Prediction of mucositis risk secondary to cancer therapy: a systematic review of current evidence and call to action

Abstract

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The broadening scope of oral mucositis and oral ulcerative mucosal toxicities of anticancer therapies

“…Sex has been reported to have an influence on mucositis risk because, in most studies, female sex is linked to increased risk 24 . However, this may be driven by dosimetric parameters (ie, calculating the risk per kilogram of body weight or per square meters of body surface area) 24,25 . An individual's low baseline performance status may be related to increased mucositis risk 25 .…”

“…An individual's low baseline performance status may be related to increased mucositis risk 25 . There is inconsistent evidence regarding the influence of age, smoking, oral hygiene, and body mass index on mucositis risk 24,26 . The risk of mucositis may be influenced by genetic variants in drug‐metabolizing pathways, immune signaling, and cell injury‐repair mechanisms, although the evidence is limited or conflicting (see Supporting Table ).…”

Antibiotic-induced disruption of the microbiome exacerbates chemotherapy-induced diarrhoea and can be mitigated with autologous faecal microbiota transplantation

“…This has been most elegantly demonstrated in the case of immunotherapy-induced colitis [32e34]; however, a growing body of evidence anecdotally suggests that similar mechanisms may dictate an individual's risk of mucosal injury caused by chemotherapy [30]. In a recent systemic review of predictors of mucosal injury coordinated by the Multinational Association for Supportive Care in Cancer [11], antibiotic use in the month leading up to cancer therapy was identified as a modulator of mucosal injury [35,36]. Consistent with these findings, antibiotic administration before MTX treatment caused a profound increase in treatment-related mortality and diarrhoea.…”

“…Of particular interest, a growing body of evidence suggests that microbial disruption (i.e. caused by antibiotic use) at the time of chemotherapy increases the risk of adverse events linked to MBI, suggesting a causal role for the host microbiome [11].…”

Effectiveness of Oral Cryotherapy for Oral Mucositis on Cancer Patient Undergoing Cancer Therapy: A Systematic Review

“…The OMDQ is a self-reported instrument that can be an alternative clinical assessment if the patient refuses to do an oral examination by health practitioners [34]. A research conducted by Wardill et al reported that the NCI-CTC is an instrument that is more widely used in assessing oral mucositis in cancer patients, followed by the Radiation Oncology Research Group, the WHO mucositis scale, OMAS, Oral Mucositis Index, and OAG [35]. This research does not specify which one is the most effective instrument and more emphasize the importance of using a validated instrument in assessing mucositis.…”