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Dose-limiting mucositis: friend or foe?

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Abstract

Dose-limiting toxicities are ubiquitous to cancer-directed therapy, presenting with severity to a degree that necessitates therapy de-escalation, pause, or discontinuation. To date, there is incredible limited understanding if these therapy de-escalations present risk for survival by limiting delivery of intensive therapy, or if they indicate physiologic susceptibility and are a favorable prognostic indicator. Mucositis is an excellent illustration of the current paradox of dose-limiting toxicities—it has existed alongside therapy for eight decades, but despite its presence, there is an incomplete understanding of how it develops, why it varies between oncologic populations, and if it relates to cancer survival. Rigorous methodologic approaches in symptom science holds potential to better understand mucositis, to determine if it is a marker of response or threat, and evaluate if it holds potential to guide therapy delivery.

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Dr. Thornton and Dr. Orgel devised the topic of this work and both equally contributed to the writing of this manuscript. Both authors have reviewed the manuscript.

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Correspondence to Clifton P. Thornton.

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Thornton, C.P., Orgel, E. Dose-limiting mucositis: friend or foe?. Support Care Cancer 31, 617 (2023). https://doi.org/10.1007/s00520-023-08101-x

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