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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

Abstract

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.

Keywords

Mucositis Radiotherapy Conformal Intensity modulated radiotherapy Side effect 

Notes

Compliance with ethical standards

Conflict of interest

We have no potential conflict of interest.

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© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

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

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