Treatment of Radiation‐ and Chemotherapy‐Induced Stomatitis

Carnel, Shirley B.; Blakeslee, Don B.; Oswald, S.; Barnes, Margaret

doi:10.1177/019459989010200404

Cited by 48 publications

(21 citation statements)

References 3 publications

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“…Relief of pain due to OM was assessed with one of four agents: dyclonine, lidocaine, cocaine, a combination rinse (kaolin-pectin, diphenhydramine, and saline), and a placebo solution. The results indicated that dyclonine provided the greatest degree of pain relief but was the least palatable of the tested agents [17]. No guideline was possible due to insufficient evidence.…”

Section: Dycloninementioning

confidence: 97%

Systematic review of antimicrobials, mucosal coating agents, anesthetics, and analgesics for the management of oral mucositis in cancer patients

Saunders

Epstein²,

Sharon

et al. 2013

Support Care Cancer

148

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Purpose The aim of this project was to develop clinical practice guidelines on the use of antimicrobials, mucosal coating agents, anesthetics, and analgesics for the prevention and management of oral mucositis (OM) in cancer patients. Methods A systematic review of the available literature was conducted. The body of evidence for the use of each agent, in each setting, was assigned a level of evidence. Based on the evidence level, one of the following three guideline determinations was possible: recommendation, suggestion, or no guideline possible. and doxepin rinse in head and neck radiation therapy (H&N RT) patients. Recommendations were developed against the use of topical antimicrobial agents for the prevention of mucositis. These included recommendations against the use of iseganan for mucositis prevention in HSCT and H&N RT and against the use of antimicrobial lozenges (polymyxintobramycin-amphotericin B lozenges/paste and bacitracinclotrimazole-gentamicin lozenges) for mucositis prevention in H&N RT. Recommendations were developed against the use of the mucosal coating agent sucralfate for the prevention or treatment of chemotherapy-induced or radiation-induced OM. No guidelines were possible for any other agent due to insufficient and/or conflicting evidence. Conclusion Additional well-designed research is needed on prevention and management approaches for OM.

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Section: Dycloninementioning

confidence: 97%

Systematic review of antimicrobials, mucosal coating agents, anesthetics, and analgesics for the management of oral mucositis in cancer patients

Saunders

Epstein²,

Sharon

et al. 2013

Support Care Cancer

148

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“…A double-blind randomized trial comparing the efficacy of viscous lidocaine with 1% cocaine to dyclonine, kaolin-pectin plus diphenhydramine and saline, or placebo favored dyclonine but failed to demonstrate a significant difference among the four solutions, mostly due to the low number of enrolled patients. 99 As the duration of pain control by topical anesthetics is usually short, combinations of local anesthetics and mouthcoating agents are frequently applied. 100,101 In patients with severe oral discomfort, however, the systemic use of analgesics has to be emphasized.…”

Section: Local Anestheticsmentioning

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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“…These modalities include viscous lidocaine, cocaine rinses and spray, dyclonine and capsaicin, the active agent of chilli peppers, which desensitises pain receptors. [76][77][78] These agents provide temporary pain relief.…”

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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Treatment of Radiation‐ and Chemotherapy‐Induced Stomatitis

Cited by 48 publications

References 3 publications

Systematic review of antimicrobials, mucosal coating agents, anesthetics, and analgesics for the management of oral mucositis in cancer patients

Systematic review of antimicrobials, mucosal coating agents, anesthetics, and analgesics for the management of oral mucositis in cancer patients

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?

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