Mechanisms for Radiation-Induced Oral Mucositis
Mechanisms for Radiation-Induced Oral Mucositis
Radiation therapy remains the primary method of treatment for patients with head and neck cancer. The tissue destruction and functional alterations in the oral cavity lead to the development of oral mucositis. The purpose of this review is to describe the mechanisms, risk factors, prevalence, and magnitude of radiation therapy-related oral mucositis and its morbidities in patients with head and neck cancer. The review concludes with a discussion of the implications for clinical practice. This review provides cancer nurses with the information necessary to identify patients with head and neck cancer who are at high risk for oral mucositis and the significant comorbidities associated with this complication of radiation therapy.
Annually, nearly 60,000 patients receive a diagnosis of head and neck cancer (HNC) including cancer of the tongue, mouth, pharynx, larynx, oral cavity, and thyroid. Patients with HNC are being treated more successfully with combined methods including radiation therapy (RT) in combination with chemotherapy, surgery, or both. However, RT remains the primary method of treatment for patients with HNC. The irradiated fields often include the salivary glands and all or a large portion of the oral mucosa, thereby increasing the risk of oral mucositis.
Mucositis is a general term referring to the inflammatory reaction and ulcerative lesions of the mouth and oropharynx that occur secondary to RT and certain chemotherapy agents. The tissue destruction and functional alterations in the oral cavity become an inevitable problem when patients with HNC receive RT. A survey of randomized studies that examined the use of conventional RT versus experimental treatment (ie, hyperfractionationed RT or RT combined with chemotherapy) showed that severe mucositis (ie, Radiation Therapy Oncology Group [RTOG] criteria grade III) occurred in up to 60% of patients in the conventional group and in 92% of the patients in the experimental treatment group.
Radiation therapy remains the primary method of treatment for patients with head and neck cancer. The tissue destruction and functional alterations in the oral cavity lead to the development of oral mucositis. The purpose of this review is to describe the mechanisms, risk factors, prevalence, and magnitude of radiation therapy-related oral mucositis and its morbidities in patients with head and neck cancer. The review concludes with a discussion of the implications for clinical practice. This review provides cancer nurses with the information necessary to identify patients with head and neck cancer who are at high risk for oral mucositis and the significant comorbidities associated with this complication of radiation therapy.
Annually, nearly 60,000 patients receive a diagnosis of head and neck cancer (HNC) including cancer of the tongue, mouth, pharynx, larynx, oral cavity, and thyroid. Patients with HNC are being treated more successfully with combined methods including radiation therapy (RT) in combination with chemotherapy, surgery, or both. However, RT remains the primary method of treatment for patients with HNC. The irradiated fields often include the salivary glands and all or a large portion of the oral mucosa, thereby increasing the risk of oral mucositis.
Mucositis is a general term referring to the inflammatory reaction and ulcerative lesions of the mouth and oropharynx that occur secondary to RT and certain chemotherapy agents. The tissue destruction and functional alterations in the oral cavity become an inevitable problem when patients with HNC receive RT. A survey of randomized studies that examined the use of conventional RT versus experimental treatment (ie, hyperfractionationed RT or RT combined with chemotherapy) showed that severe mucositis (ie, Radiation Therapy Oncology Group [RTOG] criteria grade III) occurred in up to 60% of patients in the conventional group and in 92% of the patients in the experimental treatment group.
Source...