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Future Developments in Human Thermography
Published in James Stewart Campbell, M. Nathaniel Mead, Human Medical Thermography, 2023
James Stewart Campbell, M. Nathaniel Mead
Oral mucositis, a painful inflammation linked to cancer treatment, is seen in up to 80% of patients receiving high-dose chemotherapy and in up to 100% of patients receiving radiation for head and neck cancer. Mucositis occurs in approximately 40% of patients receiving conventional chemotherapy.42 Mucositis usually becomes symptomatic 4–5 days after beginning treatment, reaching a peak at around day 10 and then slowly improving over the course of a few weeks. Mucositis associated with radiotherapy usually appears at the end of the second week of treatment and may last for six to eight weeks.43
Oral Mucosal Reactions to Anticancer Therapies
Published in Gabriella Fabbrocini, Mario E. Lacouture, Antonella Tosti, Dermatologic Reactions to Cancer Therapies, 2019
Emmanuelle Vigarios, Vincent Sibaud
Pain is the most prominent symptom of oral mucositis and providing relief is fundamental for continuing treatment (12,13,15–17,19,20). In general, no intervention is required for grade 1 mucositis, except for using mouthwash with bland solutions (sterile water, normal saline, or sodium bicarbonate) and for maintaining a good standard of oral hygiene. Good oral hygiene represents a key factor for alleviating the symptoms of oral mucositis, and basic oral care protocols should be considered as a first-line treatment for reducing the pain and severity of oral mucositis across all cancer modalities. Avoiding hot and spicy food, alcohol, and smoking is also crucial for reducing the severity of oral mucositis (Table 8.3).
Benign Oral and Dental Disease
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Konrad S. Staines, Alexander Crighton
Mucositis (mucosal barrier injury) is the widespread erythema, ulceration and soreness which commonly complicates chemo-, radio- or chemoradiotherapy. Mucositis appears from 3 to 15 days after treatment, earlier after chemotherapy and radiotherapy. Mucositis invariably follows total body irradiation and external beam radiotherapy involving the orofacial tissues. Up to 90% of patients on traditional chemotherapy develop mucositis although targeted cancer immunotherapy is less likely to give ulcers. Oral mucositis is particularly severe after haemopoietic stem cell transplant and can act as a portal for infection. Mucositis typically presents with pain which can be intense enough to interfere with eating, and significantly affect quality of life, with ulceration and sometimes bleeding.
Mitochondrial DNA as a Possible Ligand for TLR9 in Irinotecan-induced Small Intestinal Mucositis
Published in Immunological Investigations, 2022
Thiago Vinicius Ávila, Zélia Menezes-Garcia, Raquel Duque do Nascimento Arifa, Frederico Marianetti Soriani, Alexandre de Magalhães Vieira Machado, Mauro Martins Teixeira, Caio Tavares Fagundes, Daniele G. Souza
Inflammation is a central component of mucositis (Arifa et al. 2014; Bowen et al. 2019; Melo et al. 2008; Menezes-Garcia et al. 2018). Toll-like receptors (TLRs) play a crucial role in the activation of the innate immune response and in the production of pro-inflammatory mediators in response to pathogen structural components and to host tissue damage. Among the TLRs (10 of which are known in humans), TLR9 and MyD88, the adaptor molecule that signals downstream to some TLRs, such as TLR9, as well as the IL-1 cytokine family, have been involved in intestinal mucositis (Bowen et al. 2019; Kaczmarek et al. 2012; Saha et al. 2012; Wong et al. 2015). Genetic deletion of MyD88 or TLR9 effectively prevented intestinal injury when compared to irinotecan-administered WT controls (Wong et al. 2015). Kaczmarek et al. (2012) have also shown that TLR9 plays an important role in the development of doxorubicin-induced intestinal mucositis. On the other hand, Saha et al. have shown that TLR9 agonism results in protection from radiation-induced mucositis (Saha et al. 2012). Such findings might suggest that the pathogenesis of mucositis seems to be strongly dependent on the chemo- or radio-therapeutic agent used.
Palifermin as primary mucositis prophylaxis in patients with B-cell Non-Hodgkin lymphoma: a case series
Published in Pediatric Hematology and Oncology, 2022
Anthony S. Zembillas, Stefanie M. Thomas, Seth J. Rotz, Ilia N. Buhtoiarov, Rabi Hanna
Progress continues to be made regarding the treatment of children and adolescents with aggressive B-cell Non-Hodgkin Lymphoma (NHL). Recent data demonstrated patients with mature B-cell NHL have an improved overall survival with the addition of rituximab to lymphomes malins B (LMB) chemotherapy as part of ANHL1131.1 The results are very promising but there should still be awareness of therapy-related adverse events. The second most common therapy-related adverse event in this study was oral mucositis with grade 3 oral mucositis occurring in 71% of patients.1 This is likely due to the combination of high-dose methotrexate and doxorubicin.2 Complications related to mucositis may include severe pain requiring opioids, nutritional deficiencies necessitating parenteral nutrition, life-threatening bloodstream infections, and prolonged hospitalizations.3 Proper oral care is the standard first-line approach to mucositis prevention but its benefits may be limited with more intensive chemotherapy regimens.
Managing the risk of toxicity in the treatment of elderly patients with soft tissue sarcomas
Published in Expert Opinion on Drug Safety, 2021
Samia Arifi, Anastasia Constantinidou, Robin L. Jones
Correction of reversible conditions is a fundamental part before stating active treatment for cancer patients. All patients should be screened for nutritional risk. Supportive measures to prevent chemotherapy side effects should be applied in accordance with general established guidelines [49]. Prophylactic therapy with granulocyte colony-stimulating factor is recommended for patients ≥65 years old [50]. Anemia has been reported as a significant prognostic factor in STS [43]. Any cause of anemia should be treated accordingly. The management of chemotherapy-induced anemia and the use of erythropoietic agents is the same as for the general population [51]. Preventive measures are important in reducing the severity of mucositis. Maintenance of optimal nutritional support during treatment, and daily oral hygiene routine are the key strategies to reduce mucosal injury [52].