Chemotherapy-Induced Oral Mucositis Follow-up

  • Author: Nathaniel S Treister, DMD, DMSc; Chief Editor: Dirk M Elston, MD   more...
 
Updated: Dec 3, 2010
 

Further Inpatient Care

Oral mucositis (OM) is self-limiting in most patients. If lesions persist or secondary complications occur, consider other etiologies and treatments as discussed above.

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Deterrence/Prevention

Although in most cases oral mucositis cannot be effectively prevented, measures discussed in Treatment may help to reduce the severity of symptoms and the risk of developing septicemia.

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Complications

A wide range of complications are associated with oral mucositis, including, but not limited to, the following:

  • Inadequate pain control
  • Poor nutrition
  • Dehydration
  • Interruption of cytoreductive therapy
  • Increased length of hospitalization
  • Increased cost of treatment
  • Increased risk of local and systemic infection
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Prognosis

Oral mucositis is self-limiting.

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Patient Education

The patient should understand the predisposing factors and the natural course of oral mucositis. Adherence to an oral hygiene regimen during hospitalization helps to minimize the risk of infection or the exacerbation of lesions.

For excellent patient education resources, visit eMedicine's Cancer and Tumors Center. Also, see eMedicine's patient education article Cancer of the Mouth and Throat.

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Contributor Information and Disclosures
Author

Nathaniel S Treister, DMD, DMSc  Assistant Professor of Oral Medicine, Harvard School of Dental Medicine; Associate Surgeon, Division of Oral Medicine and Dentistry, Brigham and Women's Hospital

Nathaniel S Treister, DMD, DMSc is a member of the following medical societies: American Academy of Oral Medicine and American Dental Association

Disclosure: Nothing to disclose.

Coauthor(s)

Sook-Bin Woo, DMD, MS  Associate Professor, Chief, Division of Oral Medicine and Oral Pathology, Department of Oral Medicine and Diagnostic Services, Harvard School of Dental Medicine; Chief of Clinical Affairs, Brigham and Women's Hospital; Consultant, Dana Farber Cancer Institute, Beth Israel/Deaconess Medical Center

Sook-Bin Woo, DMD, MS is a member of the following medical societies: American Academy of Oral and Maxillofacial Pathology, American Academy of Oral Medicine, and American Dental Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Ponciano D Cruz Jr, MD  Vice-Chair, JB Shelmire Professor, Department of Dermatology, University of Texas Southwestern Medical Center

Ponciano D Cruz Jr, MD is a member of the following medical societies: Texas Medical Association

Disclosure: RCTS Consulting fee Independent contractor; Mary Kay Cosmetics Consulting fee Independent contractor; Galderma Grant/research funds Other

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Drore Eisen, MD, DDS  Consulting Staff, Department of Dermatology, Dermatology Research Associates of Cincinnati

Drore Eisen, MD, DDS is a member of the following medical societies: American Academy of Dermatology, American Academy of Oral Medicine, and American Dental Association

Disclosure: Nothing to disclose.

Glen H Crawford, MD  Assistant Clinical Professor, Department of Dermatology, University of Pennsylvania School of Medicine; Chief, Division of Dermatology, The Pennsylvania Hospital

Glen H Crawford, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, Phi Beta Kappa, and Society of USAF Flight Surgeons

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Department of Dermatology, Geisinger Medical Center

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

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  2. [Guideline] Keefe DM, Schubert MM, Elting LS, et al. Updated clinical practice guidelines for the prevention and treatment of mucositis. Cancer. Mar 1 2007;109(5):820-31. [Medline].

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  4. Sonis S, Treister N, Chawla S, Demetri G, Haluska F. Preliminary characterization of oral lesions associated with inhibitors of mammalian target of rapamycin in cancer patients. Cancer. Jan 1 2010;116(1):210-5. [Medline].

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  8. Cutler C, Li S, Kim HT, et al. Mucositis after allogeneic hematopoietic stem cell transplantation: a cohort study of methotrexate- and non-methotrexate-containing graft-versus-host disease prophylaxis regimens. Biol Blood Marrow Transplant. May 2005;11(5):383-8. [Medline].

  9. Stiff PJ, Erder H, Bensinger WI, et al. Reliability and validity of a patient self-administered daily questionnaire to assess impact of oral mucositis (OM) on pain and daily functioning in patients undergoing autologous hematopoietic stem cell transplantation (HSCT). Bone Marrow Transplant. Feb 2006;37(4):393-401. [Medline].

  10. Brizel DM, Murphy BA, Rosenthal DI, et al. Phase II study of palifermin and concurrent chemoradiation in head and neck squamous cell carcinoma. J Clin Oncol. May 20 2008;26(15):2489-96. [Medline].

  11. [Best Evidence] Vadhan-Raj S, Trent J, Patel S, et al. Single-dose palifermin prevents severe oral mucositis during multicycle chemotherapy in patients with cancer: a randomized trial. Ann Intern Med. Sep 21 2010;153(6):358-67. [Medline].

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  17. Rapoport AP, Miller Watelet LF, Linder T, et al. Analysis of factors that correlate with mucositis in recipients of autologous and allogeneic stem-cell transplants. J Clin Oncol. Aug 1999;17(8):2446-53. [Medline].

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  24. Woo SB, Sonis ST, Monopoli MM, Sonis AL. A longitudinal study of oral ulcerative mucositis in bone marrow transplant recipients. Cancer. Sep 1 1993;72(5):1612-7. [Medline].

 
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Hairy tongue.
Multiple mucoceles on the hard palate.
Erythematous oral mucositis lesion on the buccal mucosa.
Ulcerative oral mucositis lesion on the buccal mucosa.
Ulcerative oral mucositis lesion on the lateral and ventral surfaces of the tongue.
Ulcerative oral mucositis lesions on the labial mucosa and the floor of the mouth.
Oral pseudomembranous candidiasis on the hard palate.
Herpes simplex virus ulceration on the dorsal surface of the tongue.
Herpes simplex virus ulceration on the hard and soft palate. Note lesions on the right upper lip and the dorsum of the tongue.
Acute graft versus host disease involving the dorsal surface of the tongue. This is a keratinized site that is usually not involved by oral mucositis.
 
 
 
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