- OM is a common, debilitating, and under-reported adverse effect
of radiation to the head and neck and many forms of
chemotherapy.4
- OM is associated with frequently used chemotherapeutic agents,
including 5-fluorouracil, docetaxel, doxorubicin, etoposide,
chlorambucil, and methotrexate,15 and regimens such as
FOLFIRI and TAC.16
- Conditioning regimens for patients undergoing hematopoietic
cell transplantation are directly cytotoxic and injure the mucosal
barrier; these include total body irradiation, melphalan,
cyclophosphamide, and other agents.3
The estimated frequency of oral mucositis with varying
treatments is shown here:6,18
|
Treatment
approach
|
Estimated frequency of oral
mucositis (%)
|
|
Head and neck radiation
|
Approaching 100%
|
|
Bone marrow transplant and high-dose
chemotherapy
|
89%
|
|
5FU-containing regimens
|
Up to 41%
|
|
Anthracycline-containing regimen
|
Up to 10%
|
Numerous factors contribute to the
risk of oral mucositis including:6
|
Treatment Risk
Factors
|
Patient Risk
Factors
|
- The type of anticancer treatment received6
- Having received anticancer treatment
previously25
- Having radiation therapy for head and neck
cancer25
- Receiving a higher intensity anticancer
treatment25
|
- Having previously suffered with a history of oral
mucositis6
- Poor oral health and oral hygiene14
- Smoking14
- Drinking alcohol14
- Age (children and the elderly develop oral mucositis more
often)25
- Ethnicity (Caucasians are at a higher risk than
African-Americans)25
|
Prior OM Increases Risk
- Risk and severity are increased if OM occurred in the previous
cycle of therapy.8
- Patients who develop OM in cycle 1 are approximately 4 times
more likely to develop OM in cycle 2.24