Oral Complications of Cancer and Their Treatment

Abstract

Overview The mouth is a frequent site of direct and indirect adverse side effects of cancer therapy. In myelosuppressed patients, its diverse microbiota makes the oral cavity both a site of local infection and a potential source of bacteremias and sepsis. While about half of all patients being treated with chemotherapy or radiation therapy will develop some form of oral toxicity or infection, almost every patient receiving an aggressive myeloablative regimen or local radiotherapy to the head and neck manifests acute and chronic toxicities. The diversity of the tissues found in and around the mouth—keratinized and nonkeratinized mucosa, bone, salivary glands, and teeth—contributes to the range of susceptibility, acuity, and clinical implications of regimen‐related oral complications. In almost all instances, precancer treatment elimination or control of existing oral diseases and aggressive management of oral health during cancer therapy favorably impacts outcomes.

Quercetin prevents small intestinal damage and enhances intestinal recovery during methotrexate-induced intestinal mucositis of rats

“…Administration of QCT to MTX-treated rats resulted in: ( 1 ) significant decrease in intestinal injury score, ( 2 ) significant increase in intestinal and mucosal weight in jejunum and ileum, ( 3 ) increase on the protein content of the ileum, ( 4 ) increase in the villus height in the ileum, ( 5 ) increase of crypt depth of jejunum and ileum, and ( 6 ) increase in cell proliferation in the jejunum and ileum compared to MTX-nontreated group.…”

“…The mucosal damage of the small bowel was graded using an intestinal injury score as described by Kesik et al ( 15 ). The following parameters were investigated in the jejunum and ileum: ( 1 ) degeneration of surface and crypt epithelium, ( 2 ) degeneration of villus structure and vacuolization in the surface epithelium, and ( 3 ) inflammatory cell infiltration and edema in the lamina propria. For each parameter, a score was given using a semiquantitative scale as follows: 0 = none, 1 = mild, 2 = moderate, and 3 = severe, giving a maximum possible score of 9 for each intestinal region.…”

“…Chemotherapy-induced mucositis occurs in 10–40% of patients undergoing chemotherapy for cancer treatment, leads to dose reduction or prevention of continuation of selected therapies, prolongs hospital stay, increases re-admission rates, increases healthcare cost, compromises patients’ nutritional status, impairs patients’ quality of life, and is occasionally fatal ( 1 – 3 ). Mucositis is clinically manifested by oral symptoms such as pain and erythema, and gastrointestinal symptoms such as bloating, abdominal pain, and diarrhea.…”

Oral Mucosal Trauma and Injuries

“…The most common wound type during chemotherapy is oral mucositis which appears by inflamed erosive or ulcerative lesions on mucosal surfaces in the oral cavity [33]. Generally, buccal mucosa is affected by radiation treatment of head and neck tumors [15].…”

Dark Agouti rat model of chemotherapy-induced mucositis: Establishment and current state of the art

“…Mucositis is a clinical term used to describe damage to mucous membranes after anticancer therapies. 3 It occurs throughout the entire gastrointestinal tract (GT) (including the mouth) and genitourinary tract, and to a lesser extent in other mucosal surfaces. Its severity and duration varies with the dose and the type of drug used.…”