Vitamin E in the treatment of chemotherapy-induced mucositis

Wadleigh, Robert G.; Redman, Robert S.; Graham, Mary Lou; Krasnow, Steven H.; Anderson, Alan; Cohen, Martin H.

doi:10.1016/0002-9343(92)90744-v

Cited by 130 publications

(62 citation statements)

References 7 publications

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“…Results reported from clinical trials with supplementation of glutamine in patients with oral mucositis are controversial, since transfer of these observations from an animal model to clinical trials could not be proven. [95][96][97] Systemic application of ␤-carotene for prophylaxis, 98 and topical application of tocopherole 99 for treatment of oral mucositis has been reported as beneficial. Confirmation of these trials is necessary.…”

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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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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“…There are several studies regarding the effects of antioxidant agents such as vitamin E, β-carotene, selenium and zinc sulfate with different results on prevention of OM induced by chemotherapy and/or radiation therapy. [7][8][9][10] N-acetyl cysteine (NAC), an antioxidant containing thiol groups, is a form of amino-acid cysteine, which is widely used as mucolytic agent or an antidote for acetaminophen overdose hepatotoxicity. NAC stimulates glutathione synthesis and scavenges free radicals.…”

Section: Introductionmentioning

confidence: 99%

N-acetyl cysteine for prevention of oral mucositis in hematopoietic SCT: a double-blind, randomized, placebo-controlled trial

Moslehi

Taghizadeh-Ghehi

Gholami

et al. 2014

Bone Marrow Transplant

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Oral mucositis (OM) is a complication of high-dose chemotherapy (HDC) which is frequently observed in hematopoietic SCT settings. Antioxidant agents have been proposed to prevent OM and therefore N-acetyl cysteine (NAC) could have an important role. In the present study, we conducted a double-blind, randomized, placebo-controlled study to evaluate the NAC effect on OM incidence and severity, and also glutathione peroxidase-1 activity. Leukemia patients undergoing allogeneic hematopoietic SCT preceded by HDC were recruited into the study and received either NAC (100 mg/kg/day) (n = 38) or placebo (n = 42) from the starting day of HDC until day +15 after transplantation. OM was evaluated daily for 21 days after transplantation according to World Health Organization oral toxicity scale. The incidence of severe OM (grades 3-4) was significantly lower in the NAC group (23.7% vs 45.3%, P = 0.04). Moreover, the mean duration of OM was significantly shorter in the intervention group (6.24(2.96) vs 8.12(3.97) days, P = 0.02). The glutathione peroxidase-1 activity was also significantly higher in the NAC group seven days after transplantation (3.38(2.19) vs 2.41(1.70) ng/mL, P = 0.003). It is concluded that parenteral NAC is effective in reducing the incidence of severe cases and the total duration of OM.

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“…Among these agents, amifostine, 15 vitamins with antioxidant properties, 16 and prostaglandins or prostaglandin analogs have been evaluated with mixed results. 17,18 Pilot studies of two anticholinergic agents, pilocarpine and probanthine, suggest possible benefit, 19,20 possibly through stimulation of the salivary flow.…”

Section: Introductionmentioning

confidence: 99%

The biological basis for the attenuation of mucositis: the example of interleukin-11

1999

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Oral mucositis is common, painful, dose-limiting toxicity of drug and radiation therapy for cancer. In granulocytopenic patients, the ulcerations which accompany mucositis are frequent portals of entry for indigenous oral bacteria often leading to bacteremias or sepsis. The complexity of mucositis as a biological process has only recently been appreciated. The condition appears to represent a sequential interaction of the oral mucosal cells and tissues, pro-inflammatory cytokines, and local environmental factors in the mouth such as microorganisms and saliva. The recognition that the pathophysiology of mucositis is a multifactorial process has presented opportunities for intervention based on biological attenuation. Interleukin-11, a pleotropic cytokine, has a range of activities which is potentially relevant to mucositis. Consequently, it has been used successfully to modify the development, severity and course of mucositis in an animal model which closely mimics the equivalent human condition.

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Vitamin E in the treatment of chemotherapy-induced mucositis

Cited by 130 publications

References 7 publications

Prophylaxis and treatment of chemo- and radiotherapy-induced oral mucositis – are there new strategies?

Prophylaxis and treatment of chemo- and radiotherapy-induced oral mucositis – are there new strategies?

N-acetyl cysteine for prevention of oral mucositis in hematopoietic SCT: a double-blind, randomized, placebo-controlled trial

The biological basis for the attenuation of mucositis: the example of interleukin-11

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