From the Guidelines
Stomatitis after chemotherapy can be effectively managed with oral cryotherapy, recombinant human keratinocyte growth factor-1 (KGF-1/palifermin), low-level laser therapy, and patient-controlled analgesia with morphine, as recommended by the ESMO clinical practice guidelines 1. To manage stomatitis after chemotherapy, several approaches can be taken.
- For prevention, oral cryotherapy for 30 minutes is recommended to prevent oral mucositis in patients receiving bolus 5-fluorouracil chemotherapy 1.
- Additionally, recombinant human keratinocyte growth factor-1 (KGF-1/palifermin) can be used to prevent oral mucositis in patients receiving high-dose chemotherapy and total body irradiation, followed by autologous stem cell transplantation 1.
- Low-level laser therapy can also be used to prevent oral mucositis in patients receiving HSCT conditioned with high-dose chemotherapy, with or without total body irradiation 1.
- For pain management, patient-controlled analgesia with morphine is recommended to treat pain due to oral mucositis in patients undergoing HSCT 1. It is essential to maintain good oral hygiene by brushing gently with a soft toothbrush and alcohol-free toothpaste, and to avoid spicy, acidic, rough, or very hot foods that can irritate the mouth further.
- Staying hydrated and choosing soft, bland foods like yogurt, mashed potatoes, and smoothies can also help manage stomatitis.
- Sucking on ice chips during chemotherapy administration may help prevent stomatitis by constricting blood vessels in the mouth, reducing exposure to chemotherapy drugs. If you develop fever, severe pain, or difficulty eating or drinking, contact your healthcare provider immediately as these may indicate infection requiring antibiotics or more intensive treatment.
From the Research
Stomatitis after Chemotherapy
- Stomatitis, also known as oral mucositis, is a common toxicity of cancer chemotherapy 2.
- It can cause significant morbidity in patients with cancer, affecting their quality of life.
Prevention and Treatment
- Oral glutamine supplementation has been shown to decrease the severity of chemotherapy-induced stomatitis 2.
- A study found that patients who received glutamine supplementation had a significant decrease in the maximum grade of mucositis and the total number of days of mucositis 2.
- Topical oral solutions, such as "magic mouthwash," are also used to treat stomatitis, but their effectiveness and ingredients can vary 3.
- Morphine mouthwash has been found to be effective in reducing the severity of oral mucositis in patients with head and neck cancer 4.
Management and Care
- Early identification and treatment of stomatitis are crucial to promote symptom management and quality of life in patients with cancer 5.
- A comprehensive oral care protocol, including thorough oral assessments and patient education, can help prevent and manage stomatitis 5.
- Interventions such as allopurinol mouthwash, granulocyte macrophage-colony stimulating factor, immunoglobulin, and human placental extract have shown promise in improving or eradicating mucositis, but more research is needed to confirm their effectiveness 6.