Oral mucositis

Authors

  • C Scully,

    1. Eastman Dental Institute, University College London, University of London, London, UK
    Search for more papers by this author
  • S Sonis,

    1. Department of Oral Medicine and Diagnostic Sciences, Harvard School of Dental Medicine, Divisions of Oral Medicine, Oral and Maxillofacial Surgery and Dentistry, Brigham and Women's Hospital and the Dana Farber Cancer Institute, Boston, MA, USA
    Search for more papers by this author
  • PD Diz

    1. Special Needs Unit, School of Medicine and Dentistry, University of Santiago de Compostela, Spain
    Search for more papers by this author

Prof. Crispian Scully CBE MD PhD MDS FDSRCS FDSRCPS FFDRCSI FDSRCSE FRCPath FMedSciDsc, Director of Studies and Research, Eastman Dental Institute, University College London, University of London, 256 Gray's Inn Road, London WC1X 8LD, UK. Tel: 442 079 151 038, Fax: 442 079 151 039, E-mail: c.scully@eastman.ucl.ac.uk

Abstract

Mucositis and xerostomia are the most common oral complications of the non-surgical therapy of cancer. Mucositis, a common sequel of radio- (DXR), chemo-(CXR) and radiochemo-therapy in patients with cancer, or patients requiring haemopoietic stem cell transplants (HSCT), has a direct and significant impact on the quality of life and cost of care, and also affects survival – because of the risk of infection. Apart from dose reduction, preventive and treatment options for mucositis are scarce, although multiple agents have been tested. Evidence suggests that cryotherapy, topical benzydamine and amifostine might provide some benefit in specific situations. The recombinant human keratinocyte growth factor Palifermin (Kepivance®) was recently approved as a mucositis intervention in patients receiving conditioning regimens before HSCT for the treatment of haematological malignancies. A number of mechanistically based interventions are in various stages of development. Unfortunately, many other approaches have not been rigorously tested. This paper reviews the clinical features, prevalence, diagnosis, complications, pathogenesis, prophylaxis and management of mucositis.

Ancillary