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Journal of the National Cancer... Aug 2019Oral mucositis is a common side-effect associated with conventional cancer therapy and has also recently been reported in association with newly emerging cancer... (Review)
Review
Oral mucositis is a common side-effect associated with conventional cancer therapy and has also recently been reported in association with newly emerging cancer therapies. It is characterized as an inflammation of the oral mucous membranes accompanied by many complex mucosal and submucosal changes. Ulcerative oral mucositis can cause significant oral pain, impair nutritional intake, lead to local or systemic infection, and cause significant economic cost. In addition, it may necessitate interruptions in cancer therapy, thus adversely affecting patient prognosis. This review presents the current understanding of the pathogenesis of mucositis and discusses evidence-based clinical management strategies for oral mucositis. In addition, key research questions for future investigation are identified, followed by a discussion of strategies to promote development and funding of the needed research.
Topics: Antineoplastic Combined Chemotherapy Protocols; Disease Management; Disease Susceptibility; Head and Neck Neoplasms; Humans; Radiotherapy; Risk Factors; Severity of Illness Index; Stomatitis
PubMed: 31425601
DOI: 10.1093/jncimonographs/lgz011 -
Wounds : a Compendium of Clinical... May 2021Patients with oral mucositis (OM) have inflamed epithelial lesions of the mouth that progress to form painful ulcerations with submucosal hemorrhaging and infection....
Patients with oral mucositis (OM) have inflamed epithelial lesions of the mouth that progress to form painful ulcerations with submucosal hemorrhaging and infection. Oral mucositis makes it painful to eat, drink, and speak, resulting in distress, weight loss, and declining health.1 These symptoms occur in up to 40% of patients within 5 to 10 days after beginning chemotherapy (CT), and in nearly all patients within 1 to 2 weeks of starting radiotherapy (RT) for head and neck cancer. Oral mucositis can be severe enough to interrupt treatment and reduce survival rates. In 2014, the Mucositis Guidelines Leadership Group of the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology released OM treatment guidelines aiming to provide nutritional support, while reducing pain, inflammation, hemorrhaging, and oral microbial contamination. This installment of Evidence Corner explores 2 recent systematic reviews of randomized controlled trial (RCT) evidence informing clinical decisions in ways that may change thoughts about effective topical OM treatment.
Topics: Head and Neck Neoplasms; Humans; Mucositis; Pain; Stomatitis; Systematic Reviews as Topic
PubMed: 34370681
DOI: No ID Found -
Clinics in Dermatology 2017Contact stomatitis occurs in up to 10% of the population. Mechanical or chemical irritation, ill-fitting dentures, and dental fillings can induce irritant contact... (Review)
Review
Contact stomatitis occurs in up to 10% of the population. Mechanical or chemical irritation, ill-fitting dentures, and dental fillings can induce irritant contact stomatitis. Type I hypersensitivity and type IV hypersensitivity to dental products and foods are frequently responsible for the allergic types of contact stomatitis. We review the causal agents of contact stomatitis, the differential diagnoses, diagnostic testing, and potential treatment.
Topics: Dental Materials; Food Hypersensitivity; Humans; Irritants; Stomatitis; Stomatitis, Denture
PubMed: 28916024
DOI: 10.1016/j.clindermatol.2017.06.007 -
Archives of Disease in Childhood Feb 2022To assess the efficacy of oral low-level laser therapy (LLLT) - also known as photobiomodulation - in the reduction of oral mucositis experienced by children and young...
OBJECTIVE
To assess the efficacy of oral low-level laser therapy (LLLT) - also known as photobiomodulation - in the reduction of oral mucositis experienced by children and young people with cancer undergoing chemotherapy.
DESIGN
A systematic review to evaluate the efficacy of oral LLLT for oral mucositis in children with cancer and the safety of oral LLLT in any age with cancer (International Prospective Register of Systematic Reviews/PROSPERO registration: CRD42018099772). Multiple databases and grey literature were screened. Randomised controlled trials were considered for assessing efficacy, and all studies were considered for assessing safety. Primary outcomes included severity of oral mucositis, oral pain and adverse events. Where results were compatible, meta-analysis was performed using a random-effects model. A narrative synthesis considered other outcome measures.
RESULTS
14 studies (n>416 children) were included in the narrative synthesis of LLLT efficacy. 5 studies (n=380 children and young people) were included in the meta-analyses. Results demonstrate that LLLT may reduce the severity of oral mucositis and the level of oral pain, but further randomised controlled trials are needed to confirm or deny this. There is vast variation in different trial protocols. Insufficient blinding between LLLT or sham therapy/control led to a strong risk of performance bias. 75 studies (encompassing 2712 patients of all ages who had undergone LLLT) demonstrated minor and infrequent adverse reactions, but most studies had significant areas of weakness in quality.
CONCLUSION
LLLT appears to be a safe therapy, but further evidence is needed to assess its efficacy as a prevention or treatment tool for oral mucositis in children with cancer.
Topics: Antineoplastic Agents; Child; Humans; Low-Level Light Therapy; Neoplasms; Stomatitis; Treatment Outcome
PubMed: 34230010
DOI: 10.1136/archdischild-2020-321216 -
European Journal of Cancer (Oxford,... Sep 2021To update the 2015 clinical practice guideline for the prevention of oral mucositis in pediatric cancer or hematopoietic stem cell transplant (HSCT) patients. (Review)
Review
PURPOSE
To update the 2015 clinical practice guideline for the prevention of oral mucositis in pediatric cancer or hematopoietic stem cell transplant (HSCT) patients.
METHODS
We performed seven systematic reviews of mucositis prevention. Three reviews included randomized controlled trials (RCTs) conducted in pediatric and adult patients evaluating cryotherapy, keratinocyte growth factor (KGF) or photobiomodulation therapy with a focus on efficacy. Three reviews included studies of any design conducted in pediatric patients evaluating these same interventions with a focus on adverse events and feasibility. One review included all RCTs of any intervention for mucositis prevention in pediatric patients. Primary outcome was severe oral mucositis.
RESULTS
We included 107 unique studies of cryotherapy (22 RCTs and 4 pediatric studies); KGF (15 RCTs and 12 pediatric studies); photobiomodulation therapy (29 RCTs and 8 pediatric studies) and any intervention (31 pediatric RCTs). Effects on severe mucositis reduction from RCTs were cryotherapy risk ratio (RR) 0.49 and 95% confidence interval (CI) 0.31-0.76; palifermin RR 0.81 and 95% CI 0.69-0.95 and photobiomodulation therapy RR 0.40 and 95% CI 0.27-0.60. Cryotherapy was not feasible in young children while photobiomodulation therapy was feasible across age groups. Palifermin was associated with adverse effects.
CONCLUSIONS
Cryotherapy should be used for older cooperative pediatric patients who will receive short infusions of melphalan or 5-fluorouracil. Intraoral photobiomodulation therapy (620-750 nm spectrum) should be used in pediatric patients undergoing autologous or allogeneic HSCT and for pediatric head and neck carcinoma patients undergoing radiotherapy. Palifermin should not be used routinely in pediatric cancer or HSCT patients.
Topics: Adult; Child; Cryotherapy; Hematopoietic Stem Cell Transplantation; Humans; Low-Level Light Therapy; Neoplasms; Oropharynx; Practice Guidelines as Topic; Radiotherapy; Stomatitis
PubMed: 34252760
DOI: 10.1016/j.ejca.2021.05.013 -
Supportive Care in Cancer : Official... Oct 2019The aim of this study was to update the clinical practice guidelines for the use of basic oral care (BOC) interventions for the prevention and/or treatment of oral...
PURPOSE
The aim of this study was to update the clinical practice guidelines for the use of basic oral care (BOC) interventions for the prevention and/or treatment of oral mucositis (OM).
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. The findings were added to the database used to develop the 2013 MASCC/ISOO clinical practice guidelines. Based on the evidence level, one of the following three guideline determinations was possible: Recommendation, Suggestion, No guideline possible.
RESULTS
A total of 17 new papers across six interventions were examined and merged with a previous database. Based on the literature, the following guidelines were possible. The panel suggests that the implementation of multi-agent combination oral care protocols is beneficial for the prevention of OM during chemotherapy, head and neck (H&N) radiation therapy (RT), and hematopoietic stem cell transplantation (Level of Evidence III). The panel suggests that chlorhexidine not be used to prevent OM in patients undergoing H&N RT (Level of Evidence III). No guideline was possible for professional oral care, patient education, saline, and sodium bicarbonate, and expert opinion complemented these guidelines.
CONCLUSIONS
The evidence supports the use of multi-agent combination oral care protocols in the specific populations listed above. Additional well-designed research is needed on the other BOC interventions prior to guideline formulation.
Topics: Dental Care; Humans; Medical Oncology; Mucositis; Neoplasms; Practice Guidelines as Topic; Research Design; Stomatitis
PubMed: 31286232
DOI: 10.1007/s00520-019-04848-4 -
Current Oncology (Toronto, Ont.) Jul 2021This review aimed to evaluate the efficacy of oral cryotherapy in the prevention of chemotherapy-induced oral mucositis using meta-analysis and trial sequential... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
This review aimed to evaluate the efficacy of oral cryotherapy in the prevention of chemotherapy-induced oral mucositis using meta-analysis and trial sequential analysis, as well as to assess the quality of the results by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.
METHODS
A comprehensive search of three databases including Medline, Embase and Central was performed to identify randomized controlled trials that used oral cryotherapy for the prevention of chemotherapy-induced oral mucositis. The primary outcome was the incidence of oral mucositis for trials employing oral cryotherapy as the intervention for the prevention of oral mucositis. The meta-analysis was performed using the random-effects model and random errors of the meta-analyses were detected by trial sequential analysis.
RESULTS
A total of 14 RCTs with 1577 participants were included in the present meta-analysis. Patients treated with oral cryotherapy were associated with a significantly lower risk of developing oral mucositis of any grade (risk ratio (RR), 0.67 (95% CI: 0.56-0.81, < 0.05)). Findings from the subgroup analyses showed that oral cryotherapy significantly reduced the risk of oral mucositis in patients undergoing bone marrow transplantation (RR 0.69, CI: 0.54-0.89, < 0.05) as well as chemotherapy (RR 0.66, CI: 0.58-0.75, < 0.05). Findings from the trial sequential analysis suggested that the evidence on oral cryotherapy as a preventive intervention for oral mucositis in patients with solid malignancies receiving conventional chemotherapy was conclusive.
CONCLUSION
Oral cryotherapy is effective in preventing oral mucositis in patients undergoing chemotherapy for the management of solid malignancies. The use of oral cryotherapy in preventing oral mucositis in bone marrow transplantation settings showed promising efficacy, but the evidence is not conclusive and requires more high-quality randomized controlled trials.
Topics: Antineoplastic Agents; Cryotherapy; Humans; Neoplasms; Stomatitis
PubMed: 34436016
DOI: 10.3390/curroncol28040250 -
Anais Brasileiros de Dermatologia 2022
Topics: Humans; Kidney Failure, Chronic; Stomatitis
PubMed: 35307243
DOI: 10.1016/j.abd.2020.09.019 -
Swiss Dental Journal Jun 2024Die stomatitis migrans ist eine oft beobachtete benigne Normvariante der Mundschleimhaut mit einer Prävalenz von 1.0-2.5%, wobei sie bei jungen Erwachsenen deutlich...
Die stomatitis migrans ist eine oft beobachtete benigne Normvariante der Mundschleimhaut mit einer Prävalenz von 1.0-2.5%, wobei sie bei jungen Erwachsenen deutlich höher ist. Frauen sind häufiger betroffen. Die Ätiologie ist unbekannt, kommt aber in gleichen Familien gehäuft vor. Klinisch zeigen sich demarkierte, erythematöse Areale, die teilweise von einem gelblichen Saum umrandet sind.
Topics: Humans; Female; Male; Stomatitis; Adult; Diagnosis, Differential
PubMed: 38847058
DOI: 10.61872/sdj-2024-03-06 -
European Journal of Oral Sciences Oct 2018When celebrating 100 yr of dental research in the Nordic dental research community (i.e. Nordisk Odontologisk Förening (NOF)), it is relevant to include dental implant... (Review)
Review
When celebrating 100 yr of dental research in the Nordic dental research community (i.e. Nordisk Odontologisk Förening (NOF)), it is relevant to include dental implant treatment. In essence, the successful progress of implant treatment has added both to the quality of life for patients and also to many aspects of professional development and job satisfaction for dentists. When appreciating the success story it also seems relevant to highlight some of the problems related to this treatment. Both technical and biological complications have often been ignored when reporting long-term results following implant treatment. Different opinions have been expressed in relation to the etiology of peri-implant diseases. Some even choose to ignore this condition as a clinical problem. This article presents a short overview of peri-implant diseases (i.e. peri-implant mucositis and peri-implantitis). The lack of internationally agreed disease definitions for peri-implant diseases, as with periodontitis, results in wide variation of estimates for the occurrence of peri-implant diseases when epidemiological data are reported. The profession still strives to find and define the best way to deal with peri-implant diseases once they are accurately diagnosed. Awareness of the tissue conditions in the peri-implant area, and relevant action when indicated, seems to be critical for the continued long-term successful outcome of dental implant treatment.
Topics: Dental Implantation, Endosseous; Dental Implants; Humans; Peri-Implantitis; Stomatitis
PubMed: 30178555
DOI: 10.1111/eos.12529