The Experts below are selected from a list of 36951 Experts worldwide ranked by ideXlab platform

Stephen T Sonis - One of the best experts on this subject based on the ideXlab platform.

  • Health and Economic Consequences of Mucositis
    Oral Mucositis, 2020
    Co-Authors: Stephen T Sonis
    Abstract:

    Pain is the most universal symptom associated with Mucositis. Numerous studies have documented its relationship to clinically assessed Mucositis severity, although the variability of scoring criteria has resulted in some scales having more concordance with patient-reported pain than others. Nonetheless, data supporting a strong association between the course of clinically reported Mucositis and the level of patient-reported pain are compelling. For example, Figure 4.1 shows the correlation between Mucositis severity as graded by National Cancer Institute Common Toxicity Criteria (NCI-CTC), patient-reported mouth pain, and dysphagia as reported by Cella and colleagues in a study of 323 patients receiving stomatotoxic chemotherapy.

  • Emerging drugs for chemotherapy-induced Mucositis
    Expert Opinion on Emerging Drugs, 2020
    Co-Authors: Dorothy M. K. Keefe, Stephen T Sonis, Joanne M. Bowen
    Abstract:

    Background: Chemotherapy-induced Mucositis is an increasingly recognized problem in cancer management, preventing full doses of treatment being given, compromising cure rates and reducing quality of life. Symptoms include mouth pain and ulceration, esophagitis, abdominal pain, bloating, and diarrhea. It is associated with increased infections and occasional mortality, and its palliation is very expensive. The pathobiology of Mucositis is complex, and agents that target mechanisms to prevent Mucositis or accelerate healing are in high demand. Objectives: To review existing and potential treatments for chemotherapy-induced Mucositis in the context of current knowledge of pathobiology. Methods: We searched for Mucositis of any region of the gastrointestinal tract using Medline, the Pharmaprojects database and listed patents. Results/conclusions: There are many agents in varying stages of development for chemotherapy-induced Mucositis. The field is complicated by the question of whether treatments should be d...

  • Oral Mucositis in cancer therapy.
    The journal of supportive oncology, 2020
    Co-Authors: Stephen T Sonis
    Abstract:

    Oral Mucositis induced by radiation therapy and chemotherapy is a frequently occurring toxicity in patients with cancer. Severe Mucositis has a major impact on patient daily functioning,well-being, and quality of life. It can also compromise a patient's ability to tolerate planned therapy, resulting in missed doses or dose reductions. Mucositis negatively affects other health outcomes as well, increasing the risk of opportunistic infections and mortality due to sepsis. It also imposes a significant economic burden, since extended hospitalization and greater analgesic use can substantially increase treatment costs. A five-phase model of the pathobiology of Mucositis has been proposed that facilitates our understanding of Mucositis pathogenesis and the complex interactions that occur in response to tissue insult. Application of this evolving model has aided in the development of mechanistically based therapies for the prevention and treatment of Mucositis. Continued research is needed to optimize when these treatments should be administered during the course of cancer therapy to maximize therapeutic benefit.

  • new frontiers in the pathobiology and treatment of cancer regimen related mucosal injury
    Frontiers in Pharmacology, 2017
    Co-Authors: M Cinausero, Stephen T Sonis, Giuseppe Aprile, P Ermacora, D Basile, Maria Giuseppa Vitale, V Fanotto, Giuseppe Parisi, Lorenzo Calvetti
    Abstract:

    Mucositis is a common complication of chemotherapy, radiotherapy and targeted agents. It often affects compliance to anticancer therapies as it frequently causes schedule delays, interruptions or discontinuations of treatment. Moreover, the economic impact related to the management of Mucositis is topical and several estimations of additional hospital costs due to this clinical condition have been recently reported. The ability to determine risk factors for Mucositis, to early detect its onset, to assess correctly the degree of this toxicity and to plan its multidisciplinary management are all key elements to guarantee the quality of life of patients and to avoid useless dose reduction or interruption of treatment. The pathogenesis of Mucositis is multifactorial and it is classily subdivided into oral and gastrointestinal Mucositis according to its anatomic presentation. Treatment and patients’ related factors might help in predicting the frequency and the potential degree of symptoms onset. Here we discuss about clinical presentation and pathogenesis of Mucositis in relation to different kinds of treatments. Moreover, we focus on therapeutic and prevention strategies, describing past and present management according to international guidelines and the most promising new data about agents potentially able to further improve the treatment of Mucositis in the next future.

  • Emerging evidence on the pathobiology of Mucositis.
    Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer, 2013
    Co-Authors: Noor Al-dasooqi, Stephen T Sonis, Joanne M. Bowen, Rachel J. Gibson, Emma Bateman, Nicole Blijlevens, Richard M Logan, Raj G Nair, Andrea M Stringer, Roger Yazbeck
    Abstract:

    Considerable progress has been made in our understanding of the biological basis for cancer therapy-induced mucosal barrier injury (Mucositis). The last formal review of the subject by MASCC/ISOO was published in 2007; consequently, an update is timely. Panel members reviewed the biomedical literature on Mucositis pathobiology published between January 2005 and December 2011. Recent research has provided data on the contribution of tissue structure changes, inflammation and microbiome changes to the development of Mucositis. Additional research has focused on targeted therapy-induced toxicity, toxicity clustering and the investigation of genetic polymorphisms in toxicity prediction. This review paper summarizes the recent evidence on these aspects of Mucositis pathobiology. The ultimate goal of Mucositis researchers is to identify the most appropriate targets for therapeutic interventions and to be able to predict toxicity risk and personalize interventions to genetically suitable patients. Continuing research efforts are needed to further our understanding of Mucositis pathobiology and the pharmacogenomics of toxicity.

Rajesh V. Lalla - One of the best experts on this subject based on the ideXlab platform.

  • Mucositis (Oral and Gastrointestinal)
    The MASCC Textbook of Cancer Supportive Care and Survivorship, 2020
    Co-Authors: Rajesh V. Lalla, Dorothy M. K. Keefe
    Abstract:

    Alimentary Mucositis refers to inflammatory, erosive, and ulcerative lesions of any part of the gastrointestinal tract that occur secondary to cancer therapy. Thus, the term alimentary Mucositis encompasses both oral and gastrointestinal Mucositis. Mucositis can be classified according to the type of cancer therapy involved as chemotherapy-induced Mucositis, radiation-induced Mucositis, or a combination of the two. More recently, Mucositis following targeted anticancer therapies has been described, but our understanding of that is only beginning to develop. Mucositis can be very painful and can significantly affect nutritional intake, mouth care, and the quality of life. It can be a dose-limiting toxicity of cancer therapy and thus have direct effects on patient survival, and in addition gastrointestinal Mucositis is occasionally fatal. This chapter presents a comprehensive discussion on Mucositis including its morbidity, economic impact, pathogenesis, risk factors, clinical signs and symptoms, diagnosis and complicating factors, and measurement. In addition, preventive measures, pain control, nutritional support, and therapeutic interventions for Mucositis are discussed, with reference to the MASCC/ISOO clinical practice guidelines where applicable.

  • mascc isoo clinical practice guidelines for the management of Mucositis secondary to cancer therapy
    Cancer, 2014
    Co-Authors: Rajesh V. Lalla, Linda S Elting, Dorothy M. K. Keefe, Andrei Barasch, Joel B Epstein, Joanne M. Bowen, Cesar A Migliorati, Deborah B Mcguire, Ourania Nicolatougalitis, Douglas E Peterson
    Abstract:

    BACKGROUND: Mucositis is a highly significant, and sometimes dose-limiting, toxicity of cancer therapy. The goal of this systematic review was to update the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) Clinical Practice Guidelines for Mucositis. METHODS: A literature search was conducted to identify eligible published articles, based on predefined inclusion/exclusion criteria. Each article was independently reviewed by 2 reviewers. Studies were rated according to the presence of major and minor flaws as per previously published criteria. The body of evidence for each intervention, in each treatment setting, was assigned a level of evidence, based on previously published criteria. Guidelines were developed based on the level of evidence, with 3 possible guideline determinations: recommendation, suggestion, or no guideline possible. RESULTS: The literature search identified 8279 papers, 1032 of which were retrieved for detailed evaluation based on titles and abstracts. Of these, 570 qualified for final inclusion in the systematic reviews. Sixteen new guidelines were developed for or against the use of various interventions in specific treatment settings. In total, the MASCC/ISOO Mucositis Guidelines now include 32 guidelines: 22 for oral Mucositis and 10 for gastrointestinal Mucositis. This article describes these updated guidelines. CONCLUSIONS: The updated MASCC/ISOO Clinical Practice Guidelines for Mucositis will help clinicians provide evidence-based management of Mucositis secondary to cancer therapy.

  • chemotherapy or radiation induced oral Mucositis
    Dental Clinics of North America, 2014
    Co-Authors: Rajesh V. Lalla, Deborah P Saunders, Douglas E Peterson
    Abstract:

    SUMMARY Oral Mucositis is a significant toxicity of systemic chemotherapy and of RT to theHN14(6):505–15.3. Vera-Llonch M, Oster G, Ford CM, et al. Oral Mucositis and outcomes of alloge-neic hematopoietic stem-cell transplantation in patients with hematologic malig-nancies. Support Care Cancer 2007;15(5):491–6.4. Vera-Llonch M, Oster G, Hagiwara M, et al. Oral Mucositis in patients undergoingradiation treatment for head and neck carcinoma. Cancer 2006;106(2):329–36.5. Managing oral Mucositis in patients with hematologic malignancies. J SupportOncol 2006;4(2):79.6. Al-Dasooqi N, Sonis ST, Bowen JM, et al. Emerging evidence on the pathobiologyof Mucositis. Support Care Cancer 2013;21(7):2075–83.7. Sonis ST. The pathobiology of Mucositis. Nat Rev Cancer 2004;4(4):277–84.8. SonisST, OsterG,FuchsH, etal.OralMucositisandtheclinicalandeconomicout-comesofhematopoieticstem-celltransplantation.JClinOncol2001;19(8):2201–5.9. Elting LS, Cooksley CD, Chambers MS, et al. Risk, outcomes, and costs ofradiation-induced oral Mucositis among patients with head-and-neck malig-nancies. Int J Radiat Oncol Biol Phys 2007;68(4):1110–20.10. Duncan GG, Epstein JB, Tu D, et al. Quality of life, Mucositis, and xerostomia fromradiotherapy for head and neck cancers: a report from the NCIC CTG HN2 ran-domized trial of an antimicrobial lozenge to prevent Mucositis. Head Neck 2005;27(5):421–8.11. Bellm LA, Epstein JB, Rose-Ped A, et al. Patient reports of complications of bonemarrow transplantation. Support Care Cancer 2000;8(1):33–9.12. Elting LS, Cooksley C, Chambers M, et al. The burdens of cancer therapy. Clinicaland economic outcomes of chemotherapy-induced Mucositis. Cancer 2003;98(7):1531–9.13. Trotti A, Bellm LA, Epstein JB, et al. Mucositis incidence, severity and associatedoutcomes in patients with head and neck cancer receiving radiotherapy with orwithout chemotherapy: a systematic literature review. Radiother Oncol 2003;66(3):253–62.

  • methodology for the mascc isoo Mucositis clinical practice guidelines update
    Supportive Care in Cancer, 2013
    Co-Authors: Joanne M. Bowen, Sharon Elad, Ronald Hutchins, Rajesh V. Lalla
    Abstract:

    Members of the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) recently completed the process of updating the MASCC/ISOO Clinical Practice Guidelines for the prevention and treatment of Mucositis. These guidelines, originally published in 2004, and last updated in 2007, provide clinicians with objective, evidence-based recommendations for the management of Mucositis secondary to cancer therapy. This brief paper describes the methodology used to conduct the most recent systematic review in 2011, and develop new guidelines, providing the basis for the update. The overriding aims of the process were to assess evidence of effectiveness of interventions for the prevention and treatment of Mucositis and to produce clinical practice guidelines for the management of Mucositis using best available evidence.

  • management of oral Mucositis in patients who have cancer
    Dental Clinics of North America, 2008
    Co-Authors: Rajesh V. Lalla, Stephen T Sonis, Douglas E Peterson
    Abstract:

    Oral Mucositis is a clinically important and sometimes dose-limiting complication of cancer therapy. Mucositis lesions can be painful, affect nutrition and quality of life, and have a significant economic impact. The pathogenesis of oral Mucositis is multifactorial and complex. This review discusses the morbidity, economic impact, pathogenesis and clinical course of Mucositis. Current clinical management of oral Mucositis is largely focused on palliative measures such as pain management, nutritional support and maintenance of good oral hygiene. However, several promising therapeutic agents are in various stages of clinical development for the management of oral Mucositis. These agents are discussed in the context of recently updated evidence-based clinical management guidelines.

Douglas E Peterson - One of the best experts on this subject based on the ideXlab platform.

  • mascc isoo clinical practice guidelines for the management of Mucositis secondary to cancer therapy
    Cancer, 2014
    Co-Authors: Rajesh V. Lalla, Linda S Elting, Dorothy M. K. Keefe, Andrei Barasch, Joel B Epstein, Joanne M. Bowen, Cesar A Migliorati, Deborah B Mcguire, Ourania Nicolatougalitis, Douglas E Peterson
    Abstract:

    BACKGROUND: Mucositis is a highly significant, and sometimes dose-limiting, toxicity of cancer therapy. The goal of this systematic review was to update the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) Clinical Practice Guidelines for Mucositis. METHODS: A literature search was conducted to identify eligible published articles, based on predefined inclusion/exclusion criteria. Each article was independently reviewed by 2 reviewers. Studies were rated according to the presence of major and minor flaws as per previously published criteria. The body of evidence for each intervention, in each treatment setting, was assigned a level of evidence, based on previously published criteria. Guidelines were developed based on the level of evidence, with 3 possible guideline determinations: recommendation, suggestion, or no guideline possible. RESULTS: The literature search identified 8279 papers, 1032 of which were retrieved for detailed evaluation based on titles and abstracts. Of these, 570 qualified for final inclusion in the systematic reviews. Sixteen new guidelines were developed for or against the use of various interventions in specific treatment settings. In total, the MASCC/ISOO Mucositis Guidelines now include 32 guidelines: 22 for oral Mucositis and 10 for gastrointestinal Mucositis. This article describes these updated guidelines. CONCLUSIONS: The updated MASCC/ISOO Clinical Practice Guidelines for Mucositis will help clinicians provide evidence-based management of Mucositis secondary to cancer therapy.

  • chemotherapy or radiation induced oral Mucositis
    Dental Clinics of North America, 2014
    Co-Authors: Rajesh V. Lalla, Deborah P Saunders, Douglas E Peterson
    Abstract:

    SUMMARY Oral Mucositis is a significant toxicity of systemic chemotherapy and of RT to theHN14(6):505–15.3. Vera-Llonch M, Oster G, Ford CM, et al. Oral Mucositis and outcomes of alloge-neic hematopoietic stem-cell transplantation in patients with hematologic malig-nancies. Support Care Cancer 2007;15(5):491–6.4. Vera-Llonch M, Oster G, Hagiwara M, et al. Oral Mucositis in patients undergoingradiation treatment for head and neck carcinoma. Cancer 2006;106(2):329–36.5. Managing oral Mucositis in patients with hematologic malignancies. J SupportOncol 2006;4(2):79.6. Al-Dasooqi N, Sonis ST, Bowen JM, et al. Emerging evidence on the pathobiologyof Mucositis. Support Care Cancer 2013;21(7):2075–83.7. Sonis ST. The pathobiology of Mucositis. Nat Rev Cancer 2004;4(4):277–84.8. SonisST, OsterG,FuchsH, etal.OralMucositisandtheclinicalandeconomicout-comesofhematopoieticstem-celltransplantation.JClinOncol2001;19(8):2201–5.9. Elting LS, Cooksley CD, Chambers MS, et al. Risk, outcomes, and costs ofradiation-induced oral Mucositis among patients with head-and-neck malig-nancies. Int J Radiat Oncol Biol Phys 2007;68(4):1110–20.10. Duncan GG, Epstein JB, Tu D, et al. Quality of life, Mucositis, and xerostomia fromradiotherapy for head and neck cancers: a report from the NCIC CTG HN2 ran-domized trial of an antimicrobial lozenge to prevent Mucositis. Head Neck 2005;27(5):421–8.11. Bellm LA, Epstein JB, Rose-Ped A, et al. Patient reports of complications of bonemarrow transplantation. Support Care Cancer 2000;8(1):33–9.12. Elting LS, Cooksley C, Chambers M, et al. The burdens of cancer therapy. Clinicaland economic outcomes of chemotherapy-induced Mucositis. Cancer 2003;98(7):1531–9.13. Trotti A, Bellm LA, Epstein JB, et al. Mucositis incidence, severity and associatedoutcomes in patients with head and neck cancer receiving radiotherapy with orwithout chemotherapy: a systematic literature review. Radiother Oncol 2003;66(3):253–62.

  • management of oral Mucositis in patients who have cancer
    Dental Clinics of North America, 2008
    Co-Authors: Rajesh V. Lalla, Stephen T Sonis, Douglas E Peterson
    Abstract:

    Oral Mucositis is a clinically important and sometimes dose-limiting complication of cancer therapy. Mucositis lesions can be painful, affect nutrition and quality of life, and have a significant economic impact. The pathogenesis of oral Mucositis is multifactorial and complex. This review discusses the morbidity, economic impact, pathogenesis and clinical course of Mucositis. Current clinical management of oral Mucositis is largely focused on palliative measures such as pain management, nutritional support and maintenance of good oral hygiene. However, several promising therapeutic agents are in various stages of clinical development for the management of oral Mucositis. These agents are discussed in the context of recently updated evidence-based clinical management guidelines.

  • updated clinical practice guidelines for the prevention and treatment of Mucositis
    Cancer, 2007
    Co-Authors: Dorothy M. K. Keefe, Linda S Elting, Stephen T Sonis, Joel B Epstein, Mark M Schubert, Ronald Hutchins, Judith E Raberdurlacher, Cesar A Migliorati, Deborah B Mcguire, Douglas E Peterson
    Abstract:

    Considerable progress in research and clinical application has been made since the original guidelines for managing Mucositis in cancer patients were published in 2004, and the first active drug for the prevention and treatment of this condition has been approved by the United States Food and Drug Administration and other regulatory agencies in Europe and Australia. These changes necessitate an updated review of the literature and guidelines. Panel members reviewed the biomedical literature on Mucositis published in English between January 2002 and May 2005 and reached a consensus based on the criteria of the American Society of Clinical Oncology. Changes in the guidelines included recommendations for the use of palifermin for oral Mucositis associated with stem cell transplantation, amifostine for radiation proctitis, and cryotherapy for Mucositis associated with high-dose melphalan. Recommendations against specific practices were introduced: Systemic glutamine was not recommended for the prevention of gastrointestinal Mucositis, and sucralfate and antimicrobial lozenges were not recommended for radiation-induced oral Mucositis. Furthermore, new guidelines suggested that granulocyte–macrophage-colony stimulating factor mouthwashes not be used for oral Mucositis prevention in the transplantation population. Advances in Mucositis treatment and research have been complemented by an increased rate of publication on mucosal injury in cancer. However, additional and sustained efforts will be required to gain a fuller understanding of the pathobiology, impact on overall patient status, optimal therapeutic strategies, and improved educational programs for health professionals, patients, and caregivers. These efforts are likely to have significant clinical and economic impact on the treatment of cancer patients. Cancer 2007;109:820–31. © 2007 American Cancer Society.

  • Treatment of Mucositis, including new medications.
    Cancer Journal, 2006
    Co-Authors: Rajesh V. Lalla, Douglas E Peterson
    Abstract:

    ABSTRACT Mucositis is a clinically important and sometimes dose-limiting complication of cancer therapy. Mucositis lesions can be painful, affect nutrition and quality of life, lead to sepsis, and have significant economic impact. Recent modeling of the toxicity has been based on the continuum of clinical signs and symptoms of Mucositis involving the alimentary tract, including both oral and gastrointestinal sites. The pathogenesis of oral and gastrointestinal Mucositis is multifactorial and complex. In recent years, there has been a substantial increase in both basic and clinical research related to mucosal injury in cancer patients. Since most of this research has been directed to oral Mucositis, the present review principally addresses this component of the toxicity. Morbidity, economic impact, pathogenesis and clinical course of Mucositis are discussed. In addition, several agents in clinical development for Mucositis are discussed in the context of the current pathobiologic model as well as the recently updated evidence-based clinical management guidelines.

Joel B Epstein - One of the best experts on this subject based on the ideXlab platform.

  • mascc isoo clinical practice guidelines for the management of Mucositis secondary to cancer therapy
    Cancer, 2014
    Co-Authors: Rajesh V. Lalla, Linda S Elting, Dorothy M. K. Keefe, Andrei Barasch, Joel B Epstein, Joanne M. Bowen, Cesar A Migliorati, Deborah B Mcguire, Ourania Nicolatougalitis, Douglas E Peterson
    Abstract:

    BACKGROUND: Mucositis is a highly significant, and sometimes dose-limiting, toxicity of cancer therapy. The goal of this systematic review was to update the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) Clinical Practice Guidelines for Mucositis. METHODS: A literature search was conducted to identify eligible published articles, based on predefined inclusion/exclusion criteria. Each article was independently reviewed by 2 reviewers. Studies were rated according to the presence of major and minor flaws as per previously published criteria. The body of evidence for each intervention, in each treatment setting, was assigned a level of evidence, based on previously published criteria. Guidelines were developed based on the level of evidence, with 3 possible guideline determinations: recommendation, suggestion, or no guideline possible. RESULTS: The literature search identified 8279 papers, 1032 of which were retrieved for detailed evaluation based on titles and abstracts. Of these, 570 qualified for final inclusion in the systematic reviews. Sixteen new guidelines were developed for or against the use of various interventions in specific treatment settings. In total, the MASCC/ISOO Mucositis Guidelines now include 32 guidelines: 22 for oral Mucositis and 10 for gastrointestinal Mucositis. This article describes these updated guidelines. CONCLUSIONS: The updated MASCC/ISOO Clinical Practice Guidelines for Mucositis will help clinicians provide evidence-based management of Mucositis secondary to cancer therapy.

  • updated clinical practice guidelines for the prevention and treatment of Mucositis
    Cancer, 2007
    Co-Authors: Dorothy M. K. Keefe, Linda S Elting, Stephen T Sonis, Joel B Epstein, Mark M Schubert, Ronald Hutchins, Judith E Raberdurlacher, Cesar A Migliorati, Deborah B Mcguire, Douglas E Peterson
    Abstract:

    Considerable progress in research and clinical application has been made since the original guidelines for managing Mucositis in cancer patients were published in 2004, and the first active drug for the prevention and treatment of this condition has been approved by the United States Food and Drug Administration and other regulatory agencies in Europe and Australia. These changes necessitate an updated review of the literature and guidelines. Panel members reviewed the biomedical literature on Mucositis published in English between January 2002 and May 2005 and reached a consensus based on the criteria of the American Society of Clinical Oncology. Changes in the guidelines included recommendations for the use of palifermin for oral Mucositis associated with stem cell transplantation, amifostine for radiation proctitis, and cryotherapy for Mucositis associated with high-dose melphalan. Recommendations against specific practices were introduced: Systemic glutamine was not recommended for the prevention of gastrointestinal Mucositis, and sucralfate and antimicrobial lozenges were not recommended for radiation-induced oral Mucositis. Furthermore, new guidelines suggested that granulocyte–macrophage-colony stimulating factor mouthwashes not be used for oral Mucositis prevention in the transplantation population. Advances in Mucositis treatment and research have been complemented by an increased rate of publication on mucosal injury in cancer. However, additional and sustained efforts will be required to gain a fuller understanding of the pathobiology, impact on overall patient status, optimal therapeutic strategies, and improved educational programs for health professionals, patients, and caregivers. These efforts are likely to have significant clinical and economic impact on the treatment of cancer patients. Cancer 2007;109:820–31. © 2007 American Cancer Society.

  • antimicrobials mucosal coating agents anesthetics analgesics and nutritional supplements for alimentary tract Mucositis
    Supportive Care in Cancer, 2006
    Co-Authors: Andrei Barasch, Sharon Elad, Arnold J Altman, Kathryn Damato, Joel B Epstein
    Abstract:

    This review focuses on the value of several groups of agents for the prevention and treatment of Mucositis. The review refers to alimentary Mucositis as a generalized term that includes oral Mucositis and gastrointestinal Mucositis. This paper is part of the systematic review made by the Mucositis study group which operates in the Multinational Association of Supportive Care in Cancer (MASCC)/International Society of Oral Oncology (ISOO). Several new guidelines are suggested in this review as an update to the primary systematic review that was published by the same group in 2004.

  • Assessment and measurement of oral Mucositis
    Seminars in Oncology Nursing, 2004
    Co-Authors: June G Eilers, Joel B Epstein
    Abstract:

    Abstract OBJECTIVE: To discuss the assessment and monitoring of Mucositis and provide an overview of instruments available to assess or measure Mucositis. DATA SOURCE: Published journal articles, texts, and clinical experience. CONCLUSION: The lack of consistent use of valid and reliable instruments for the assessment of Mucositis have limited progress in the prevention and management of Mucositis. IMPLICATIONS FOR NURSING PRACTICE: Nurses play a key role in the assessment of oral cavity changes. Using valid and reliable measures will foster the ability to predict risk for Mucositis and to test the effectiveness of protocols for its prevention and treatment.

  • oral Mucositis a challenging complication of radiotherapy chemotherapy and radiochemotherapy part 2 diagnosis and management of Mucositis
    Head and Neck-journal for The Sciences and Specialties of The Head and Neck, 2004
    Co-Authors: C Scully, Joel B Epstein, Stephen T Sonis
    Abstract:

    Background. Oral Mucositis is a common sequel of radiotherapy, chemotherapy, and radiochemotherapy in patients with cancer or patients requiring hemopoietic stem cell trans- plants. Mucositis has a direct and significant impact on the du- ration of disease remission and cure rates, because it is a treat- ment-limiting toxicity. Mucositis also affects survival because of the risk of infection and has a significant impact on quality of life and cost of care. Methods. This article reviews publications on the diagnosis and management of oral Mucositis accessible from a MEDLINE search using as key words Mucositis, radiotherapy, chemo- therapy, hemopoietic stem cell transplant, and oral. Conclusions. Conventional care of patients with Mucositis is currently essentially palliative, with good oral hygiene, narcotic analgesics, and topical palliative mouth rinses. © 2004 Wiley Pe- riodicals, Inc. Head Neck 26: 77-84, 2004

Dorothy M. K. Keefe - One of the best experts on this subject based on the ideXlab platform.

  • Mucositis (Oral and Gastrointestinal)
    The MASCC Textbook of Cancer Supportive Care and Survivorship, 2020
    Co-Authors: Rajesh V. Lalla, Dorothy M. K. Keefe
    Abstract:

    Alimentary Mucositis refers to inflammatory, erosive, and ulcerative lesions of any part of the gastrointestinal tract that occur secondary to cancer therapy. Thus, the term alimentary Mucositis encompasses both oral and gastrointestinal Mucositis. Mucositis can be classified according to the type of cancer therapy involved as chemotherapy-induced Mucositis, radiation-induced Mucositis, or a combination of the two. More recently, Mucositis following targeted anticancer therapies has been described, but our understanding of that is only beginning to develop. Mucositis can be very painful and can significantly affect nutritional intake, mouth care, and the quality of life. It can be a dose-limiting toxicity of cancer therapy and thus have direct effects on patient survival, and in addition gastrointestinal Mucositis is occasionally fatal. This chapter presents a comprehensive discussion on Mucositis including its morbidity, economic impact, pathogenesis, risk factors, clinical signs and symptoms, diagnosis and complicating factors, and measurement. In addition, preventive measures, pain control, nutritional support, and therapeutic interventions for Mucositis are discussed, with reference to the MASCC/ISOO clinical practice guidelines where applicable.

  • Emerging drugs for chemotherapy-induced Mucositis
    Expert Opinion on Emerging Drugs, 2020
    Co-Authors: Dorothy M. K. Keefe, Stephen T Sonis, Joanne M. Bowen
    Abstract:

    Background: Chemotherapy-induced Mucositis is an increasingly recognized problem in cancer management, preventing full doses of treatment being given, compromising cure rates and reducing quality of life. Symptoms include mouth pain and ulceration, esophagitis, abdominal pain, bloating, and diarrhea. It is associated with increased infections and occasional mortality, and its palliation is very expensive. The pathobiology of Mucositis is complex, and agents that target mechanisms to prevent Mucositis or accelerate healing are in high demand. Objectives: To review existing and potential treatments for chemotherapy-induced Mucositis in the context of current knowledge of pathobiology. Methods: We searched for Mucositis of any region of the gastrointestinal tract using Medline, the Pharmaprojects database and listed patents. Results/conclusions: There are many agents in varying stages of development for chemotherapy-induced Mucositis. The field is complicated by the question of whether treatments should be d...

  • mascc isoo clinical practice guidelines for the management of Mucositis secondary to cancer therapy
    Cancer, 2014
    Co-Authors: Rajesh V. Lalla, Linda S Elting, Dorothy M. K. Keefe, Andrei Barasch, Joel B Epstein, Joanne M. Bowen, Cesar A Migliorati, Deborah B Mcguire, Ourania Nicolatougalitis, Douglas E Peterson
    Abstract:

    BACKGROUND: Mucositis is a highly significant, and sometimes dose-limiting, toxicity of cancer therapy. The goal of this systematic review was to update the Multinational Association of Supportive Care in Cancer and International Society of Oral Oncology (MASCC/ISOO) Clinical Practice Guidelines for Mucositis. METHODS: A literature search was conducted to identify eligible published articles, based on predefined inclusion/exclusion criteria. Each article was independently reviewed by 2 reviewers. Studies were rated according to the presence of major and minor flaws as per previously published criteria. The body of evidence for each intervention, in each treatment setting, was assigned a level of evidence, based on previously published criteria. Guidelines were developed based on the level of evidence, with 3 possible guideline determinations: recommendation, suggestion, or no guideline possible. RESULTS: The literature search identified 8279 papers, 1032 of which were retrieved for detailed evaluation based on titles and abstracts. Of these, 570 qualified for final inclusion in the systematic reviews. Sixteen new guidelines were developed for or against the use of various interventions in specific treatment settings. In total, the MASCC/ISOO Mucositis Guidelines now include 32 guidelines: 22 for oral Mucositis and 10 for gastrointestinal Mucositis. This article describes these updated guidelines. CONCLUSIONS: The updated MASCC/ISOO Clinical Practice Guidelines for Mucositis will help clinicians provide evidence-based management of Mucositis secondary to cancer therapy.

  • Microbiota and their role in the pathogenesis of oral Mucositis
    Oral Diseases, 2014
    Co-Authors: Barbara Vanhoecke, Andrea M Stringer, T De Ryck, T. Van De Wiele, Dorothy M. K. Keefe
    Abstract:

    Oral Mucositis in patients undergoing cancer therapy is a significant problem. Its prevalence ranges between 20 and 100%, depending on treatment type and protocols and patient-based variables. Mucositis is self-limiting when uncomplicated by infection. Unfortunately, the incidence of developing a local or systemic infection during the course of the treatment is very high. At this stage, it is unclear which role oral microbiota play in the onset, duration, and severity of oral Mucositis. Nevertheless, there is growing interest in this underexplored topic, and new studies are being undertaken to unravel their impact on the pathogenesis of Mucositis.

  • patient reported measurements of oral Mucositis in head and neck cancer patients treated with radiotherapy with or without chemotherapy demonstration of increased frequency severity resistance to palliation and impact on quality of life
    49th Annual Meeting of the American-Society-for-Therapeutic-Radiology-and-Oncology (ASTRO), 2008
    Co-Authors: Linda S Elting, Adam S. Garden, Dorothy M. K. Keefe, Stephen T Sonis, Andrei Barasch, F K L Spijkervet, Roy B Tishler, Thomas P Canty, Mahesh K Kudrimoti, Montserrat Verallonch
    Abstract:

    BACKGROUND. The risk, severity, and patient-reported outcomes of radiation-induced Mucositis among head and neck cancer patients were prospectively estimated. METHODS. A validated, patient-reported questionnaire (OMDQ), the FACT quality of life (QOL), and the Functional Assessment of Chronic Illness Therapy (FACIT) fatigue scales were used to measure Mucositis (reported as mouth and throat soreness), daily functioning, and use of analgesics. Patients were studied before radiotherapy (RT), daily during RT, and for 4 weeks after RT. RESULTS. Contrary to previous reports, the risk of Mucositis was virtually identical in the 126 patients with oral cavity or oropharynx tumors (99% overall; 85% grade 3-4) compared with 65 patients with tumors of the larynx or hypopharynx (98% overall; 77% grade 3-4). The mean QOL score decreased significantly during RT, from 85.1 at baseline to 69.0 at Week 6, corresponding with the peak of Mucositis severity. The mean functional status score decreased by 33% from 18.3 at baseline to 12.3 at Week 6. The impact of Mucositis on QOL was proportional to its severity, although even a score of 1 or 2 (mild or moderate) was associated with a significant reduction in QOL (from 93.6 at baseline to 74.7 at Week 6). Despite increases in analgesic use from 34% at baseline to 80% at Week 6, mean Mucositis scores exceeded 2.5 at Week 6. CONCLUSIONS. Mucositis occurs among virtually all patients who are undergoing radiation treatment of head and neck cancers. The detrimental effects on QOL and functional status are significant, and opioid analgesia provides inadequate relief. Preventive rather than symptom palliation measures are needed. Cancer 2008;113:2704–13. � 2008 American Cancer Society.