Supportive Care in Cancer

, Volume 14, Issue 6, pp 505–515

Epidemiology of treatment-associated mucosal injury after treatment with newer regimens for lymphoma, breast, lung, or colorectal cancer

  • Jeffrey A. Jones
  • Elenir B. C. Avritscher
  • Catherine D. Cooksley
  • Marisol Michelet
  • B. Nebiyou Bekele
  • Linda S. Elting
Review Article

DOI: 10.1007/s00520-006-0055-4

Cite this article as:
Jones, J.A., Avritscher, E.B.C., Cooksley, C.D. et al. Support Care Cancer (2006) 14: 505. doi:10.1007/s00520-006-0055-4

Abstract

Goals of work: Oral and gastrointestinal (GI) mucositis are frequent complications of chemotherapy and radiotherapy for cancer, contributing to not only the morbidity of treatment but its cost as well. The risk associated with specific chemotherapeutic agents, alone and in combination, has been characterized previously. In the current study, we sought to estimate the risk associated with newer regimens for the treatment of non-Hodgkin’s lymphoma (NHL) and common solid tumors. Methods: We reviewed published studies reporting phase II and III clinical trials of dose-dense regimens for breast cancer and NHL, TAC (docetaxel, adriamycin, cyclophosphamide) chemotherapy for breast cancer, and infusional 5-fluorouracil-based regimens for colorectal cancer. Platinum-, gemcitabine-, and taxane-based regimens for lung cancer, either alone or in combination with radiotherapy, were also considered. Using modified meta-analysis methods, we calculated quality-adjusted estimates of the risk for oral and GI mucositis by tumor type and regimen. Case reports are used to emphasize the relevance of the findings for patient care. Main results: Our findings demonstrate that mucosal toxicity remains an important complication of cancer treatment. Moreover, innovations in drug combinations, scheduling, or mode of administration significantly modulate the risk for both oral and GI mucositis. Conclusions: Ongoing review of the clinical trial experience will remain important as newer, targeted agents enter standard clinical practice.

Keywords

Oral and gastrointestinal mucositis Chemotherapy Risk estimate Meta-analysis Case reports 

Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Jeffrey A. Jones
    • 1
  • Elenir B. C. Avritscher
    • 1
  • Catherine D. Cooksley
    • 1
  • Marisol Michelet
    • 2
  • B. Nebiyou Bekele
    • 3
  • Linda S. Elting
    • 1
  1. 1.Section of Health Services Research, Department of BiostatisticsThe University of Texas M. D. Anderson Cancer CenterHoustonUSA
  2. 2.FUNDALEU (Foundation for the Fight Against Leukemia)Buenos AiresArgentina
  3. 3.Department of Biostatistics and Applied MathematicsThe University of Texas M. D. Anderson Cancer CenterHoustonUSA

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