KEMOTERAPİYE BAĞLI MUKOZİT

Kemoterapiye bağlı mukozit, sistemik kemote- rapinin kişiye sınırlı bir kopmplikasyonudur. Esas olarak hızlı bölünen epitelyal hücrelerin kemoterapi tarafından uyarılan hasarı ve reaktif oksijen radikallerinin artması ve salınması sonucu gelişir. Oral beslenmeyi bozması- nın yanı sıra mukozit aynı zamanda mikrobiyal ajanlara karşı mukozal bariyerin bozulması nedeniyle sistemik bakteriyemi, fungemi ve viremiye de yol açabilir. Her ne kadar çeşitli profilaktik ve terapötik yaklaşımlar mevcut olsa da bunlardan çoğu etkin değildir. Risk değerlendirmesi ve etkin önleyici tedavi gereklidir.

Anahtar Kelimeler:

Kemoterapi, Mukozit

MUCOSITIS RELATED TO CHEMOTHERAPY

Chemotherapy induced mucositis is a self-limited complication of systemic chemotherapy. It is mainly due to the chemotherapy induced DNA damage of rapidly dividing epithelial cells and release and upregulation of reactive oxygene radicals. In addition to interfering oral nutrition, mucositis can also leads to systemic bacteriemia fungemia and viremia due to the destruction of mucosal barrier against microbial agents. Although, several prophylactic and therapeutic approaches are available, most of them are ineffective. Risk assesment and effective preventive treatment is mandatory

Keywords:

Chemotherapy, mucositis,

PDF

___

Epstein JB, Thariat J, Bensadoun RJ, et al. Oral complications of cancer and cancer therapy: From cancer treatment to survivorship. CA Cancer J Clin 2012; 62:400-22.
Krishna SG, Zhao W, Grazziutti ML, et al. Incidence and risk factors for lower alimentary tract mucositis after 1529 courses of chemotherapy in a homogenous population of oncology patients: clinical and research implications. Cancer 2011; 117:648-55.
Sonis ST, Elting LS, Keefe D, et al. Perspectives on cancer pathogenesis, measurement, epidemiology, and mucosal injury: RAD51 genes and clinical
National Cancer Institute Common Toxicity Criteria. http://ctep.cancer.gov/protocolDevelopment/electr onic_applications/docs/ctcaev3.pdf (Accessed on March 08, 2011).
Eisen D, Essell J, Broun ER. Oral cavity complications of bone marrow transplantation. Semin Cutan Med Surg 1997 Dec;16:265-72.
Ruescher TJ, Sodeifi A, Scrivani SJ, et al. The impact streptococcal infection in patients undergoing autologous bone marrow transplantation for hematologic malignancies. Cancer 1998; 82:2275- 81. on alpha-hemolytic
. DeGregorio MW, Lee WM, Ries CA. Candida infections in patients with acute leukemia: ineffectiveness of nystatin prophylaxis and relationship between oropharyngeal and systemic candidiasis. Cancer 1982; 50: 2780-4.
Elad S, Zadik Y, Hewson I, et al. A systematic review of viral infections associated with oral involvement in cancer patients: a spotlight on Herpesviridea. Support Care Cancer. 2010;18:993- 1006.
Whitley RJ, Gnann JW Jr. Acyclovir: a decade later. N Engl J Med 1992; 327:782-9.
Djuric M, Hillier-Kolarov V, Belic A, et al. Mucositis prevention by improved dental care in acute leukemia patients. Support Care Cancer 2006; 14:137-46.
Saadeh CE. Chemotherapy- and radiotherapy- induced oral mucositis: review of preventive strategies and treatment. Pharmacotherapy. 2005 Apr;25: 540-54.
Mahood DJ, Dose AM, Loprinzi CL, et al. Inhibition of cryotherapy. J Clin Oncol 1991; 9: 449-52. stomatitis by oral
Tartarone A, Matera R, Romano G, et al. Prevention of high-dose melphalan-induced mucositis by cryotherapy. Leuk Lymphoma 2005; 46:633-4.
Farrell CL, Bready JV, Rex KL, et al. Keratinocyte growth factor protects mice from chemotherapy and radiation-induced gastrointestinal injury and mortality. Cancer Res 1998; 58: 933-9.
Keefe DM, Schubert MM, Elting LS, et al. Updated clinical practice guidelines for the prevention and treatment of mucositis. Cancer 2007; 109:820-31.
Cowen D, Tardieu C, Schubert M, et al. Low energy Helium-Neon laser in the prevention of oral mucositis in patients undergoing bone marrow transplant: results of a double blind randomized trial. Int J Radiat Oncol Biol Phys 1997; 38:697- 703.
Peterson DE, Jones JB, Petit RG 2nd. Randomized, placebo-controlled trial of Saforis for prevention and treatment of oral mucositis in breast cancer patients chemotherapy. Cancer 2007; 109:322-31. anthracycline-based
Papas AS, Clark RE, Martuscelli G, et al. A prospective, randomized trial for the prevention of mucositis in patients undergoing hematopoietic stem cell transplantation. Bone Marrow Transplant 2003; 31: 705-12.
Chi KH, Chen CH, Chan WK, et al. Effect of granulocyte-macrophage colony-stimulating factor on oral mucositis in head and neck cancer patients after cisplatin, fluorouracil, and leucovorin chemotherapy. J Clin Oncol 1995; 13: 2620-8.
Sorensen JB, Skovsgaard T, Bork E, et al. Double- blind, placebo-controlled, randomized study of chlorhexidine prophylaxis for 5-fluorouracil-based chemotherapy-induced nonblinded randomized comparison to oral cooling (cryotherapy) in gastrointestinal malignancies. Cancer 2008; 112:1600-6. mucositis with
Hita-Iglesias P, Torres-Lagares D, Gutiérrez-Pérez JL. Evaluation of the clinical behaviour of a polyvinylpyrrolidone and sodium hyalonurate gel (Gelclair) in patients subjected to surgical treatment with CO2 laser. Int J Oral Maxillofac Surg 2006; 35: 514-7.
Wadleigh RG, Redman RS, Graham ML, et al. Vitamin E in the treatment of chemotherapy- induced mucositis. Am J Med 1992; 92:481-4.
Cerchietti LC, Navigante AH, Bonomi MR, et al. Effect of topical morphine for mucositis-associated pain following concomitant chemoradiotherapy for head and neck carcinoma. Cancer 2002; 95: 2230- 6.
Berger A, Henderson M, Nadoolman W, et al. Oral capsaicin provides temporary relief for oral mucositis pain secondary to chemotherapy/ radiation therapy. J Pain Symptom Manage 1995; 10:243-8.