Abstract
Radiation-induced mucositis is an important dose-limiting acute side effect associated with the treatment of tumors of the upper aerodigestive tract. The toxicity of radiation therapy increases with prior or concurrent administration of some chemotherapeutic agents. Pretreatment eradication of infection, maintenance of oral hygiene, and treatment breaks, as necessary, have been the mainstay of the therapeutic options for patients with radiation-induced mucositis. Recent research has begun to clarify the pathophysiology of radiation-induced mucositis. This suggests that new, more effective agents for both prevention and treatment may be forthcoming in the near future. Currently, no highly effective and widely accepted prevention or treatment exists.
Similar content being viewed by others
References
Scully C, Epstein JB: Oral health care for the cancer patient. Oral Oncol 1996, 32B:281–292.
Denham JW, Walker QJ, Lamb DS, et al.: Mucosal regeneration during radiotherapy. Radiotherapy and Oncology 1996, 41:109–118.
Kaanders JHAM, van derKogelAJ, Ang KK: Altered fractionation: limited by mucosal reactions? Radiother Oncol 1998, 50:247–260.
Handschel J, Prott FJ, Sunderkotter C, et al.: Irradiation induces increase of adhesion molecules and accumulation of beta2-integrin-expressing cells in humans. Int J Radiat Oncol Biol Phys 1999, 45:475–481. The authors describe the histomorphologic alterations of irradiated tissue and the expression patterns of various adhesion molecules.
Sonis ST, Eilers JP, Epstein JB, et al.: Validation of a new scoring system for the assessment of clinical trial research of oral mucositis induced by radiation or chemotherapy. Cancer 1999, 85:2103–2113.
Farrell CL, Bready JV, Rex KL, et al.: Keratinocyte growth factor protects mice from chemotherapy and radiation-induced gastrointestinal injury and mortality. Cancer Res 1998, 58:933–939.
Danilenko DM: Preclinical and early clinical development of keratinocyte growth factor, an epithelial-specific tissue growth factor. Toxicol Pathol 1999, 27:64–71. Recombinant human KGF provides significant cytoprotection to epithelial tissues in a variety of animal models.
Mascarin M, Franchin G, Minatel E, et al.: The effect of granulocyte colony-stimulating factor on oral mucositis in head and neck cancer patients treated with hyperfractionated radiotherapy. Oral Oncol 1999, 35:203–208.
Wagner W, Alfrink M, Haus U, Matt J: Treatment of irradiationinduced mucositis with growth factors (rhGM-CSF) in patients with head and neck cancer. Anticancer Res 1999, 19:799–803. This cytokine ameliorated symptoms of mucositis and oral pain.
Nicolatou O, Sotiropoulou-Lontou A, Skarlatos J, et al.: A pilot study of the effect of granulocyte-macrophage colonystimulating factor on oral mucositis in head and neck cancer patients during X-radiation therapy: a preliminary report. Int J Radiat Oncol Biol Phys 1998, 42:551–556.
Kannan V, Bapsy PP, Anantha N, et al.: Efficacy and safety of granulocyte macrophage-colony stimulating factor (GM-CSF) on the frequency and severity of radiation mucositis in patients with head and neck carcinoma. Int J Radiat Oncol Biol Phys 1997, 37:1005–1010.
Sonis S, Edwards L, Lucey C: The biological basis for the attenuation of mucositis: the example of interleukin-11. Leukemia 1999, 13:831–834. Interleukin-11 may be relevant to the prevention and treatment of mucositis. Intervention through biologic modification is very appealing.
Hanson WR, Marks JE, Reddy SP, et al.: Protection from radiation-induced oral mucositis by a mouth rinse containing the prostaglandin E1 analog, misoprostol: a placebo controlled double blind clinical trial. Adv Exp Med Biol 1997, 400B:811–808.
Leborgne JH, Leborgne F, Zubizarreta E, et al.: Corticosteroids and radiation mucositis in head and neck cancer: a doubleblind placebo-controlled randomized trial. Radiother Oncol 1998, 47:145–148.
Wagner W, Prott FJ, Schonekas KG: Amifostine: a radioprotector in locally advanced head and neck tumors. Oncol Rep 1998, 5:1255–1257.
Buntzel J, Kuttner K, Frohlich D, Glatzel M: Selective cytoprotection with amifostine in concurrent radiochemotherapy for head and neck cancer. Ann Oncol 1998, 9:505–509. In a phase II randomized trial, amifostine served to reduce the toxicity of chemoradiation in head and neck cancer patients.
Cengiz M, Ozyar E, Ozturk D, et al.: Sucralfate in the prevention of radiation-induced oral mucositis. J Clin Gastroenterol 1999, 28:40–43.
Lievens Y, Haustermans K, Van den Weyngaert D, et al.: Does sucralfate reduce the acute side-effects in head and neck cancer treated with radiotherapy? A double-blind randomized trial. Radiother Oncol 1998, 47:149–153.
Carter DL, Hebert ME, Smink K, et al.: Double blind randomized trial of sucralfate vs placebo during radical radiotherapy for head and neck cancers. Head & Neck 1999, 21:760–6.
Adamietz IA, Rahn R, Bottcher HD, et al.: Prophylaxis with povidone-iodine against induction of oral mucositis by radiochemotherapy. Support Care Cancer 1998, 6:373–377.
Rahn R, Adamietz IA, Boettcher HD, et al.: Povidone-iodine to prevent mucositis in patients during antineoplastic radiochemotherapy. Dermatology 1997, 195:57–61.
Oguchi M, Shikama N, Sasaki S, et al.: Mucosa-adhesive water-soluble polymer film for treatment of acute radiationinduced oral mucositis. Int J Radiat Oncol Biol Phys 1998, 40:1033–1037.
McIlroy P: Radiation mucositis: a new approach to prevention and treatment. Eur J Cancer Care 1996, 5:153–158.
Okuno SH, Foote RL, Loprinzi CL, et al.: A randomized trial of a nonabsorbable antibiotic lozenge given to alleviate radiationinduced mucositis. Cancer 1997, 79:2193–2199.
Cowen D, Tardieu C, Schubert M, et al.: Low energy heliumneon laser in the prevention of oral mucositis in patients undergoing bone marrow transplant: results of a double blind randomized trial. Int J Radiat Oncol Biol Phys 1997, 38:697–703.
Bensadoun RJ, Franquin JC, Ciais G, et al.: Low-energy He/Ne laser in the prevention of radiation-induced mucositis: a multicenter phase III randomized study in patients with head and neck cancer. Support Care Cancer 1999, 7:238–246.
Thorn JJ, Kallehave F, Westergaard P, et al.: The effect of hyperbaric oxygen on irradiated oral tissues: transmucosal oxygen tension measurements. J Oral Maxillofac Surg 1997, 55:1033–1037.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Johnson, J.T. Prevention of radiation-induced mucositis. Curr Oncol Rep 3, 56–58 (2001). https://doi.org/10.1007/s11912-001-0043-2
Issue Date:
DOI: https://doi.org/10.1007/s11912-001-0043-2