From the Guidelines
Oral mucositis is primarily caused by cancer treatments, specifically chemotherapy and radiation therapy to the head and neck region, as evidenced by the most recent and highest quality study 1. These treatments damage the rapidly dividing cells lining the mouth and throat, leading to inflammation, ulceration, and painful sores. High-dose chemotherapy drugs like 5-FU, capecitabine, irinotecan, or tegafur are particularly associated with mucositis development, as they can lead to a clinically significant incidence of alimentary tract mucositis 1. Radiation therapy causes cumulative damage to oral tissues, with severity increasing as treatment progresses. Biological factors also play a role, including the release of pro-inflammatory cytokines, oxidative stress, and bacterial colonization of damaged tissues. Individual risk factors include poor oral hygiene, existing dental problems, smoking, alcohol use, and certain genetic predispositions that affect how the body processes cancer treatments. Additionally, immunosuppression from cancer or its treatment can worsen mucositis by reducing the body's ability to heal damaged tissues and increasing susceptibility to secondary infections that exacerbate the condition. Some key points to consider in the management of oral mucositis include:
- The use of palifermin, cryotherapy, and low-level laser therapy (LLLT) as preventive measures in certain cases 1
- The importance of oral hygiene and dental care in preventing and managing mucositis
- The need for individualized treatment plans based on the specific cause and severity of mucositis, as well as the patient's overall health status. It is essential to prioritize the most recent and highest quality evidence when making decisions about the management of oral mucositis, as this will help to minimize morbidity, mortality, and improve quality of life for patients with this condition 1.
From the Research
Causes of Oral Mucositis
Oral mucositis is a common complication among cancer patients, and its causes can be attributed to various factors, including:
- Radiation therapy to the head and neck area 2, 3, 4
- Chemotherapy agents 2, 3, 5, 6, 4
- Hematopoietic stem cell transplantation 2
- Type, dosage, and schedule of radiation or chemotherapy 4
- Patient-related factors, such as poor oral hygiene and pre-existing oral conditions 4
Risk Factors
The risk of developing oral mucositis is increased in patients who:
- Receive high-dose chemotherapy or radiation therapy 3, 5, 6
- Have a history of oral mucositis 6
- Have poor oral hygiene or pre-existing oral conditions 4
- Undergo hematopoietic stem cell transplantation 2
Underlying Mechanisms
The development of oral mucositis involves multiple cellular processes, including: