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Oral Mucositis in Patients Undergoing Chemotherapy and Radiotherapy: A Review

Yıl 2020, Cilt: 13 Sayı: 3, 185 - 194, 15.07.2020
https://doi.org/10.46483/deuhfed.634402

Öz

Oral mucositis is caused by disruption of oral mucosal integrity following chemotherapy and / or radiotherapy. Especially head and neck radiotherapy, antimetabolite and alkylating chemotherapy agents cause an increase the frequency and severity of oral mucositis. In patients with oral mucositis emerges serious complications such as pain in the mouth / throat, infection and bleeding. It may also have clinical and economic consequences such as deterioration in daily living activities, fluid, nutrient and analgesia support, prolonged hospital stay and increased treatment cost. Many pharmacological and non-pharmacological agents are used in the prevention / treatment of oral mucositis. In this review, the definition, epidemiology, developmental mechanism, etiology / risk factors, clinical / economic outcomes, evaluation, prevention/treatment of oral mucositis and the role of nurse will be discussed.

Kaynakça

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Kemoterapi ve Radyoterapi Alan Hastalarda Oral Mukozit: Bir Gözden Geçirme

Yıl 2020, Cilt: 13 Sayı: 3, 185 - 194, 15.07.2020
https://doi.org/10.46483/deuhfed.634402

Öz

Oral mukozit, kemoterapi ve/veya radyoterapiyi takiben oral mukoza bütünlüğünün bozulmasıyla ortaya çıkmaktadır. Özellikle baş-boyun bölgesine uygulanan radyoterapi, antimetabolit ve alkilleyici kemoterapi ajanları oral mukozit sıklığında ve şiddetinde artışa neden olmaktadır. Oral mukozit gelişen hastalarda ağız/boğazda ağrı, enfeksiyon ve kanama gibi ciddi komplikasyonlar ortaya çıkmaktadır. Ayrıca günlük yaşam aktivitelerinde bozulma, sıvı, besin ve analjezi desteği, hastanede yatış süresinin uzaması ve tedavi maliyetinde artış gibi klinik ve ekonomik sonuçları olabilmektedir. Oral mukozitin önlenmesi/tedavisinde farmakolojik ve farmakolojik olmayan birçok ajan kullanılmaktadır. Bu derlemede oral mukozitin tanımı, epidemiyolojisi, gelişme mekanizması, etiyolojisi/risk faktörleri, klinik/ekonomik sonuçları, değerlendirilmesi, önlenmesi/tedavisi ve hemşirenin rolü tartışılacaktır.

Kaynakça

  • 1. Maria OM, Eliopoulos N, Muanza T. Radiation-induced oral mucositis. Front Oncol 2017;7:89.
  • 2. Chaudhry HM, Bruce AJ, Wolf RC, Litzow MR, Hogan WJ, Patnaik MS, et al. The incidence and severity of oral mucositis among allogeneic hematopoietic stem cell transplantation patients: a systematic review. Biol Blood Marrow Transplant 2016;22(4):605-616.
  • 3. Kamińska M, Juszkiewicz M, Tymicka R, Bronikowska A, Kolak A. Procedure in the prevention and nurturing of inflammatory changes of oral mucositis among patients treated for oncological conditions. Medical Studies/Studia Medyczne. 2016;32(2):145-149.
  • 4. Barkokebas A, Silva IHM, De Andrade SC, Carvalho AAT, Gueiros LAM, Paiva SM, et al. Impact of oral mucositis on oral-health-related quality of life of patients diagnosed with cancer. Journal of Oral Pathology & Medicine. 2015;44(9):746-751.
  • 5. Schub E, Gilberto C. Stomatitis (Oral mucositis), Cancer treatment-induced. Cinahl Information Systems 2017.
  • 6. Wilberg P, Hjermstad MJ, Ottesen S, Herlofson BB. Chemotherapy-associated oral sequelae in patients with cancers outside the head and neck region. J Pain Symptom Manage 2014;48(6):1060-1069.
  • 7. Çakmak S, Nural N. Incidence of and risk factors for development of oral mucositis in outpatients undergoing cancer chemotherapy. Int J Nurs Pract 2019;25(1):e12710.
  • 8. Mercadante S, Aielli F, Adile C, Ferrera P, Valle A, Fusco F, et al. Prevalence of oral mucositis, dry mouth, and dysphagia in advanced cancer patients. Support Care Cancer 2015;23(11):3249-3255.
  • 9. Staudenmaier T, Cenzer I, Crispin A, Ostermann H, Berger K. Burden of oral mucositis in stem cell transplant patients—the patients’ perspective. Support Care Cancer 2018;26(5):1577-1584.
  • 10. Jo KS, Kim NC. Incidence and factors influencing oral mucositis in patients with hematopoietic stem cell transplantation. J Korean Acad Nurs 2014;44(5):542-551.
  • 11. Luitel A, Rimal J, Maharjan IK, Regmee P. Assessment of oral mucositis among patients undergoing radiotherapy for head and neck cancer. Kathmandu Univ Med J 2019;65(1):63-67.
  • 12. Bilodeau EA, Lalla RV. Recurrent oral ulceration: Etiology, classification, management, and diagnostic algorithm. Periodontology 2019;80(1):49-60.
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  • 49. Mozaffari HR, Payandeh M, Ramezani M, Sadeghi M, Mahmoudiahmadabadi M, Sharifi R. Efficacy of palifermin on oral mucositis and acute GVHD after hematopoietic stem cell transplantation (HSCT) in hematology malignancy patients: a meta-analysis of trials. Wspolczesna Onkol 2017;21(4):299-305.
  • 50. Adil M, Sriram S, Azharuddin M, Ghosh P, Sharma M. PCN4 Effect of palifermin on oral mucositis and acute GVHD after allogeneic hematopoietic stem cell transplantation in patients with hematologic malignancy: a meta-analysis. Value Health 2019;22:56.
  • 51. Treister N, Nieder M, Baggott C, Olson E, Chen L, Dang H, et al. Caphosol for prevention of oral mucositis in pediatric myeloablative haematopoietic cell transplantation. Br J Cancer 2016;116:121.
  • 52. Murdock JL, Reeves DJ. Chemotherapy-induced oral mucositis management: A retrospective analysis of MuGard, Caphosol, and standard supportive care measures. J Oncol Pharm Pract. 2019;26(3):521-528.
  • 53. Svanberg A, Öhrn K, Birgegård G. Caphosol® mouthwash gives no additional protection against oral mucositis compared to cryotherapy alone in stem cell transplantation. A pilot study. Eur J Oncol Nurs. 2015;19(1):50-53.
  • 54. Wong KH, Kuciejewska A, Sharabiani MTA, Ng-Cheng-Hin B, Hoy S, Hurley T, et al. A randomised controlled trial of Caphosol mouthwash in management of radiation-induced mucositis in head and neck cancer. Radiother Oncol. 2017;122(2):207-211.
  • 55. Yarom N, Hovan A, Bossi P, Ariyawardana A, Jensen SB, Gobbo M, et al. Systematic review of natural and miscellaneous agents for the management of oral mucositis in cancer patients and clinical practice guidelines—part 1: vitamins, minerals, and nutritional supplements. Support Care Cancer. 2019;27(10):3997-4010.
  • 56. Rambod M, Pasyar N, Ramzi M. The effect of zinc sulfate on prevention, incidence, and severity of mucositis in leukemia patients undergoing chemotherapy. Eur J Oncol Nurs. 2018;33:14-21.
  • 57. Tian X, Liu X-L, Pi Y-P, Chen H, Chen W-Q. Oral zinc sulfate for prevention and treatment of chemotherapy-induced oral mucositis: a meta-analysis of five randomized controlled trials. Front Oncol 2018;8:484.
  • 58. Cruzat V, Macedo Rogero M, Noel Keane K, Curi R, Newsholme P. Glutamine: Metabolism and immune function, supplementation and clinical translation. Nutrients. 2018;10(11):1564.
  • 59. Sayles C, Hickerson SC, Bhat RR, Hall J, Garey KW, Trivedi MV. Oral glutamine in preventing treatment-related mucositis in adult patients with cancer: a systematic review. Nutr Clin Pract 2016;31(2):171-179.
  • 60. Pathak S, Soni TP, Sharma LM, Patni N, Gupta AK. A randomized controlled trial to evaluate the role and efficacy of oral glutamine in the treatment of chemo-radiotherapy-induced oral mucositis and dysphagia in patients with oropharynx and larynx carcinoma. Cureus. 2019; 11 (6): e4855.
  • 61. Manzi ND, Silveira R, dos Reis PED. Prophylaxis for mucositis induced by ambulatory chemotherapy: systematic review. J Adv Nurs 2016;72(4):735-746.
  • 62. Oberoi S, Zamperlini–Netto G, Beyene J, Treister NS, Sung L. Effect of prophylactic low level laser therapy on oral mucositis: a systematic review and meta-analysis. PLoS one. 2014;9(9):e107418.
  • 63. Ferreira B, da Motta Silveira FM, de Orange FA. Low-level laser therapy prevents severe oral mucositis in patients submitted to hematopoietic stem cell transplantation: a randomized clinical trial. Support Care Cancer. 2016;24(3):1035-1042.
  • 64. Silva GBL, Sacono NT, Othon-Leite AF, Mendonça EF, Arantes AM, Bariani C, et al. Effect of low-level laser therapy on inflammatory mediator release during chemotherapy-induced oral mucositis: a randomized preliminary study. Lasers Med Sci 2015;30(1):117-126.
  • 65. Zadik Y, Arany PR, Fregnani ER, Bossi P, Antunes HS, Bensadoun R-J, et al. Systematic review of photobiomodulation for the management of oral mucositis in cancer patients and clinical practice guidelines. Support Care Cancer. 2019;27(10):3969-3983.
  • 66. Gholizadeh N, Sheykhbahaei N, Sadrzadeh-Afshar M-S. New treatment approaches of oral mucositis: a review of literature. Adv Hum Biol 2016;6(2):66.
  • 67. Park S-H, Han SH. Effect of oral cryotherapy for reducing oral mucositis in hematopoietic stem cell transplantation: a systematic review and meta-analysis. Korean J. Adult Nurs. 2018;30(4):362-375.
  • 68. Correa MEP, Cheng KKF, Chiang K, Kandwal A, Loprinzi CL, Mori T, et al. Systematic review of oral cryotherapy for the management of oral mucositis in cancer patients and clinical practice guidelines. Support Care Cancer. 2019;28 (5): 2449-2456.
  • 69. Samdariya S, Lewis S, Kauser H, Ahmed I, Kumar D. A randomized controlled trial evaluating the role of honey in reducing pain due to radiation induced mucositis in head and neck cancer patients. Indian J Palliat 2015;21(3):268-273.
  • 70. Cho HK, Jeong YM, Lee HS, Lee YJ, Hwang SH. Effects of honey on oral mucositis in patients with head and neck Cancer: A meta-analysis. The Laryngoscope. 2015;125(9):2085-2092.
  • 71. Xu JL, Xia R, Sun ZH, Sun L, Min X, Liu C, et al. Effects of honey use on the management of radio/chemotherapy-induced mucositis: a meta-analysis of randomized controlled trials. Int J Oral Maxillofac Surg. 2016;45(12):1618-1625.
  • 72. Nagi R, Patil DJ, Rakesh N, Jain S, Sahu S. Natural agents in the management of oral mucositis in cancer patients-systematic review. J Oral Biol Craniofac Res 2018;8(3):245-254.
  • 73. Raeessi MA, Raeessi N, Panahi Y, Gharaie H, Davoudi SM, Saadat A, et al. “Coffee plus Honey” versus “topical steroid” in the treatment of chemotherapy-induced oral mucositis: a randomised controlled trial. BMC Complement Altern Med 2014;14(1):293.
  • 74. Khanjani Pour-Fard-Pachekenari A, Rahmani A, Ghahramanian A, Asghari Jafarabadi M, Onyeka TC, Davoodi A. The effect of an oral care protocol and honey mouthwash on mucositis in acute myeloid leukemia patients undergoing chemotherapy: a single-blind clinical trial. Clin Oral Investig 2019;23(4):1811-1821.
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  • 77. Kasiotis KM, Anastasiadou P, Papadopoulos A, Machera K. Revisiting Greek Propolis: Chromatographic Analysis and Antioxidant Activity Study. Plos One. 2017;12(1):e0170077.
  • 78. Anjum S, Ullah A, Khan K, Attaullah M, Khan H, Ali H, et al. Composition and functional properties of propolis (bee glue): A review. Saudi J Biol Sci 2018;26(7):1695-1703.
  • 79. Bolouri AJ, Pakfetrat A, Tonkaboni A, Aledavood SA, Najafi MF, Delavarian Z, et al. Preventing and therapeutic effect of propolis in radiotherapy induced mucositis of head and neck cancers: a triple-blind, randomized, placebo-controlled trial. Iran J Cancer Prev 2015;8(5):e4019.
  • 80. Piredda M, Facchinetti G, Biagioli V, Giannarelli D, Armento G, Tonini G, et al. Propolis in the prevention of oral mucositis in breast cancer patients receiving adjuvant chemotherapy: A pilot randomised controlled trial. Eur J Cancer 2017;26(6):1-8.
  • 81. Chaitanya NC, Muthukrishnan A, Babu DBG, Kumari CS, Lakshmi MA, Palat G, et al. Role of vitamin E and vitamin A in oral mucositis induced by cancer chemo/radiotherapy- a meta-analysis. J Clin Diagn Res 2017;11(5):4.
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  • 83. Ameri A, Abbasinazari M, Fazeli A, Sarafzadeh F, Mahboubi A. The effect of oral selenium on radiotherapy induced mucositis in patients with head and neck cancer: a pilot double-blind study. JKMU 2016;23(1):12-20.
  • 84. Radha MH, Laxmipriya NP. Evaluation of biological properties and clinical effectiveness of Aloe vera: A systematic review. J Tradit Complement Med 2015;5(1):21-26.
  • 85. Aghamohamamdi A, Hosseinimehr SJ. Natural products for management of oral mucositis induced by radiotherapy and chemotherapy. Integr Cancer Ther 2016;15(1):60-68.
  • 86. Chen H, Pu J, Liu D, Yu W, Shao Y, Yang G, et al. Anti-inflammatory and antinociceptive properties of flavonoids from the fruits of black mulberry (Morus nigra L.). Plos One. 2016;11(4):e0153080.
  • 87. Li Y, Bao T, Chen W. Comparison of the protective effect of black and white mulberry against ethyl carbamate-induced cytotoxicity and oxidative damage. Food Chem 2018;243:65-73.
  • 88. Demir Doğan M, Can G, Meral R. Effectiveness of black mulberry molasses in prevention of radiotherapy-induced oral mucositis: a randomized controlled study in head and neck cancer patients. J Altern Complement Med. 2017;23(12):971-979.
  • 89. Harman M, Ovayolu N, Ovayolu O. The effect of three different solutions on preventing oral mucositis in cancer patients undergoing stem cell transplantation: a non-randomized controlled trial: A Turkish study-non-randomised trial. J Pak Med Assoc. 2019;69(6):811-816.
  • 90. Leppla L, De Geest S, Fierz K, Deschler-Baier B, Koller A. An oral care self-management support protocol (OrCaSS) to reduce oral mucositis in hospitalized patients with acute myeloid leukemia and allogeneic hematopoietic stem cell transplantation: a randomized controlled pilot study. Support Care Cancer. 2016;24(2), 773-782.
  • 91. Carvalho CG, Medeiros-Filho JB, Ferreira MC. Guide for health professionals addressing oral care for individuals in oncological treatment based on scientific evidence. Support Care Cancer. 2018;26(8):2651-2661.
  • 92. Lopes LD, Rodrigues AB, Brasil DRM, Moreira MMC, Amaral JG, Oliveira PPD. Prevention and treatment of mucositis at an oncology outpatient clinic: a collective construction. Texto & Contexto - Enfermagem. 2016;25(1).
  • 93. Avci S, Sari HY. Effect of an evidence-based nursing intervention on the diagnosis of oral mucositis in the pediatric stem cell transplant unit. Asia Pac J Oncol Nurs. 2019;6(3), 292-299.
  • 94. Kanagalingam J, Wahid MIA, Lin J-C, Cupino NA, Liu E, Kang J-H, et al. Patient and oncologist perceptions regarding symptoms and impact on quality-of-life of oral mucositis in cancer treatment: results from the Awareness Drives Oral Mucositis PercepTion (ADOPT) study. Support Care Cancer. 2018;26(7):2191-2200.
Toplam 94 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Hemşirelik
Bölüm Derleme
Yazarlar

Seher Çakmak 0000-0003-4684-8333

Nesrin Nural 0000-0003-2100-7386

Yayımlanma Tarihi 15 Temmuz 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 13 Sayı: 3

Kaynak Göster

APA Çakmak, S., & Nural, N. (2020). Kemoterapi ve Radyoterapi Alan Hastalarda Oral Mukozit: Bir Gözden Geçirme. Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi, 13(3), 185-194. https://doi.org/10.46483/deuhfed.634402

Dokuz Eylül Üniversitesi Hemşirelik Fakültesi Elektronik Dergisi ULAKBİM Türk Tıp Dizini, Türk Medline, Türkiye Atıf Dizini, Şubat 2021 tarihinden beri EBSCO Host ve 26 Ekim 2021 tarihinden itibaren DOAJ ve 18 Ocak 2022 tarihinden beri Index Copernicus tarafından indekslenmektedir.

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