Cinausero Marika, Aprile Giuseppe, Ermacora Paola, Basile Debora, Vitale Maria G, Fanotto Valentina, Parisi Giuseppe, Calvetti Lorenzo, Sonis Stephen T
Department of Oncology, University and General HospitalUdine, Italy.
Department of Oncology, San Bortolo General HospitalVicenza, Italy.
Front Pharmacol. 2017 Jun 8;8:354. doi: 10.3389/fphar.2017.00354. eCollection 2017.
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.
黏膜炎是化疗、放疗和靶向药物治疗的常见并发症。它经常影响抗癌治疗的依从性，因为它经常导致治疗计划延迟、中断或停止。此外，与黏膜炎管理相关的经济影响备受关注，最近有几份报告估计了由于这种临床状况导致的额外住院费用。确定黏膜炎的危险因素、早期检测其发病、正确评估这种毒性的程度以及规划其多学科管理的能力，都是保证患者生活质量和避免不必要的剂量减少或治疗中断的关键因素。黏膜炎的发病机制是多因素的，根据其解剖表现可分为口腔黏膜炎和胃肠道黏膜炎。治疗和患者相关因素可能有助于预测症状出现的频率和潜在程度。在此，我们讨论与不同类型治疗相关的黏膜炎的临床表现和发病机制。此外，我们重点关注治疗和预防策略，根据国际指南描述过去和现在的管理方法，以及关于可能在未来进一步改善黏膜炎治疗的药物的最有前景的新数据。
