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1.
Jan Magnus Bjordal Rene-Jean Bensadoun Jan Tun��r Lucio Frigo Kjersti Gjerde Rodrigo AB Lopes-Martins 《Supportive care in cancer》2011,19(8):1069-1077
Purpose
The purpose of this study is to review the effects of low-level laser therapy (LLLT) in the prevention and treatment of cancer therapy-induced oral mucositis (OM). 相似文献2.
Purpose
Pain is a prominent symptom in radiotherapy-induced oral mucositis (OM). This study assesses the effect of pharmacological treatment in head and neck cancer patients with OM-induced pain and swallowing difficulties. 相似文献3.
Purpose
Chemotherapy-induced oral mucositis (CIOM) is a common side effect of cancer therapy that may lead to significant morbidity and interfere with the treatment plan. The present prospective, cross-sectional study intended to describe the prevalence of clinically relevant CIOM (CRCIOM) in outpatients receiving chemotherapy for solid tumors. 相似文献4.
Ourania Nicolatou-Galitis Triantafyllia Sarri Joanne Bowen Mario Di Palma Vassilios E. Kouloulias Pasquale Niscola Dorothea Riesenbeck Monique Stokman Wim Tissing Eric Yeoh Sharon Elad Rajesh V. Lalla 《Supportive care in cancer》2013,21(1):357-364
Purpose
The aim of this study was to review the available literature from 1966 until December 31, 2010 and define clinical practice guidelines for the use of amifostine for the prevention and treatment of oral mucositis in cancer patients.Methods
A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology. The body of evidence for the use of amifostine, in each cancer treatment setting was assigned an evidence level. Based on the evidence level, one of the following three guideline determinations was possible: recommendation, suggestion, or no guideline possible.Results
Thirty papers were reviewed for evidence on amifostine as an intervention for oral mucositis. No guideline was possible for amifostine in any cancer treatment setting due to inadequate and conflicting evidence.Conclusion
Review of the amifostine studies for the prevention and treatment of oral mucositis has found insufficient evidence to support its use in any cancer treatment setting for this purpose. Additional well-designed research is needed to clarify the role of amifostine as an intervention for oral mucositis. 相似文献5.
Ourania Nicolatou-Galitis Triantafyllia Sarri Joanne Bowen Mario Di Palma Vassilios E. Kouloulias Pasquale Niscola Dorothea Riesenbeck Monique Stokman Wim Tissing Eric Yeoh Sharon Elad Rajesh V. Lalla 《Supportive care in cancer》2013,21(11):3179-3189
Purpose
The aim of this project was to review the available literature and define clinical practice guidelines for the use of anti-inflammatory agents for the prevention and treatment of oral mucositis in cancer patients.Materials and methods
A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology. The body of evidence for use of each intervention, in each cancer treatment setting, was assigned an evidence level. Based on the evidence level, one of the following three guideline determinations was possible: recommendation, suggestion, and no guideline possible.Results
Forty-one papers were reviewed. There was sufficient evidence to recommend the use of benzydamine mouthwash for the prevention of oral mucositis in head and neck cancer patients receiving moderate-dose radiation therapy (up to 50 Gy), without concomitant chemotherapy. A new suggestion was developed against the use of misoprostol mouthwash for the prevention of oral mucositis in head and neck cancer patients receiving radiation therapy. Positive results were reported for some other anti-inflammatory agents. However, no guidelines were able to be developed for any other agents due to insufficient and/or conflicting evidence.Conclusions
The use of anti-inflammatory agents continues to be a promising strategy for the prevention and treatment of oral mucositis. Additional well-designed studies are needed to examine the use of this class of agents for oral mucositis. 相似文献6.
H. Bornemann-Cimenti S.K. Kobald I.S. Szilagyi Prof. Dr. A. Sandner-Kiesling 《Schmerz (Berlin, Germany)》2013,27(3):253-262
Background
The pain provoked by mucositis is often described as the most excruciating symptom of cancer treatment. It often causes reduced ingestion, malnutrition, and sometimes postponement or withdrawal of the therapy. For health care providers, adequate pain treatment is a major challenge. The aim of this article is to present an overview of studies on the topical treatment of mucositis pain.Methods
A systematic search was performed in PubMed with the keywords “mucositis” “pain” and “topical” or “local”. In addition, reference lists and relevant websites were scanned for appropriate literature.Results
A total of 47 articles were included. There is only scarce evidence for the topical treatment of mucositis pain. The most convincing studies tested opioids, corticoids and benzydamine. For the other substances, too few studies were performed, the results were contradictory, or the study quality was low.Conclusion
Based on the information gathered in this systematic search of the literature, topical treatment of mucositis pain today is based on empiricism and not on scientific evidence. 相似文献7.
Tatiana Hadjieva Eva Cavallin-Ståhl Margareta Linden Fredrik Tiberg 《Supportive care in cancer》2014,22(6):1557-1562
Purpose
CAM2028, a vehicle that forms a bioadhesive lipid barrier when applied to the oral mucosa, was developed as a carrier system for local delivery of benzydamine, an NSAID used for pain relief in oral mucositis. This trial compared the analgesic effect of CAM2028 plus benzydamine (CAM2028-benzydamine) with unmedicated CAM2028 (CAM2028-control) for the treatment of oral mucositis in patients with head-and-neck cancer.Methods
Thirty-eight study participants were enrolled during their 3rd to 4th week of radiation therapy. Participants were required to have symptomatic oral mucositis (WHO Grade 2 or above) at screening and pain scores of at least 6 on an 11-point Likert scale at screening and on each day before treatment with study medication. After undergoing radiation, patients were administered a single dose of CAM2028-control or CAM2028-benzydamine 2 days apart, in a randomized crossover fashion. Pain was assessed over the following 8 h.Results
With both treatments, patients experienced a mean 40 % decrease in pain intensity at 6 h (the primary study endpoint). Both treatments resulted in significant pain relief within 5 min of application that was evident during the entire 8-h assessment period. There was no difference in pain relief between the two interventions at any time point. Both treatments were safe and well tolerated.Conclusions
CAM2028-benzydamine and CAM2028-control were both efficacious in reducing pain in patients with oral mucositis related to radiation therapy for head-and-neck cancer. Analgesic effects of both medications were immediate, clinically significant, and persistent for up to 8 h. 相似文献8.
Nobue Saito Yutaka Imai Takashi Muto Toshimi Sairenchi 《Supportive care in cancer》2012,20(12):3373-3377
Purpose
The association between body mass index (BMI) and oral mucositis in oral cancer patients receiving radiotherapy is unclear. This study examined whether low BMI could be a risk factor for oral mucositis in oral cancer patients receiving radiotherapy.Methods
Between April 2007 and March 2011, a total of 33 inpatients with oral cancer receiving radiotherapy were recruited. They were followed from the beginning of radiotherapy to discharge from hospital. All patients had no mucositis when radiotherapy started. The odds ratio (OR) and 95?% confidence interval (CI) of BMI for incident grade 2 and grade 3 mucositis were calculated by use of univariable logistic regression models.Results
All patients developed oral mucositis (grade 1 in 39.4?%, grade 2 in 30.3?%, grade 3 in 30.3?%), with the maximum grade occurring at an average of 32.4?days. Compared with normal BMI (≥22.0), the OR of low BMI (<22.0) for moderate to severe mucositis was 9.07 (95?% CI, 1.72-47.68).Conclusions
Low BMI may be a risk factor of moderate to severe oral mucositis. 相似文献9.
Mustafa Ozturk Seref Komurcu Selim Kilic Ahmet Ozet Fikret Arpaci Bekir Ozturk Okan Kuzhan Selmin Ataergin 《Supportive care in cancer》2009,17(10):1295-1299
Purpose
This study was done to evaluate the frequency and severity of mucositis in the early period of stem cell transplantation (SCT) and the relation of conditioning regimens with mucositis. 相似文献10.
Deborah Tomlinson Tanya Hesser Anne-Marie Maloney Sandra Ross Ahmed Naqvi Lillian Sung 《Supportive care in cancer》2014,22(1):115-119
Purpose
We previously developed a pediatric-specific measure of oral mucositis named the Children's International Mucositis Evaluation Scale (ChIMES). Availability as an electronic version may improve self-report response rates. The objectives were to develop an electronic version of ChIMES (eChIMES) and to determine whether the instrument is easy to use, understandable, and suitable for measuring mucositis among children and adolescents with cancer.Methods
Development of eChIMES was on an iPad; the initial version was piloted with ten children to refine instructions for use and presentation. A crosssectional study then was conducted and included English-speaking children and adolescents 8–18 years of age receiving active treatment for cancer. Participants were shown eCHIMES and were asked to complete it. Questions elicited whether they found eChIMES easy or difficult to use, easy or difficult to understand, and suitable (a good way) for children with cancer to monitor mucositis. Outcomes were rated using five-point ordinal scales.Results
Following the development and initial refinement of eChIMES, 40 children were enrolled. Median age was 12.4 (range, 8.0 to 17.8)?years. The instrument was found to be easy or very easy to use and understood by 40 (100 %) and 38 (95 %) participants, respectively. The application was considered suitable or very suitable for measuring mucositis by 37 (92 %).Conclusions
We found that eChIMES was easy to use, understandable, and suitable for monitoring mucositis among children with cancer. Incorporation into clinical trials may improve the ability to compare and evaluate interventions for mucositis. 相似文献11.
Judith E. Raber-Durlacher Inger von B��ltzingsl?wen Richard M. Logan Joanne Bowen Abdul Rahman Al-Azri Hele Everaus Erich Gerber Jes��s Garcia Gomez Bo G. Pettersson Yoshihiko Soga Fred K. L. Spijkervet Wim J. E. Tissing Joel B. Epstein Sharon Elad Rajesh V. Lalla 《Supportive care in cancer》2013,21(1):343-355
Purpose
The aim of this project was to review the literature and define clinical practice guidelines for the use of cytokines and growth factor agents for the prevention or treatment of oral mucositis induced by cancer chemotherapy or radiotherapy.Methods
A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO). The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. Based on the evidence level, one of the following three guideline determinations was possible: Recommendation, Suggestion, No guideline possible.Results
Sixty-four clinical studies across 11 interventions were evaluated. A recommendation was made for the use of recombinant human KGF-1 (palifermin) at a dose of 60???g/kg per day for 3?days prior to conditioning treatment and for 3?days post-transplant for prevention of oral mucositis in patients receiving high-dose chemotherapy and total body irradiation followed by autologous stem cell transplantation for hematological malignancies. A suggestion was made against using granulocyte macrophage colony-stimulating factor mouthwash for the prevention of oral mucositis in the setting of high-dose chemotherapy followed by autologous or allogeneic stem cell transplantation. No guideline was possible for any other cytokine or growth factor agents due to inconclusive evidence.Conclusions
Of the cytokine and growth factor agents studied for oral mucositis, the evidence only supports use of palifermin in the specific population listed above. Additional well-designed research is needed on other cytokine and growth factor interventions and in other cancer treatment settings. 相似文献12.
Rajesh V. Lalla Carol C. Pilbeam Stephen J. Walsh Stephen T. Sonis Dorothy M. K. Keefe Douglas E. Peterson 《Supportive care in cancer》2010,18(1):95-103
Goals
Oral mucositis can be a significant and dose-limiting complication of high-dose cancer therapy. Mucositis is a particularly severe problem in patients receiving myeloablative chemotherapy prior to bone marrow or hematopoetic stem cell transplant (HSCT). The cyclooxygenase (COX) pathway mediates tissue injury and pain through upregulation of pro-inflammatory prostaglandins, including prostaglandin E2 (PGE2) and prostacyclin (PGI2). The objective of this small (n = 3) pilot study was to examine the role of the COX pathway in causing mucosal injury and pain in chemotherapy-induced oral mucositis. 相似文献13.
Kanayo Takahashi Yoshihiko Soga Yumeno Murayama Mika Udagawa Hitomi Nishimoto Yuko Sugiura Yoshinobu Maeda Mitsune Tanimoto Shogo Takashiba 《Supportive care in cancer》2010,18(1):115-119
Goals of work
Severe oral mucositis induced by allogeneic hematopoietic cell transplantation (HCT) is associated with intolerable pain and risk of systemic bacteremia infection. Differences between conventional HCT and reduced-intensity regimens for allogeneic HCT (RIST) may influence the occurrence and severity of oral mucositis. Here, we evaluated oral mucositis in patients undergoing RIST and compared the results with those in conventional allogeneic HCT patients to facilitate predictive measures for mucositis. 相似文献14.
Yoshihiko Soga Yuko Sugiura Kanayo Takahashi Hitomi Nishimoto Yoshinobu Maeda Mitsune Tanimoto Shogo Takashiba 《Supportive care in cancer》2010,19(2):303-307
Purpose
Oral mucositis is a common symptomatic complication associated with hematopoietic stem cell transplantation (HCT). We use simple strategies aimed to reduce oral mucositis by keeping the oral cavity clean and moist. Here, we report on the progress of oral care and the changes in the degree of oral mucositis. The purpose of this pilot study is to evaluate the effects of our strategies on the prevalence and the severity of oral mucositis. 相似文献15.
Noam Yarom Anura Ariyawardana Allan Hovan Andrei Barasch Virginia Jarvis Siri Beier Jensen Yehuda Zadik Sharon Elad Joanne Bowen Rajesh V. Lalla 《Supportive care in cancer》2013,21(11):3209-3221
Purpose
The aim of this study was to review the available literature and define clinical practice guidelines for the use of natural agents for the prevention and treatment of oral mucositis.Methods
A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology. The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. Based on the evidence level, one of the following three guideline determinations was possible: recommendation, suggestion, and no guideline possible.Results
A total of 49 papers across 15 interventions were examined. A new suggestion was developed in favor of systemic zinc supplements administered orally in the prevention of oral mucositis in oral cancer patients receiving radiation therapy or chemoradiation (Level III evidence). A recommendation was made against the use of intravenous glutamine for the prevention of oral mucositis in patients receiving high-dose chemotherapy prior to hematopoietic stem cell transplant (Level II evidence). No guideline was possible for any other agent, due to inadequate and/or conflicting evidence.Conclusions
Of the various natural agents reviewed here, the available evidence supported a guideline only for two agents: a suggestion in favor of zinc and a recommendation against glutamine, in the treatment settings listed above. Well-designed studies of other natural agents are warranted. 相似文献16.
Philippa Hawley Allan Hovan Colleen E. McGahan Deborah Saunders 《Supportive care in cancer》2014,22(3):751-761
Background
Few treatments have the potential to reduce the severity of radiation-induced mucositis in head and neck cancer patients. Some small studies have suggested that organic honey may be a useful preventive treatment.Methods
This investigator-initiated double-blind randomized placebo-controlled trial investigated whether honey reduced the severity of radiation-induced oral mucositis (ROM). One hundred six head and neck cancer patients from the Vancouver and Sudbury Cancer Centers in Canada were randomized to swish, hold, and swallow either 5 ml of irradiated organic manuka honey or a placebo gel, four times a day throughout radiation treatment, plus seven more days. Severity of oral mucositis according to the Radiation Therapy Oncology Group (RTOG), World Health Organization (WHO), and Oral Mucositis Assessment Scale scales, weight, and subjects' symptom severity and quality of life were assessed weekly. Sialometry was performed at baseline and at the last study visit.Results
One hundred six patients were recruited. Twenty-four did not attend any mucositis assessments. One was removed from the study because of off-study consumption of store-bought manuka honey. The remaining 81 patients had at least one mucositis assessment and were included in the analysis. Sixty-two percent of subjects received concurrent chemotherapy; 81 % were male. The groups were well-matched, and blinding was excellent. Dropouts were mostly due to nausea and were similar in both arms, with 78 % being able to tolerate the study products for more than 1 week. The dropout rate was 57 % in those who received honey and 52 % in those who received placebo gel. The dropout rate in those who had concurrent chemotherapy was 59 % and in those who only received radiation was 47 %. There was no statistically significant difference between the honey and placebo arms in any of the outcome indicators. Those who completed the study in both treatment arms had low rates of RTOG greater than or equal to grade 3 mucositis; 35 % in the honey group and 43 % in the placebo group.Conclusion
Despite promising earlier reports, manuka honey was not tolerated well by our patients and, even when used as directed, did not have a significant impact on the severity of ROM. 相似文献17.
M. Gobbo G. Ottaviani G. Perinetti F. Ciriello A. Beorchia M. Giacca R. Di Lenarda K. Rupel G. Tirelli S. Zacchigna M. Biasotto 《Supportive care in cancer》2014,22(7):1851-1856
Purpose
To retrospectively evaluate the role of class IV laser therapy in the amelioration of nutritional status of patients affected by oral mucositis due to radiotherapy of the head and neck region during oncological treatment.Methods
Sixty-three oncological patients were included in this study. All patients were affected by tumors in the head and neck region and had developed oral mucositis during radiotherapy. Forty-two patients had been treated by high-power laser therapy whereas 21 patients had been managed with traditional medications. Data collection included weight measurement (kilogram) and body mass index (BMI) calculation (mass (kilogram)/(height) (square meter)) on the first and last day of radiotherapy. In addition, gender, age, pathology, and the kind of oncological treatment have been considered.Results
Laser-treated patients decreased less in BMI during radiotherapy (p?=?0.000). Patients treated by combined oncological treatments (radiotherapy and/or chemotherapy and/or surgery) had a higher weight loss during radiotherapy (p?=?0.015). According to a multivariate regression analysis, the only variable which significantly influenced the reduction of BMI was laser treatment (p?=?0.000).Conclusions
Laser therapy is actually considered one of the recommended remedies for the healing of oral mucositis due to cancer treatments. Healing of mucositis can deeply influence the feeding capacity of patients, through reduction of pain and improvement of chewing and swallowing capacities. It also allows lowering the costs for hospitalization and supportive care. Laser therapy should become part of nutritional interventions in oncological patients affected by oral mucositis. 相似文献18.
Douglas E. Peterson Kerstin ?hrn Joanne Bowen Monica Fliedner Judith Lees Charles Loprinzi Takehiko Mori Anthony Osaguona Dianna S. Weikel Sharon Elad Rajesh V. Lalla 《Supportive care in cancer》2013,21(1):327-332
Purpose
This systematic review analyzed the strength of the literature and defined clinical practice guidelines for the use of oral cryotherapy for the prevention and/or treatment of oral mucositis caused by cancer therapy.Methods
A systematic review on relevant oral cryotherapy studies indexed prior to 31 December 2010 was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society for Oral Oncology (MASCC/ISOO) using OVID/MEDLINE, with publications selected for review based on defined inclusion and exclusion criteria. Findings from the reviewed studies were integrated into guidelines based on the overall level of evidence for each intervention. Guidelines were classified into three types: recommendation, suggestion, or no guideline possible.Results
Twenty-two clinical studies and two meta-analyses were analyzed. Results were compared with the MASCC/ISOO guidelines published in 2007. The recommendation for the use of oral cryotherapy to prevent oral mucositis in patients receiving bolus fluorouracil (5-FU) was maintained, in agreement with the 2007 guidelines. A suggestion for use of oral cryotherapy to prevent oral mucositis in patients receiving high-dose melphalan as conditioning regimen with or without total body irradiation for HCST was revised from the 2007 guidelines. No guideline was possible for any other intervention, due to insufficient evidence.Conclusions
The evidence continues to support the use of oral cryotherapy for prevention of oral mucositis in patients receiving bolus 5-FU chemotherapy or high-dose melphalan. This intervention is consistent with the MASCC/ISOO guidelines published in 2007. The literature is limited by the fact that utilization of a double-blind study design is not feasible. Future studies that compare efficacy of oral cryotherapy with other mucositis agents in patients receiving chemotherapy with relatively short plasma half-lives would be useful. 相似文献19.
David Tung PhD Peter H. Cheung PhD Gregory Tudor PhD Catherine Booth PhD Saurabh Saha MD PhD 《Current therapeutic research》2011,(6):262-272
Background
Fluorouracil (5-FU) is a pyrimidine analogue used as a cancer treatment. Its toxic side effects, including mucositis, are reported to occur in 40% of the treated patients. Because of the inflammatory component of mucositis, we explored the possibility of modulating this condition with an immunomodulatory agent and a tumor necrosis factor-α inhibitor.Objective
The aim of this study was to evaluate the effect of 2 immunosuppressive agents, etanercept and cyclosporine, in a murine model of 5-FU–induced mucositis.Methods
To study the short-term effects of 5-FU on mucositis, cyclosporine and etanercept were administered to mice after an injection of 5-FU. The animals (n = 8) were euthanized at 6 hours post-challenge. Hematoxylin and eosin–stained histologic sections of the small intestine were examined for signs of apoptosis. To further examine the potential of cyclosporine in the treatment of 5-FU–induced mucositis in a longer duration, the animals (N = 15) were given 2 challenges of 5-FU within 6 hours. All mice were dosed daily until day 9 with either cyclosporine (100 mg/kg) or phosphate-buffered saline (PBS).Results
Six hours after 5-FU challenge, 25 mg/kg etanercept and 50 mg/kg cyclosporine had no effect on 5-FU–induced apoptosis (P > 0.05). However, 100 mg/kg cyclosporine significantly reduced the cumulative level of apoptosis >41.6% of the intestinal crypt surface (P < 0.05). During long-term observation, all mice began to lose weight at a rate of approximately 0.8 g/day after 5-FU exposure. The rates of weight loss and survival were not affected by cyclosporine treatment. The diarrhea onset began on day 4 with 46.7% of the PBS-treated mice showing signs of diarrhea compared with 53.3% in the cyclosporine group. The diarrhea score for both groups plateaued on day 7, with a cumulative score of 41 for the PBS group and 50 for the cyclosporine group. Cyclosporine treatment did not affect the diarrhea onset day or severity compared with the PBS-treated group (P > 0.05).Conclusions
Our data indicated that etanercept is not a suitable treatment for 5-FU–induced mucositis. Despite decreased apoptosis in the gut, cyclosporine did not affect the severity of the diarrhea or survival. Therefore, we concluded that cyclosporine treatment was only effective in mediating the short-term apoptotic events in the intestines but has no long-term effect on the animals' survival and diarrhea. 相似文献20.
Systematic review of laser and other light therapy for the management of oral mucositis in cancer patients 总被引:1,自引:0,他引:1
Cesar Migliorati Ian Hewson Rajesh V. Lalla Heliton Spindola Antunes Cherry L. Estilo Brian Hodgson Nilza Nelly Fontana Lopes Mark M. Schubert Joanne Bowen Sharon Elad 《Supportive care in cancer》2013,21(1):333-341