition to the second stage of mucositis, the aphthous stomatitis was morphologically observed, as well as dead epithelial cells and the cells undergoing parakeratotic transformation. After the application of the proposed therapy, erosion remained after the film rejection, which recovered without scarring. Thus, cytostatic therapy in patients with leukemia always causes manifestations of OM, which are more pronounced in patients with concomitant risk factors. The use of a combination of Cyanocobalamin and Septefril significantly reduces the manifestation of OM and improves the quality of life of patients against cytostatic therapy.

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Section: Discussionsupporting

confidence: 77%

Section: Introductionmentioning

confidence: 99%

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Pharmacological correction of various morphological forms of oral mucositis in patients with leukemia

et al. 2019

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“…Hemoterapeutici imaju uticaj na koštanu srž i dovode do smanjenja mijeloproliferacije, što ima za posledicu, između ostalog, trombocitopeniju, leukopeniju i neutropeniju. Ovi agensi takođe izazivaju promene na oralnoj mukozi, koje se manifestuju kao smanjenje mitotičke aktivnosti oralnih epitelnih ćelija, što za posledicu ima epitelnu atrofiju, smanjenu otpornost epitela na mehaničke iritacije, mukozitise i oralne ulceracije 12,13 . Ulceracije obezbeđuju slobodan prolaz sekundarnoj infekciji, zbog virulentnih mikroorganizama oralne flore.…”

Section: Chemotherapyunclassified

“…Chemotherapeutics have an impact on bone marrow and lead to impaired myeloproliferative activity, which consequently lead to the thrombocytopenia, leucopenia and neutropenia. These agents also cause the changes on oral mucosa, which manifest thought impaired mitotic activity within oral epithelial cells, and consequently lead to epithelial atrophy, impaired epithelial activity on the mechanical irritations, mucositis and oral ulcerations 12,13 . The ulcerations provide free entrance for secondary infections, caused by virulent microorganisms of oral flora.…”

Section: Procedures Koje Se Izvode Pre Radioterapije Ili Hemoterapijementioning

confidence: 99%

The effects of radiotherapy and chemotherapy on oral tissues

Petrović¹,

Cvetanović²,

Obradoviç³

et al. 2019

Acta stomatologica Naissi

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SažetakUvod:Tretman bolesnika koji boluju od raka, u smislu hemoterapije i radioterapije, značajno je evoluirao od svog začetka. Obe terapije, naročito ako se koriste u kombinaciji, imaju veoma ozbiljan potencijal da dovedu do neželjenih efekata, koji narušavaju kvalitet života i potencijalno povećavaju mortalitet bolesnika obolelih od raka. Cilj rada:U ovom radu opisan je uticaj radioterapije i hemoterapije na oralna tkiva. Oralne komplikacije koje se posledično javljaju mogu se svrstati u sledeće kategorije: mukozsitis, kserostomija, gljivične, virusne i bakterijske infekcije, disgeuzija, disfagija, profuzno krvarenje, osteonekroza i mišićni trizmus. Zaključak:Budući da je potreban širok spektar preventivnih i kurativnih mera, pojavljuje se potreba za sastavljanjem posebnih timova za brigu o bolesnicima pre, tokom i nakon radioterapije i hemoterapije. Takav onkološki tim trebalo bi imati doktora stomatologije, specijalistu oralne medicine kao aktivnog člana. AbstractIntroduction: Cancer treatment, in terms of chemotherapy and radiotherapy has evolved significantly from its beginning. Both therapies, especially used in combination, had the potential to cause side effects, that potentially decrease in quality of life and lead to increased mortality rate in patients with cancer. The aim:of the study: The effects of radiotherapy and chemotherapy were described. The oral complications which consequently occurred could be classified into following categories: mucositis, oral dryness, fungal, viral and bacterial infections, disgeusia, disfagio, profuse bleeding, osteonecrosis and muscle trismus. Conclusion: Because of the wide range of preventive and curative measures, it is necessary to create a special team for caring of patients before, during and after radiotherapy and chemotherapy. In such case, dentist, oral medicine specialists should be an active member of oncology team.

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Scheduling radiotherapy for patients with nasopharyngeal carcinoma in the corresponding time window can reduce radiation‐induced oral mucositis: A randomized, prospective study

Liao

et al. 2023

Cancer Medicine

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BackgroundTo explore a new method to reduce radiation‐induced oral mucositis by scheduling radiotherapy for patients with nasopharyngeal carcinoma (NPC) in the corresponding time window of the cycle of oral mucosal cells.MethodsEighty‐two NPC patients were randomly divided into a day group (n = 41) and a night group (n = 41). The radiotherapy was scheduled at noon (11:30–15:30) for the day group, while at night (19:00–23:00) for the night group. Oral mucositis and oral pain were recorded in both groups after each radiotherapy fraction. The short‐term efficacy of primary tumor regression, weight loss, and bone marrow suppression was recorded.ResultsThe incidence of Grade 2 oral mucositis was 87.8% (36/41) and 63.4% (26/41) in the night group and day group, respectively (p = 0.010). The incidence of Grade 3 oral mucositis was 65.9% (27/41) and 22.0% (9/41) in the night group and day group, respectively (p < 0.001). The mean number of radiotherapy for patients to develop Grade 2 oral mucositis was 15.67 ± 5.05 and 20.92 ± 6.21 in the night group and day group, respectively. The incidence of Grade 2 oral pain was 48.8% (20/41) and 22.0% (9/41) in the night group and day group, respectively (p = 0.011). There were no significant differences in tumor regression, weight loss, and bone marrow suppression between the two groups.ConclusionBy scheduling radiotherapy based on the corresponding time window of the cycle of oral mucosal cells, the severity of oral mucositis in NPC patients was reduced.

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Mucosal Injury during Anti-Cancer Treatment: From Pathobiology to Bedside

Cited by 97 publications

References 140 publications

Pharmacological correction of various morphological forms of oral mucositis in patients with leukemia

Pharmacological correction of various morphological forms of oral mucositis in patients with leukemia

The effects of radiotherapy and chemotherapy on oral tissues

Scheduling radiotherapy for patients with nasopharyngeal carcinoma in the corresponding time window can reduce radiation‐induced oral mucositis: A randomized, prospective study

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