European Archives of Oto-Rhino-Laryngology

, Volume 273, Issue 9, pp 2285–2293 | Cite as

Radiation induced oral mucositis: a review of current literature on prevention and management

  • Supriya MallickEmail author
  • Rony Benson
  • G. K. Rath
Review Article


Oral mucositis (OM) is a major limiting acute side effect of radiotherapy for head and neck cancer. The spectrum of problems associated with mucositis includes oral pain, odynophagia, reduced oral intake, and secondary infections. Incidence of mucositis is increased with addition of concurrent chemotherapy as well as altered fractionation schedules. This leads to treatment interruption and suboptimal disease control. Hence, prevention as well as timely management of OM is necessary for optimum tumor control. We reviewed the English literature with key words “Radiation induced mucositis, Mucositis, Oral Mucositis” to find relevant articles describing incidence, pathophysiology, prophylaxis, and treatment of oral mucositis. Prevention and treatment of OM is an active area of research. Maintenance of oral hygiene is an important part in prevention of OM. A battery of agents including normal saline and alkali (soda bicarbonate) mouth washes, low level laser therapy, and benzydamine (non-steroidal analgesic and anti-inflammatory) have effectiveness in the prevention and treatment of radiation induced oral mucositis. Chlorhexidine mouth gargles are recommended for prevention of chemotherapy induced oral mucositis but is not recommended for radiotherapy associated mucositis. Treatment of co-existing infection is also important and both topical (povidone iodine) and systemic anti fungals should be used judiciously. Radiation induced oral mucositis is a common problem limiting the efficacy of radiation by increasing treatment breaks. Adequate prophylaxis and treatment may limit the severity of radiation mucositis and improve compliance to radiation which may translate in better disease control and survival.


Mucositis Radiotherapy Conformal Intensity modulated radiotherapy Side effect 


Compliance with ethical standards

Conflict of interest

We have no potential conflict of interest.


  1. 1.
    Trotti A, Bellm LA, Epstein JB, Frame D, Fuchs HJ, Gwede CK, Komaroff E, Nalysnyk L, Zilberberg MD (2003) Mucositis incidence, severity and associated outcomes in patients with head and neck cancer receiving radiotherapy with or without chemotherapy: a systematic literature review. Radiother Oncol 66(3):253–262CrossRefPubMedGoogle Scholar
  2. 2.
    Sonis ST (2004) The pathobiology of mucositis. Nat Rev Cancer 4(4):277–284CrossRefPubMedGoogle Scholar
  3. 3.
    Ps SK, Balan A, Sankar A, Bose T (2009) Radiation induced oral mucositis. Indian J Palliat Care 15(2):95–102CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Bjarnason GA, Mackenzie RG, Nabid A, Hodson ID, El-Sayed S, Grimard L, Brundage M, Wright J, Hay J, Ganguly P, Leong C, Wilson J, Jordan RC, Walker M, Tu D, Parulekar W (2009) Comparison of toxicity associated with early morning versus late afternoon radiotherapy in patients with head-and-neck cancer: a prospective randomized trial of the National Cancer Institute of Canada Clinical Trials Group (HN3). Int J Radiat Oncol Biol Phys 73(1):166–172CrossRefPubMedGoogle Scholar
  5. 5.
    Mcguire DB, Fulton JS, Park J, Brown CG, Correa ME, Eilers J, Elad S (2013) Systematic review of basic oral care for the management of oral mucositis in cancer patients. Support Care Cancer 21(11):3165–3177CrossRefPubMedGoogle Scholar
  6. 6.
    Bossi P, Numico G, De Santis V, Ruo Redda MG, Reali A, Belgioia L, Cossu Rocca M, Orlandi E, Airoldi M, Bacigalupo A, Mazzer M, Saibene G, Russi E (2014) Prevention and treatment of oral mucositis in patients with head and neck cancer treated with (chemo) radiation: report of an Italian survey. Support Care Cancer 22(7):1889–1896PubMedGoogle Scholar
  7. 7.
    Quinn B (2013) Efficacy of a supersaturated calcium phosphate oral rinse for the prevention and treatment of oral mucositis in patients receiving high-dose cancer therapy: a review of current data. Eur J Cancer Care (Engl) 22(5):564–579CrossRefGoogle Scholar
  8. 8.
    Lambrecht M, Mercier C, Geussens Y, Nuyts S (2013) The effect of a supersaturated calcium phosphate mouth rinse on the development of oral mucositis in head and neck cancer patients treated with (chemo)radiation: a single-center, randomized, prospective study of a calcium phosphate mouth rinse + standard of care versus standard of care. Support Care Cancer 21(10):2663–2670CrossRefPubMedGoogle Scholar
  9. 9.
    Kazemian A, Kamian S, Aghili M, Hashemi FA, Haddad P (2009) Benzydamine for prophylaxis of radiation-induced oral mucositis in head and neck cancers: a double-blind placebo-controlled randomized clinical trial. Eur J Cancer Care 18:174–178CrossRefGoogle Scholar
  10. 10.
    Epstein JB, Silverman S Jr, Paggiarino DA, Crockett S, Schubert MM, Senzer NN, Lockhart PB, Gallagher MJ, Peterson DE, Leveque FG (2001) Benzydamine hcl for prophylaxis of radiation-induced oral mucositis: results from a multicenter, randomized, double-blind, placebo-controlled clinical trial. Cancer 92(4):875–885CrossRefPubMedGoogle Scholar
  11. 11.
    Nicolatou-Galitis O, Sarri T, Bowen J, Di Palma M, Kouloulias VE, Niscola P, Riesenbeck D (2013) Systematic review of anti-inflammatory agents for the management of oral mucositis in cancer patients. Support Care Cancer 21(11):3179–3189CrossRefPubMedGoogle Scholar
  12. 12.
    Cengiz M, Ozyar E, Oztürk D, Akyol F, Atahan IL, Hayran M (1999) Sucralfate in the prevention of radiation-induced oral mucositis. J Clin Gastroenterol 28(1):40–43CrossRefPubMedGoogle Scholar
  13. 13.
    Carter DL, Hebert ME, Smink K, Leopold KA, Clough RL, Brizel DM (1999) Double blind randomized trial of sucralfate vs placebo during radical radiotherapy for head and neck cancers. Head Neck 21(8):760–766CrossRefPubMedGoogle Scholar
  14. 14.
    Saunders DP, Epstein JB, Elad S, Allemano J, Bossi P, van de Wetering MD, Rao NG, Potting C, Cheng KK, Freidank A, Brennan MT, Bowen J, Dennis K, Lalla RV, Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) (2013) Systematic review of antimicrobials, mucosal coating agents, anesthetics, and analgesics for the management of oral mucositis in cancer patients. Support Care Cancer 21(11):3191–3207CrossRefPubMedGoogle Scholar
  15. 15.
    Sahebjamee M, Mansourian A, Mohammad MH, Zadeh MT, Bekhradi R, Kazemian A, Manifar S, Ashnagar S, Doroudgar K (2014) Comparative efficacy of aloe vera and benzydamine mouth washes on radiation-induced oral mucositis: a triple-blind, randomised, controlled clinical trial. Oral Health Prev Dent. doi: 10.3290/j.ohpd.a33091 (Epub ahead of print) Google Scholar
  16. 16.
    Bennet NT, Shult GS (1993) Growth factors and wound healing: biochemical properties of growth factors and their receptors. Am J Surg 165:728–737CrossRefGoogle Scholar
  17. 17.
    Braunstein S, Kaplan G, Gottlieb AB, Schwartz M, Walsh G, Abalos RM, Fajardo TT, Guido LS, Krueger JG (1994) GM-CSF activates regenerative epidermal growth and stimulates keratinocyte proliferation in human skin in vivo. J Invest Dermatol 103:601–604CrossRefPubMedGoogle Scholar
  18. 18.
    Nicolatou O, Sotiropoulou-Lontou A, Skarlatos J, Kyprianou K, Kolitsi G, Dardoufas K (1998) A pilot study of the effect of granulocyte-macrophage colony-stimulating factor on oral mucositis in head and neck cancer patients during X-radiation therapy: a preliminary report. Int J Radiat Oncol Biol Phys 42(3):551–556CrossRefPubMedGoogle Scholar
  19. 19.
    Wagner W, Alfrink M, Haus U, Matt J (1999) Treatment of irradiation induced mucositis with growth factors (rhgm-CSF) in patients with head and neck cancer. Anticancer Res 19:799–803PubMedGoogle Scholar
  20. 20.
    Saarilahti K, Kajanti M, Joensuu T, Kouri M, Joensuu H (2002) Comparison of granulocyte-macrophage colony-stimulating factor and sucralfate mouthwashes in the prevention of radiation-induced mucositis: a double-blind prospective randomized phase III study. Int J Radiat Oncol Biol Phys 54(2):479–485CrossRefPubMedGoogle Scholar
  21. 21.
    Mcaleese JJ, Bishop KM, A’Hern R, Henk JM (2006) Randomized phase II study of GMCSF to reduce mucositis caused by accelerated radiotherapy of laryngeal cancer. Br J Radiol 79(943):608–613CrossRefPubMedGoogle Scholar
  22. 22.
    Hoffman KE, Pugh SL, James JL, Scarantino C, Movsas B, Valicenti RK, Fortin A (2014) The impact of concurrent granulocyte-macrophage colony-stimulating factor on quality of life in head and neck cancer patients: results of the randomized, placebo-controlled Radiation Therapy Oncology Group 9901 trial. Qual Life Res 23(6):1841–1858CrossRefPubMedPubMedCentralGoogle Scholar
  23. 23.
    Ryu JK, Swann S, leveque F, Scarantino CW, Johnson D, Chen A, Fortin A, Pollock J, Kim H, Ang KK (2007) The impact of concurrent granulocyte macrophage-colony stimulating factor on radiation-induced mucositis in head and neck cancer patients: a double-blind placebo-controlled prospective phase III study by Radiation Therapy Oncology Group 9901. Int J Radiat Oncol Biol Phys 67(3):643–650CrossRefPubMedGoogle Scholar
  24. 24.
    Masucci G, Broman P, Kelly C, Lindahl S, Malmberg L, Reizenstein J, Alenius M, Lewensohn R (2005) Therapeutic efficacy by recombinant human granulocyte/monocyte-colony stimulating factor on mucositis occurring in patients with oral and oropharynx tumors treated with curative radiotherapy: a multicenter open randomized phase III study. Med Oncol 22(3):247–256CrossRefPubMedGoogle Scholar
  25. 25.
    Spijkervet FK, Van Saene HK, Van Saene JJ, Panders AK, Vermey A, Mehta DM, Fidler V (1991) Effect of selective elimination of the oral flora on mucositis in irradiated head and neck cancer patients. J Surg Oncol 46(3):167–173CrossRefPubMedGoogle Scholar
  26. 26.
    Symonds RP, Mcilroy P, Khorrami J, Paul J, Pyper E, Alcock SR, Mccallum I, Speekenbrink AB, Mcmurray A, Lindemann E, Thomas M (1996) The reduction of radiation mucositis by selective decontamination antibiotic pastilles: a placebo-controlled double-blind trial. Br J Cancer 74(2):312–317CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Wijers OB, Levendag PC, Harms ER, Gan-Teng AM, Schmitz PI, Hendriks WD, Wilims EB, van der Est H, Visch LL (2001) Mucositis reduction by selective elimination of oral flora in irradiated cancers of the head and neck: a placebo-controlled double-blind randomized study. Int J Radiat Oncol Biol Phys 50(2):343–352CrossRefPubMedGoogle Scholar
  28. 28.
    De Paula Eduardo F, Bezinelli LM, da Graça Lopes RM, Nascimento Sobrinho JJ, Hamerschlak N, Correa L (2014) Efficacy of cryotherapy associated with laser therapy for decreasing severity of melphalan-induced oral mucositis during hematological stem-cell transplantation: a prospective clinical study. Hematol Oncol. doi: 10.1002/hon.2133 (Epub ahead of print) Google Scholar
  29. 29.
    Saadeh CE (2005) Chemotherapy- and radiotherapy-induced oral mucositis: review of preventive strategies and treatment. Pharmacotherapy 25(4):540–554CrossRefPubMedGoogle Scholar
  30. 30.
    Spielberger R, Stiff P, Bensinger W, Gentile T, Weisdorf D, Kewalramani T, Shea T, Yanovich S, Hansen K, Noga S, McCarty J, LeMaistre CF, Sung EC, Blazar BR, Elhardt D, Chen MG, Emmanouilides C (2004) Palifermin for oral mucositis after intensive therapy for hematologic cancers. N Engl J Med 351:2590–2598CrossRefPubMedGoogle Scholar
  31. 31.
    Vadhan-Raj S, Trent J, Patel S, Zhou X, Johnson MM, Araujo D, Ludwig JA, O’Roark S, Gillenwater AM, Bueso-Ramos C (2010) Single-dose palifermin prevents severe oral mucositis during multicycle chemotherapy in patients with cancer: a randomized trial. Ann Intern Med 153(6):358–367CrossRefPubMedGoogle Scholar
  32. 32.
    Henke M, Alfonsi M, Foa P, Giralt J, Bardet E, Cerezo L, Salzwimmer M, Lizambri R, Emmerson L, Chen MG, Berger D (2011) Palifermin decreases severe oral mucositis of patients undergoing postoperative radiochemotherapy for head and neck cancer: a randomized, placebo-controlled trial. J Clin Oncol 29(20):2815–2820CrossRefPubMedGoogle Scholar
  33. 33.
    Le QT, Kim HE, Schneider CJ, Muraközy G, Skladowski K, Reinisch S, Chen Y, Hickey M, Mo M, Chen MG, Berger D, Lizambri R, Henke M (2011) Palifermin reduces severe mucositis in definitive chemoradiotherapy of locally advanced head and neck cancer: a randomized, placebo-controlled study. J Clin Oncol 29(20):2808–2814CrossRefPubMedGoogle Scholar
  34. 34.
    Bianco JA, Appelbaum FR, Nemunaitis J, Almgren J, Andrews F, Kettner P, Shields A, Singer JW (1991) Phase I–II trial of pentoxifylline for the prevention of transplant-related toxicities following bone marrow transplantation. Blood 78(5):1205–1211PubMedGoogle Scholar
  35. 35.
    Peterson DE, Jones JB, Petit RG 2nd (2007) A Randomized, placebo-controlled trial of Saforis for prevention and treatment of oral mucositis in breast cancer patients receiving anthracycline-based chemotherapy. Cancer 109:322–331CrossRefPubMedGoogle Scholar
  36. 36.
    Anderson PM, Schroeder G, Skubitz KM (1998) Oral glutamine reduces the duration and severity of stomatitis after cytotoxic cancer chemotherapy. Cancer 83(7):1433–1439CrossRefPubMedGoogle Scholar
  37. 37.
    Tsujimoto T, Yamamoto Y, Wasa M, Takenaka Y, Nakahara S, Takagi T, Tsugane M (2015) l-glutamine decreases the severity of mucositis induced by chemoradiotherapy in patients with locally advanced head and neck cancer: a double-blind, randomized, placebo-controlled trial. Oncol Rep 33(1):33–39PubMedGoogle Scholar
  38. 38.
    Chattopadhyay S, Saha A, Azam M, Mukherjee A, Sur PK (2014) Role of oral glutamine in alleviation and prevention of radiation-induced oral mucositis: a prospective randomized study. South Asian J Cancer 3(1):8–12CrossRefPubMedPubMedCentralGoogle Scholar
  39. 39.
    Bensadoun RJ, Franquin JC, Ciais G, Darcourt V, Schubert MM, Viot M, Dejou J, Tardieu C, Benezery K, Nguyen TD, Laudoyer Y, Dassonville O, Poissonnet G, Vallicioni J, Thyss A, Hamdi M, Chauvel P, Demard F (1999) Low-energy He/Ne laser in the prevention of radiation-induced mucositis: a multicenter phase III randomized study in patient’s with head and neck cancer. Support Care Cancer 7:244–252CrossRefPubMedGoogle Scholar
  40. 40.
    Basso FG, Pansani TN, Soares DG, Scheffel DL, Bagnato VS, Costa CA, Hebling J (2015) Biomodulation of Inflammatory Cytokines Related to Oral Mucositis by Low-Level Laser Therapy. Photochem Photobiol. doi: 10.1111/php.12445 (Epub ahead of print) PubMedGoogle Scholar
  41. 41.
    Fekrazad R, Chiniforush N (2014) Oral mucositis prevention and management by therapeutic laser in head and neck cancers. J Lasers Med Sci 5(1):1–7 (Review) PubMedPubMedCentralGoogle Scholar
  42. 42.
    Gautam AP, Fernandes DJ, Vidyasagar MS, Maiya AG, Vadhiraja BM (2012) Low level laser therapy for concurrent chemoradiotherapy induced oral mucositis in head and neck cancer patients—a triple blinded randomized controlled trial. Radiother Oncol 104(3):349–354CrossRefPubMedGoogle Scholar
  43. 43.
    Carvalho PA, Jaguar GC, Pellizzon AC, Prado JD, Lopes RN, Alves FA (2011) Evaluation of low-level laser therapy in the prevention and treatment of radiation-induced mucositis: a double-blind randomized study in head and neck cancer patients. Oral Oncol 47(12):1176–1181CrossRefPubMedGoogle Scholar
  44. 44.
    Lima AG, Antequera R, Peres MP, Snitcosky IM, Federico MH, Villar RC (2010) Efficacy of low-level laser therapy and aluminum hydroxide in patients with chemotherapy and radiotherapy-induced oral mucositis. Braz Dent J 21(3):186–192CrossRefPubMedGoogle Scholar
  45. 45.
    Oberoi S, Zamperlini-Netto G, Beyene J, Treister NS, Sung L (2014) Effect of prophylactic low level laser therapy on oral mucositis: a systematic review and meta-analysis. PLoS One 9(9):e107418CrossRefPubMedPubMedCentralGoogle Scholar
  46. 46.
    Mills EE (1988) The modifying effect of beta-carotene on radiation and radiotherapy and chemotherapy induced oral mucositis. Br J Cancer 57:416–417CrossRefPubMedPubMedCentralGoogle Scholar
  47. 47.
    Mose S, Adamietz IA, Saran F, Thilmann C, Heyd R, Knecht R, Böttcher HD (1997) Can prophylactic application of immunoglobulin decrease radiotherapy-induced oral mucositis. Am J Clin Oncol 20:407–411CrossRefPubMedGoogle Scholar
  48. 48.
    Labar B, Mrsic M, Pavletic Z, Bogdanic V, Nemet D, Aurer I, Radman I, Filipovic-Grcic N, Sertic D, Kalenic S et al (1993) Prostaglandin E2 for prophylaxis of oral mucositis following BMT. Bone Marrow Transplant 11(379–382):36Google Scholar
  49. 49.
    Kuhrer I, Kuzmits R, Linkesch W, Ludwig H (1986) Topical PGE2 enhances healing of chemotherapy-associated mucosal lesions. Lancet 1(8481):623CrossRefPubMedGoogle Scholar
  50. 50.
    Bubley GJ, Chapman B, Chapman SK, Crumpacker CS, Schnipper LE (1989) Effect of acyclovir on radiation- and chemotherapy-induced mouth lesions. Antimicrob Agent Chemother 33(6):862–865CrossRefGoogle Scholar
  51. 51.
    Trotti A, Garden A, Warde P, Symonds P, Langer C, Redman R, Pajak TF, Fleming TR, Henke M, Bourhis J, Rosenthal DI, Junor E, Cmelak A, Sheehan F, Pulliam J, Devitt-Risse P, Fuchs H, Chambers M, O’Sullivan B, Ang KK (2004) A multinational, randomized phase III trial of iseganan hcl oral solution for reducing the severity of oral mucositis in patients receiving radiotherapy for head-and-neck malignancy. Int J Radiat Oncol Biol Phys 58(3):674–681CrossRefPubMedGoogle Scholar
  52. 52.
    Adamietz IA, Rahn R, Böttcher HD, Schäfer V, Reimer K, Fleischer W (1998) Prophylaxis with povidone–iodine against induction of oral mucositis by radiochemotherapy. Support Care Cancer 6(4):373–377CrossRefPubMedGoogle Scholar
  53. 53.
    El-Sayed S, Nabid A, Shelley W, Hay J, Balogh J, Gelinas M, MacKenzie R, Read N, Berthelet E, Lau H, Epstein J, Delvecchio P, Ganguly PK, Wong F, Burns P, Tu D, Pater J (2002) Prophylaxis of radiation-associated mucositis in conventionally treated patients with head and neck cancer: a double-blind, phase III, randomized, controlled trial evaluating the clinical efficacy of an antimicrobial lozenge using a validated mucositis scoring system. J Clin Oncol 20(19):3956–3963CrossRefPubMedGoogle Scholar
  54. 54.
    Nicolatou-Galitis O, Velegraki A, Sotiropoulou-Lontou A, Dardoufas K, Kouloulias V, Kyprianou K, Kolitsi G, Skarleas C, Pissakas G, Papanicolaou VS, Kouvaris J (2006) Effect of fluconazole antifungal prophylaxis on oral mucositis in head and neck cancer patients receiving radiotherapy. Support Care Cancer 14(1):44–51CrossRefPubMedGoogle Scholar
  55. 55.
    Ehrnrooth E, Grau C, Zachariae R, Andersen J (2001) Randomized trial of opioids versus tricyclic antidepressants for radiation-induced mucositis pain in head and neck cancer. Acta Oncol 40(6):745–750CrossRefPubMedGoogle Scholar
  56. 56.
    Leenstra JL, Miller RC, Qin R, Martenson JA, Dornfeld KJ, Bearden JD, Puri DR, Stella PJ, Mazurczak MA, Klish MD, Novotny PJ, Foote RL, Loprinzi CL (2014) Doxepin rinse versus placebo in the treatment of acute oral mucositis pain in patients receiving head and neck radiotherapy with or without chemotherapy: a phase III, randomized, double-blind trial (NCCTG-N09C6 [Alliance]). J Clin Oncol 32(15):1571–1577CrossRefPubMedPubMedCentralGoogle Scholar
  57. 57.
    Kim JH, Chu FC, Lakshmi V, Houde R (1986) Benzydamine hcl, a new agent for the treatment of radiation mucositis of the oropharynx. Am J Clin Oncol 9:132–134CrossRefPubMedGoogle Scholar
  58. 58.
    Meredith R, Salter M, Kim R, Spencer S, Weppelmann B, Rodu B, Smith J, Lee J (1997) Sucralfate for radiation mucositis: results of a double-blind randomized trial. Int J Radiat Oncol Biol Phys 37(2):275–279CrossRefPubMedGoogle Scholar
  59. 59.
    Pfeiffer P, Hansen O, Madsen EL, May O (1990) A prospective pilot study on the effect of sucralfate mouth-swishing in reducing stomatitis during radiotherapy of the oral cavity. Acta Oncol 29(4):471–473CrossRefPubMedGoogle Scholar
  60. 60.
    Kaushal V, Verma K, Manocha S, Hooda HS, Das BP (2001) Clinical evaluation of human placental extract (placentrex) in radiation-induced oral mucositis. Int J Tissue React 23:105–110PubMedGoogle Scholar
  61. 61.
    Arun Maiya G, Sagar MS, Fernandes D (2006) Effect of low level helium–neon (He–Ne) laser therapy in the prevention and treatment of radiation induced mucositis in head and neck cancer patients. Indian J Med Res 124(4):399–402PubMedGoogle Scholar
  62. 62.
    Zanin T, Zanin F, Carvalhosa AA, Castro PH, Pacheco MT, Zanin IC, Brugnera A Jr (2010) Use of 660-nm diode laser in the prevention and treatment of human oral mucositis induced by radiotherapy and chemotherapy. Photomed Laser Surg 28(2):233–237CrossRefPubMedGoogle Scholar
  63. 63.
    Khouri VY, Stracieri AB, Rodrigues MC, Moraes DA, Pieroni F, Simões BP, Voltarelli JC (2009) Use of therapeutic laser for prevention and treatment of oral mucositis. Braz Dent J 20(3):215–220CrossRefPubMedGoogle Scholar
  64. 64.
    Bjordal JM, Bensadoun RJ, Tunèr J, Frigo L, Gjerde K, Lopes-Martins RA (2011) A systematic review with meta-analysis of the effect of low-level laser therapy (LLLT) in cancer therapy-induced oral mucositis. Support Care Cancer 19(8):1069–1077CrossRefPubMedGoogle Scholar
  65. 65.
    Lalla Rajesh V, Bowen J, Barasch A, Elting L, Epstein J, Keefe Dorothy M, McGuire Deborah B, Migliorati C, Nicolatou-Galitis O, Peterson Douglas E, Raber-Durlacher Judith E, Sonis Stephen T, Elad S, The Mucositis Guidelines Leadership Group of the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) (2014) MASCC/ISOO clinical practice guidelines for the management of mucositis secondary to cancer therapy. Cancer 120(10):1453–1461CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Department of Radiation OncologyAll India Institute of Medical SciencesNew DelhiIndia

Personalised recommendations