Chemotherapy- and radiotherapy-induced mucositis in head and neck cancer patients: new trends in pathophysiology, prevention and treatment |
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Authors: | R-J Bensadoun N Magné P-Y Marcy F Demard |
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Institution: | (1) Department of Radiation Oncology, Centre Antoine Lacassagne, 33 Avenue de Valombrose, 06189 Nice Cedex 2, France e-mail: rene-jean.bensadoun@nice.fnclcc.fr Tel: +33-4-92031270, Fax: +33-4-92-031570, FR;(2) Department of Radiology, Centre Antoine Lacassagne, 06189 Nice, France, FR;(3) Department of Head and Neck Surgery, Centre Antoine Lacassagne, 06189 Nice, France, FR |
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Abstract: | Mucositis is the intensity-limiting toxicity in the management of locally advanced non-resectable head and neck cancer with
radiotherapy and chemotherapy. New radiation modalities (hyperfractionation and/or acceleration) as well as combined modality
regimens in this situation induce higher rates of acute toxicity. Hyperfractionation, for example, allows higher control rates,
with few late toxicities, but it slightly increases acute mucositis. The addition of chemotherapy introduces systemic toxicity
and can exacerbate local tissue reactions when used concurrently with radiotherapy. Mucositis is recognized as the principal
limiting factor to further treatment intensification. As local regional control and overall survival are related to dose-intensity
in this case, further research into the assessment, analysis, prevention and treatment of mucosal toxicity is not only crucial
to improvement in quality of life, but certainly also to improved rates of disease control. Several topical and systemic treatments
are directed to the decrease and the acceptance of this acute toxicity, but few have shown a significant preventive effect.
The efficacy of low-level laser therapy in the management of such toxicity could hence yield important developments with this
method in the field of oncology.
Received: 1 May 2001 / Accepted: 15 May 2001 |
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Keywords: | Mucositis Stomatitis Chemotherapy Radiotherapy Head and neck cancer Low-level laser therapy |
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