Systematic review of agents for the management of gastrointestinal mucositis in cancer patients

Gibson, Rachel J.; Keefe, Dorothy; Lalla, Rajesh V.; Bateman, Emma; Blijlevens, Nicole M. A.; Fijlstra, Margot; King, Emily E.; Stringer, Andrea M.; Velden, Walter J.F.M. van der; Yazbeck, Roger; Sharon, Elad; Bowen, Joanne M.; Isoo,

doi:10.1007/s00520-012-1644-z

Cited by 180 publications

(107 citation statements)

References 135 publications

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“…A possible explanation for these observations requiring additional investigation is that clinical manifestations of diarrhoea are not exclusively the result of mucositis and that, as in the non-oncology population, disruptions in the normal microbial flora may result in disturbed bowel function. Data supporting such a hypothesis have been derived from intervention studies using probiotic factors, which have proven effective in reducing cancer therapy-induced diarrhoea in the preclinical and clinical settings [75,76]. An additional factor affecting the role of the microbiota may be the effect of the tumour on the immune response.…”

Section: Gut Microbiomementioning

confidence: 99%

Emerging evidence on the pathobiology of mucositis

Al‐Dasooqi

Sonis

Bowen

et al. 2013

Support Care Cancer

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169

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Background Considerable progress has been made in our understanding of the biological basis for cancer therapyinduced mucosal barrier injury (mucositis). The last formal review of the subject by MASCC/ISOO was published in 2007; consequently, an update is timely. Methods Panel members reviewed the biomedical literature on mucositis pathobiology published between January 2005 and December 2011.Results Recent research has provided data on the contribution of tissue structure changes, inflammation and microbiome changes to the development of mucositis. Additional research has focused on targeted therapyinduced toxicity, toxicity clustering and the investigation of genetic polymorphisms in toxicity prediction. This review paper summarizes the recent evidence on these aspects of mucositis pathobiology. Conclusion The ultimate goal of mucositis researchers is to identify the most appropriate targets for therapeutic interventions and to be able to predict toxicity risk and personalize interventions to genetically suitable patients. Continuing research efforts are needed to further our understanding of mucositis pathobiology and the pharmacogenomics of toxicity.

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Section: Gut Microbiomementioning

confidence: 99%

Emerging evidence on the pathobiology of mucositis

Al‐Dasooqi

Sonis

Bowen

et al. 2013

Support Care Cancer

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169

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“…The severity of gastrointestinal adverse effects associated with 5FU/LV chemotherapy is increased with the incorporation of oxaliplatin in the regimen (Bano and Najam, 2013b;Bano et al, 2013c) FOLFOX4 is associated with grade 3 or 4 diarrhea (Uncu et al, 2013) and nausea/vomiting (Lee et al, 2013) protocol. Diarrhea is a frequent dose limiting toxicity of FOLFOX (Comeau and Mohundro, 2013) Lactobacillus spp containing probiotic treatment is recommended in chemotherapy or radiotherapy induced diarrhea (Gibson et al, 2013). Nausea and vomiting can be effectively managed by dexamethasone and indisetron in optimal doses in approximately 80% cases (Nakatsumi et al, 2013).…”

Section: Introductionmentioning

confidence: 99%

Gastrointestinal Adverse Effects in Advanced Colorectal Carcinoma Patients Treated with Different Schedules of FOLFOX

Bano

Najam²,

Qazi³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: To assess the frequency and severity of gastrointestinal adverse effects in advanced colorectal carcinoma patients treated with four different schedules of FOLFOX. Materials and Methods: Patients (median age 61 years) who underwent surgery were included in the study. All had measureable disease at CT scan, ultrasonography or clinical examination. Toxicity was graded on a scale of 1-5 according to the general grade definition of CTC v2.0. The severity of adverse effects (Grade 3 and 4) assessed in each treatment arm was compared. Results: Differences between the incidence rates of 3 and 4 toxicity and all grades of toxicity for all parameters in GI toxicity were very highly significant (p<0.001). Severe gastrointestinal symptoms of toxicity were noted with FOLFOX7 (oxaliplatin 130 mg/m 2 ). Grade 3 diarrhea was reported in 25% patients and grade 4 diarrhea in 4% in the FOLFOX7 treatment arm. Grade 2 vomiting was very frequently reported in the FOLFOX4 treatment arm (oxaliplatin 85mg/m 2 ). Grade 2 stomatitis was reported in 42% patients treated with mFOLFOX6 (oxaliplatin 100mg/m 2 ). Differences in the incidence rate of nausea, diarrhea and stomatitis among all treatment arms of FOLFOX were significant (p<0.05) . Conclusions: Severe diarrhea is associated with FOLFOX7 treatment. No grade 3 or 4 GI toxicity was reported in patients of the mFOLFOX6 arm.

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“…Chronic gastrointestinal side effects occur in over 30% of patients [42]. A meta-analysis concluded that probiotic treatment with Lactobacillus spp could prevent chemotherapy and radiation enteritis-induced diarrhea in patients with pelvic malignancies [52].…”

Section: Radiation Enteritismentioning

confidence: 99%

Probiotics and Periodontal Diseases

Morales¹,

Bravo²,

Bedoya³

et al. 2017

Insights Into Various Aspects of Oral Health

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Probiotics are defined as live microorganisms that, when administered in adequate amounts, confer a health benefit on the host. Probiotics have been used to directly modify the resident oral microbiome and proposed to modulate immune responses. In dentistry, probiotics have been employed as useful adjuncts for the reduction of caries development, suppressing oral Candida infection and controlling halitosis. Plaque-induced gingivitis is a gingival inflammation caused by the adherent bacterial biofilm around teeth. Gingivitis and periodontitis are considered to be a continuum of the same inflammatory process, although many gingivitis lesions do not progress to periodontitis. Periodontitis is an inflammatory process that affects the attachment structures of teeth. It constitutes a second cause of tooth loss worldwide. Conventional treatment modalities of periodontal disease include non-surgical and/or surgical management, with an emphasis on mechanical debridement. However, mechanical debridement as a sole therapy is not always effective to improve clinical parameters. A growing number of studies support probiotic therapy to prevent or treat gingivitis and periodontitis. Oral administration of probiotics is an effective adjunct in reducing pathogenic bacteria and improving clinical signs of disease. Probiotics may serve as adjunct or replacement therapy substitute antibiotics in managing human periodontal infections in future.

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Systematic review of agents for the management of gastrointestinal mucositis in cancer patients

Cited by 180 publications

References 135 publications

Emerging evidence on the pathobiology of mucositis

Emerging evidence on the pathobiology of mucositis

Gastrointestinal Adverse Effects in Advanced Colorectal Carcinoma Patients Treated with Different Schedules of FOLFOX

Probiotics and Periodontal Diseases

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