Oropharyngeal
mucositis is a common and treatment-limiting side effect of
cancer therapy. Severe
oral mucositis can lead to the need to interrupt or discontinue
cancer therapy and thus may have an impact on cure of the primary disease.
Mucositis may also increase the risk of local and systemic
infection and significantly affects quality of life and cost of care. Current care of patients with
mucositis is essentially palliative and includes appropriate
oral hygiene, nonirritating diet and oral care products, topical palliative
mouth rinses,
topical anesthetics, and
opioid analgesics. Systemic
analgesics are the mainstay of
pain management. Topical approaches to
pain management are under investigation. The literature supports use of
benzydamine for prophylaxis of
mucositis caused by conventional fractionationated head and neck
radiotherapy, and
cryotherapy for short-half-life stomatoxic
chemotherapy, such as bolus
fluorouracil. Continuing studies are investigating the potential use of
biologic response modifiers and
growth factors, including topical and systemic delivery of epithelial
growth factors and agents. Progress in the prevention and management of
mucositis will improve quality of life, reduce cost of care, and facilitate completion of more intensive
cancer chemotherapy and
radiotherapy protocols. In addition, improved management of
mucositis may allow implementation of
cancer treatment protocols that are currently excessively mucotoxic but may produce higher cure rates. Continuing research related to the pathogenesis and management of
mucositis will undoubtedly lead to the development of potential interventions and improved patient care.