The cancer patient with severe mucositis

Sonis ST: Mucositis as a biological process: a new hypothesis for the development of chemotherapy-induced stoma toxicity. Oral Oncol 1998, 34:39–43.

Berger AM, Kilroy TJ: Oral Complications In Cancer: Principles and Practice of Oncology, edn 5. Edited by DeVita VT et al. Philadelphia: Lippincott-Raven; 1997:2714–2725.

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, 854:2103–2113. Potential systemic risks in relation to severe mucositis are emphasized. The application of a scoring system for assessment of mucositis is elaborated on. The study was designed to provide adequate statistical power to validate the scale in chemotherapy and radiotherapy. The article is of interest to researchers but offers no solution for the prevention and treatment of mucositis.

Amdur RJ, Parson ST, Mendenhall WM, et al.: Split course versus continuous irradiation in the post operative setting for squamous carcinoma of head and neck. Int J Radiat Oncol Biol Phys 1989, 17:279–285.

Chen TY: Radiation. In Cancer and the Oral Cavity. Edited by Carl W, Sako K. Chicago: Quintessence Publishing Co.; 1986:109–117.

Symonds RP: Treatment-induced mucositis: an old problem with new remedies. Br J Cancer 1998, 77:1689–1695. The limitations of many traditionally used agents in controlling mucositis are discussed. Granulocyte and GM-CSFs can reduce mucositis, but to determine the best schedule, dosage, and method of administration, more studies are needed. The importance of maintaining good oral sanitation is emphasized.

Carl W: Local radiation and systemic chemotherapy: preventing and managing the oral complications. J Am Dent Assoc 1993, 124:119–123.

Foote RL, Lobrinzi CL, Frank AR, et al.: Randomized trial of a Chlorhexidine mouth wash for alleviation of radiationinduced mucositis. J Clin Oncol 1994, 12:2630–2633.

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.

Okuno SH, Foote RL, Lubrinizi CL, et al.: A randomized trial of a nonabsorbable antibiotic lozenge given to alleviate radiation-induced mucositis. Cancer 1997, 79:2193–2199.

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.

Wagner W, Alfrink M, Haus U, et al.: Treatment of irradiationinduced mucositis with growth factors (rh GM-CSF) in patients with head and neck cancer. Anticancer Res 1999, 19:799–803. Discusses the use of rh GM-CSF in the treatment of irradiationinduced mucositis in a limited study and its potential in providing prolonged protection against mucositis. Mucositis-associated pain was significantly lower when compared with the control group.

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.

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.

Goodman DC: Vitamin A and retinoids in health and disease. N Engl J Med 1984, 310:1023–1031.

Cohen G, Elad S, Or R, et al.: The use of tretinoin as oral mucositis prophylaxis in bone marrow transplantation patients: a preliminary study. Oral Dis 1997, 3:243–246.

Anderson PM, Ramsey NKC, Shu XO, et al.: Effect of low does oral glutamine on painful stomatitis during bone marrow transplantation. Bone Marrow Transplant 1998, 22:339–344. Defines the role of low-dose oral glutamine on painful stomatitis in BMT. In autologous patients glutamine supplement reduced the duration of pain in the oropharynx, but not in allogeneic patients with BMT.

Skubitz KM, Anderson PM: Oral glutamine to prevent chemotherapy-induced stomatitis: a pilot study. J Lab Clin Med 1996, 127:223–228.

Cartee L, Petros WP, Rosner GL, et al.: Evaluation of GM-CSF mouthwash for prevention of chemotherapy-induced mucositis: a randomized, double blind dose-ranging study. Cytokine 1995, 7:471–477.

Sonis ST, Koplowsky A, Mitus J, et al.: Relationship of chemotherapy-induced mucositis and myelosuppression in hamsters. Eur J Cancer 1992, 28:43–53.

Katano M, Nakamura M, Matsuo T, et al.: Effect of granulocyte colony-stimulating factor (G-CSF) on chemotherapy-induced oral mucositis. Surg Today 1995, 25:202–206.

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. In Eicosanoids and Other Bioactive Lipids in Cancer, Inflammation and Radiation Injury, edn 2. Edited by Honn KV et al. New York: Plenum Press; 1997:811–816. Describes the use of the prostaglandin E1 analog, misoprostol, in protection from radiation-induced oral mucositis. It also discusses the potential of such protectors in tumor protection.

Carl W: Gingival hyperplasia and management in a leukemic patient: case report. Periodont Insights 1996, 3:10–12.

Carl W, Daly C, Andreana S, et al.: Clinical evaluation of the effect of a hydrogen peroxide mouth rinse, Toothette-plus Swab containing sodium bicarbonate, and water-soluble mouth moisturizer on oral health in medically compromised patients. Periodont Insights 1999, 6:12–16.