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1.
Braz Dent J ; 31(3): 310-318, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32667525

RESUMO

Oral mucositis is a common inflammatory complication among patients with cancer. This study evaluated the histopathological, stereological, and antioxidant markers of 2% eucalyptus extract in induced oral mucositis in male golden hamsters. In this animal study, oral mucositis was induced in 30 male golden hamsters by 5-FU (60 mg/kg) on days 0, 5, and 10 of the study. The cheek pouch was scratched with a sterile needle once daily on days 3 and 4. On days 14-17, 2% eucalyptus hydroalcoholic extract gel and Calendula officinalis extract gel groups were treated and then compared with a non-treated control group. The histopathological and stereological scores and the pouch content of malondialdehyde, as well as the activities of glutathione and myeloperoxidase in the pouch tissue, were evaluated. Histopathologic scores of oral mucositis were lower in the eucalyptus gel group than those of the calendula and control groups (p<0.05). Also, a lower malondialdehyde level and higher myeloperoxidase and glutathione activities were detected in the eucalyptus group in comparison to the calendula and control groups (p<0.001). The thickness of the mucosa and submucosa increased in the eucalyptus group. The numerical density of the fibroblast and the volume density of the collagen significantly increased in the eucalyptus group. In conclusion, the use of eucalyptus hydroalcoholic extract may be associated with reduced intensity of oral mucositis, diminished concentration of malondialdehyde, increased activity of myeloperoxidase and glutathione, increased volume of mucosa and submucosa, increased fibroblast and collagen in the induced oral mucositis in golden hamsters undergoing 5-FU consumption.


Assuntos
Eucalyptus , Mucosite , Estomatite , Animais , Cricetinae , Fluoruracila , Masculino , Mesocricetus , Mucosa Bucal , Extratos Vegetais
2.
Stomatologiia (Mosk) ; 99(3): 37-40, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32608947

RESUMO

OBJECTIVE: To study changes in the parameters of endogenous intoxication using the level of substances of low and medium molecular weight in the oral fluid in patients with catarrhal stomatitis, which got developed after the acute drug poisoning. MATERIAL AND METHODS: To determine the degree of intoxication, we studied the concentrations of low and medium molecular weight substances (SLMMW) in the oral fluid of patients. We studied the saliva of 20 patients (13 men and 7 women, average age 39 years). The control was done against the oral fluid of 10 healthy individuals. The studies were conducted in a control group consisting of 10 healthy individuals with intact oral mucosa and two groups of patients (20 patients in total) with drug poisoning. The first of these two groups of patients included 8 individuals without pathological changes in the oral mucosa, while the second group consisted of 12 patients diagnosed with catarrhal stomatitis that developed after acute drug poisoning. RESULTS: It became known that endogenous intoxication develops in the oral fluid of patients with acute drug poisoning, which is manifested by a statistically significant increase in the content of SLMMW in comparison with practically healthy individuals (15.3%). And the total level of SLMMW in the oral fluid of patients with acute drug stomatitis and catarrhal stomatitis has increased by 42.3% relative to the data of practically healthy individuals. CONCLUSION: Studies have shown the need for monitoring the oral cavity in patients with acute drug poisoning, with the aim of timely detection of pathologies of the oral mucosa in them and the appointment of complex treatment.


Assuntos
Resfriado Comum , Estomatite , Transtornos Relacionados ao Uso de Substâncias , Adulto , Feminino , Humanos , Masculino , Mucosa Bucal , Saliva
4.
Spec Care Dentist ; 40(4): 364-373, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32544269

RESUMO

AIMS: This study aimed to evaluate the effect of laser photobiomodulation in the prevention of oral mucositis (OM), salivary hypofunction and referred pain in patients with head and neck cancer. METHODS AND RESULTS: This randomized clinical study divided patients into two groups: the laser group (LG, n = 30) and the control group (CG, n = 24). The LG (InGaAlP, 660 nm, 86.7 mW, 2 J/cm2 ) participated in the preventive protocol, while the CG underwent a simulated procedure without light emission. The degree of OM, salivary flow, and referred pain were evaluated at five different periods of radiotherapy. Both groups showed a significant increase in the degree of OM (P < .01). Regarding OM, salivary flow, and oral pain, there were no significant differences between the groups. CONCLUSIONS: The laser photobiomodulation protocol used in this study was not effective in preventing radiochemotherapy-induced OM, salivary hypofunction, and referred pain in patients with head and neck cancer. Notably, although the development of OM did not differ significantly according to the use of laser therapy, the severity of oral mucositis was reduced in patients who underwent laser therapy compared to that in patients who did not.


Assuntos
Neoplasias de Cabeça e Pescoço , Terapia com Luz de Baixa Intensidade , Estomatite , Quimiorradioterapia , Humanos
5.
J Evid Based Dent Pract ; 20(1): 101398, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32381407

RESUMO

OBJECTIVE: To evaluate the additional effect of probiotic Lactobacillus in the nonsurgical management of peri-implant diseases (peri-implant mucositis and peri-implantitis). METHODS: Six databases were searched up to May 2019 without time and language restrictions. Study selection and data extraction were conducted independently by 2 reviewers. The inclusion criteria for this systematic review were defined based on the participants, intervention, comparison, outcomes, and study design (PICOS) format. Randomized controlled trials comparing nonsurgical treatment combined with probiotic Lactobacillus or placebo agent in patients with peri-implant diseases were included. The methodological quality of retrieved studies was assessed according to the Cochrane Collaboration's Risk of Bias tool, and the quality of evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) tool. Odds ratio and 95% confidence interval (CI) were used to describe dichotomous data, while mean difference and standardized mean difference with 95% CI were used to describe continuous variables. RESULTS: Seven randomized controlled trials with 296 implants were included in this meta-analysis. The mean difference of probing pocket depth (PPD) was -0.05 (95% CI: -0.28 to 0.18; P = .67) immediately after treatment termination and -0.17 (95% CI: -1.01 to 0.67, P = .69) at least 2 months after treatment termination. There was a slight reduction of PPD after treatment termination. Compared with placebo, Lactobacillus provided limited benefits in peri-implant mucositis. There were no significant differences in the secondary outcomes of bleeding on probing or plaque index (P > .05). In a narrative synthesis of peri-implantitis, the effect of Lactobacillus on PPD and bleeding on probing remained controversial. CONCLUSIONS: This systematic review and meta-analysis showed that probiotic Lactobacillus provide limited benefits to the nonsurgical treatment of peri-implant mucositis or peri-implantitis.


Assuntos
Implantes Dentários , Peri-Implantite , Probióticos , Estomatite , Humanos , Lactobacillus
6.
Int J Oral Implantol (Berl) ; 13(2): 123-139, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32424380

RESUMO

PURPOSE: To assess the effectiveness of different nonsurgical protocols for the treatment of peri-implant mucositis. MATERIALS AND METHODS: The identification of randomised clinical trials (RCTs) was systematically performed in three databases and supplemented by a thorough manual search of the literature in periodontics/implantology-related journals. Studies investigating the effect of mechanical and/or chemical plaque control agents aimed at preventing the development of peri-implant mucositis were excluded. When comparable trials were found, a meta-analysis was performed. RESULTS: Fourteen studies were included in the systematic review and three in the meta-analysis. None of the selected studies reported a complete resolution of the peri-implant mucositis lesions. A nonsurgical therapy alone showed an average reduction of: 0.57 mm (95% CI [0.30 to 0.83]) in probing pocket depth (PPD); 22.41% (95% CI [12.74 to 32.08]) in bleeding on probing (BOP); 17.28% (95% CI [3.99 to 30.58]) in the plaque index (PI); and 13.41% (95% CI [3.50 to 23.31]) in the bleeding index (BI). The meta-analysis failed to demonstrate significant improvements with the adjunct use of chlorhexidine disinfectant to nonsurgical mechanical debridement for PPD reduction (-0.07 mm; 95% CI [-0.33 to 1.15], P = 0.62), and relative attachment level (RAL) gain (-0.13 mm; 95% CI [-0.6 to 0.35]), P = 0.6). CONCLUSION: Conventional nonsurgical mechanical therapy alone may be considered the standard treatment for peri-implant mucositis as there is still a lack of evidence supporting the use of additional chemical/mechanical agents for clinical and/or microbiological improvement.


Assuntos
Implantes Dentários , Mucosite , Peri-Implantite , Estomatite , Humanos , Índice Periodontal
7.
Anticancer Res ; 40(5): 2701-2706, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32366415

RESUMO

BACKGROUND/AIM: Oral mucositis, which occurs frequently in the treatment of cancer, is a major problem. In this study, we aimed to develop a rat model of oral mucositis induced by cancer chemotherapy for quantitative measurement. MATERIALS AND METHODS: A model animal of oral mucositis was prepared by injecting an acetic acid aqueous solution into the buccal mucosa of rats to which a 5-FU solution had been previously administered. The doses of 5-FU and acetic acid were examined, and a treatment experiment using Kenalog® was performed. RESULTS: The optimal dose of the 5-FU solution and the optimal concentration of the acetic acid aqueous solution were 40 mg/kg and 25%, respectively. Treatment with Kenalog® confirmed that this model mimics immunocompromised oral mucositis. CONCLUSION: Compared with a mouse model, oral mucositis can be easily observed in this model and provides a large amount of oral mucosal tissue.


Assuntos
Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Neoplasias/tratamento farmacológico , Estomatite/induzido quimicamente , Animais , Peso Corporal/efeitos dos fármacos , Modelos Animais de Doenças , Fluoruracila/efeitos adversos , Fluoruracila/uso terapêutico , Contagem de Leucócitos , Masculino , Ratos Wistar , Estomatite/sangue , Úlcera/induzido quimicamente
8.
J Cancer Res Clin Oncol ; 146(7): 1801-1811, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32435894

RESUMO

PURPOSE: Oral mucositis is a debilitating inflammatory disorder observed in patients undergoing active cancer treatment, particularly cancer of the head and neck region. A key pathway believed to be involved in the pathogenesis of oral mucositis is the formation of reactive oxygen species (ROS). The identification of compounds that can inhibit this pathway may therefore be of benefit in treating this disorder. The kava plant (Piper methysticum) contains various constituents, including flavokawain A (FKA), flavokawain B (FKB), yangonin, methysticin and kavain. These constituents are known to be biologically active and possess anti-oxidative properties. This study therefore focused on examining these constituents for their effect on ROS formation in an in vitro oral mucositis model. METHODS: Cell proliferation was assessed in normal oral keratinocytes (OKF6) treated with and without kava constituents, namely FKA, FKB, yangonin, methysticin and kavain using an MTS in vitro assay. Oxidative stress was assessed by co-treating and pre-treating OKF6 cells with H2O2. The effects were quantified by analysis of ROS production, using a CM-H2DCFDA assay. RESULTS: Pre-treatment of cells for 24 h with 2.5 µg/ml kavain and 5 µg/ml FKA demonstrated a significant protective anti-oxidative effect. Similarly, FKB at a concentration of 2.5 µg/ml, demonstrated a trend of ROS reduction but was observed to be cytotoxic at concentrations greater than 5 µg/ml. Reduction in ROS production by methysticin and yangonin was compromised by their cell cytotoxicity. CONCLUSION: This was the first study to identify the anti-oxidative effects and safety of FKA and kavain with regard to oral keratinocytes, highlighting their potential use in the development of a preventative treatment for oral mucositis.


Assuntos
Kava/química , Extratos Vegetais/farmacologia , Substâncias Protetoras/farmacologia , Antioxidantes/química , Antioxidantes/farmacologia , Linhagem Celular Tumoral , Células Cultivadas , Humanos , Peróxido de Hidrogênio/metabolismo , Queratinócitos/efeitos dos fármacos , Queratinócitos/metabolismo , Estresse Oxidativo/efeitos dos fármacos , Extratos Vegetais/química , Substâncias Protetoras/química , Piranos/farmacologia , Pironas/farmacologia , Espécies Reativas de Oxigênio/metabolismo , Estomatite/tratamento farmacológico , Estomatite/etiologia
9.
PLoS One ; 15(5): e0231588, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32421698

RESUMO

We have recently established a protocol to grow wildtype human oral mucosa organoids. These three-dimensional structures can be maintained in culture long-term, do not require immortalization, and recapitulate the multilayered composition of the epithelial lining of the oral mucosa. Here, we validate the use of this model to study the effect of Leucovorin (LV) on Methotrexate (MTX)-induced toxicity. MTX is a chemotherapeutic agent used in the treatment of pediatric acute lymphoblastic leukemia. Although effective, the use of MTX often results in severe side-effects, including oral mucositis, which is characterized by epithelial cell death. Here, we show that organoids are sensitive to MTX, and that the addition of LV reduces MTX toxicity, in both a concentration- and timing-dependent manner. Additionally, we show that a 24 hour 'pretreatment' with LV reduces MTX-induced cell death, suggesting that such a pretreatment could decrease mucositis in patients. Taken together, we provide the first in vitro model to study the effect of MTX on wildtype oral mucosa cells. Our findings underscore the relevance of the clinically applied LV regimen and highlight the potential of this model to further optimize modifications in dosing and timing of Leucovorin on oral mucosa cells.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Apoptose/efeitos dos fármacos , Mucosa Bucal/efeitos dos fármacos , Organoides/patologia , Leucemia-Linfoma Linfoblástico de Células Precursoras/tratamento farmacológico , Estomatite/patologia , Adolescente , Criança , Humanos , Técnicas In Vitro , Leucovorina/administração & dosagem , Metotrexato/administração & dosagem , Mucosa Bucal/patologia , Técnicas de Cultura de Órgãos , Organoides/efeitos dos fármacos , Leucemia-Linfoma Linfoblástico de Células Precursoras/patologia , Estomatite/induzido quimicamente
10.
J Evid Based Dent Pract ; 20(1): 101414, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32381416

RESUMO

ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION: The effect of supportive care in preventing peri-implant diseases and implant loss: A systematic review and meta-analysis. Lin C-Y, Chen Z, Pan W-L, Want H-L. Clin Oral Implants Res 2019;30(8):714-24. SOURCE OF FUNDING: University of Michigan Periodontal Graduate Student Research Fund. TYPE OF STUDY/DESIGN: Systematic review with meta-analysis.


Assuntos
Implantes Dentários , Mucosite , Peri-Implantite , Estomatite , Humanos , Taxa de Sobrevida
11.
Dermatol Online J ; 26(2)2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-32239890

RESUMO

Thiotepa is a common alkylating agent known to precipitate cutaneous reactions consistent with toxic erythema of chemotherapy, including erythema and hyperpigmentation. Herein, we describe an atypical case of malignant intertrigo involving preferential erythema and desquamation not only of skin folds but also of occluded areas after thiotepa-based conditioning. The diagnosis was complicated by concurrent stomatitis and oral petechiae in the setting of autologous stem cell transplant 11 days prior for diffuse large B-cell lymphoma. Histopathological examination from two cutaneous sites demonstrated epidermal dysmaturation and eccrine gland necrosis consistent with thiotepa-induced desquamation and not Stevens-Johnson syndrome or graft-versus-host-disease. Malignant intertrigo can present with extensive cutaneous involvement, as evidenced by our patient who had 25% body surface area affected. Mucosal involvement is common with most chemotherapeutic regimens and its presence should not deter the astute clinician from consideration of a diagnosis of toxic erythema of chemotherapy. No further interventions were needed and the patient healed spontaneously.


Assuntos
Antineoplásicos Alquilantes/efeitos adversos , Erros de Diagnóstico , Hiperpigmentação/induzido quimicamente , Intertrigo/diagnóstico , Síndrome de Stevens-Johnson/diagnóstico , Tiotepa/efeitos adversos , Idoso , Humanos , Hiperpigmentação/diagnóstico , Hiperpigmentação/patologia , Intertrigo/induzido quimicamente , Intertrigo/patologia , Linfoma Difuso de Grandes Células B/complicações , Linfoma Difuso de Grandes Células B/tratamento farmacológico , Masculino , Estomatite/induzido quimicamente
12.
Medicine (Baltimore) ; 99(16): e19661, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32311938

RESUMO

BACKGROUND: Oral mucositis (OM) is a common, disabling, and severe early effect of chemotherapy and radiotherapy that limits the effectiveness of anticancer therapy. The prevention and treatment of OM in patients with malignant tumors is an urgent problem in the field of anticancer therapy. METHODS: Databases including PubMed, Embase, Scopus, The Cochrane Library, and Google Scholar were searched to collect published randomized control trials (RCTs) about the effects of different oral care solutions on the prevention of OM from inception to January 2019. We used the Cochrane Handbook to assess the methodological quality of the RCTs. Two of the authors independently extracted the articles and predefined data. Network meta-analysis was then performed using Stata 15.0 software. RESULTS: A total of 28 RCTs involving 1861 patients were included. The results of network meta-analysis showed that chlorhexidine, benzydamine, honey, and curcumin were more effective than placebo (P < .05) and that honey and curcumin were more effective than povidone-iodine (P < .05). Probability ranking according to the Surface Under the Cumulative Ranking curve showed the following treatments: curcumin, honey, benzydamine, chlorhexidine, allopurinol, sucralfate, granulocyte-macrophage colony-stimulating factor, povidone-iodine, and aloe. CONCLUSION: Our preliminary results indicate that curcumin and honey may serve as the preferred options for patients to prevent OM. The findings may offer an important theoretical basis for clinical prevention and treatment. However, this conclusion still requires an RCT with a larger sample size for further verification.


Assuntos
Estomatite/prevenção & controle , Curcumina/uso terapêutico , Mel , Humanos , Metanálise em Rede
14.
Braz Dent J ; 31(1): 78-88, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32159710

RESUMO

This study aimed to evaluate the factors associated with the occurrence of severe oral mucositis (SOM) in pediatric oncology patients during the chemotherapeutic treatment. This is a nested case-control to a prospective cohort that monitored 105 patients for 10 consecutive weeks after the beginning of the chemotherapy treatment. Logistic regression was used to identify the factors associated with SOM, by group of malignancy (hematologic or solid tumors) (Sig.=5%). To patients with hematologic tumors were found factors associated with SOM in two weeks of treatment: in the 6th week (increase in frequency of chemotherapy doses (OR=3.02)) and in the 7th week (female sex (OR=21.28); and increase in frequency of chemotherapy doses (OR=2.51)); and to patients with solid tumors were found factors associated with SOM in five weeks of treatment: in the 1st week (female sex (OR=14.43); age increase (OR=1.24)); in the 2nd week (Miscellany (OR=6.39)); in the 5th week (Antimetabolites (OR=17.44); Miscellany (OR=45.42); and platelets reduction (OR=1.12)); in the 6th week (creatinine increase (OR=1.63)); and in the 7th week (creatinine increase (OR=2.39)). For patients with hematologic tumors, to be female, and the increase in the frequency of chemotherapy doses increased the risk for SOM and for patients with solid tumors, to be female, the increase in age and in level blood concentration of creatinine, the reduction in number of platelets and the use of chemotherapy with miscellany and antimetabolites agents were associated with an increase in risk for occurrence of SOM.


Assuntos
Neoplasias , Estomatite , Estudos de Casos e Controles , Criança , Feminino , Humanos , Estudos Prospectivos
16.
Medicine (Baltimore) ; 99(10): e19129, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32150054

RESUMO

Patients develop a number of oral complications during cancer treatments. Oral bacteria are associated with the onset of dental focal infections and the progression of oral mucositis. Dental focal infections are frequently associated with the systemic onset of bacteremia, sepsis, and pneumonia. The degeneration of oral function with these complications may become an obstacle to cancer treatments. Although comprehensive oral management, including oral care, the removal of dental focal infections, and improvements in oral function with dentures, is conducted for cancer patients in Japan, few studies have assessed its efficacy.The aim of the present study was to investigate the incidence of dental/oral complications in cancer patients with perioperative oral managements (POMs) based on a large number of case series with a multicenter retrospective analysis.The medical records of cancer patients with POMs were retrospectively reviewed and the incidence of oral complications and efficacy of oral management were investigated.A total of 2744 cancer patients with POMs (1684 males and 1080 females, mean age 65.9 ±â€Š13.0 years) were included and investigated in the present study. Among these patients, 2097 (76.4%) started POM before the initiation of cancer treatments, with 2130 (77.6%) receiving oral care only and 391 (14.2%) being subjected to invasive treatments, such as tooth extraction. The incidence of dental focal infections during the period of cancer treatments was 8.2%. The most frequent infection was acute periodontitis, including alveolar abscesses (112 patients, 4.1%). The incidence of grade 2 and 3 oral mucositis was 2.8%. Prolonged fever was observed in 113 patients (4.1%), with 7 having dental focal infections (6.2%). These incidence rates were lower than those reported previously.Based on analyses of a large number of patients, the present results support the efficacy of oral management in cancer patients. However, further studies are needed to establish adequate oral management guidelines for cancer patients.


Assuntos
Antineoplásicos/efeitos adversos , Neoplasias/terapia , Estomatite/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Assistência Perioperatória , Estudos Retrospectivos , Fatores de Risco , Estomatite/etiologia , Estomatite/prevenção & controle , Adulto Jovem
17.
Dent Clin North Am ; 64(2): 305-313, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-32111270

RESUMO

With a very large number of endosseous dental implants placed by generalists and specialists, complications are to be expected. Among them are problems with the soft tissue interface and the hard tissue attachment. Peri-implant mucositis and peri-implantitis are not uncommon, but their prevalence and impact may be reduced with diagnosis and appropriate management, as can the likelihood of progression from mucositis to peri-implantitis. Successful implant dentistry does not end with integration and restoration, and both patient and professionally administered modalities are important for long-term implant maintenance.


Assuntos
Implantes Dentários , Mucosite , Peri-Implantite , Estomatite , Humanos , Fatores de Risco
18.
Support Care Cancer ; 28(5): 2473-2484, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32052137

RESUMO

PURPOSE: To update the clinical practice guidelines for the use of antimicrobials, mucosal coating agents, anesthetics, and analgesics for the prevention and/or treatment of oral mucositis (OM). METHODS: A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. The findings were added to the database used to develop the 2014 MASCC/ISOO clinical practice guidelines. Based on the evidence level, the following guidelines were determined: Recommendation, Suggestion, and No Guideline Possible. RESULTS: A total of 9 new papers were identified within the scope of this section, adding to the 62 papers reviewed in this section previously. A new Suggestion was made for topical 0.2% morphine for the treatment of OM-associated pain in head and neck (H&N) cancer patients treated with RT-CT (modification of previous guideline). A previous Recommendation against the use of sucralfate-combined systemic and topical formulation in the prevention of OM in solid cancer treatment with CT was changed from Recommendation Against to No Guideline Possible. Suggestion for doxepin and fentanyl for the treatment of mucositis-associated pain in H&N cancer patients was changed to No Guideline Possible. CONCLUSIONS: Of the agents studied for the management of OM in this paper, the evidence supports a Suggestion in favor of topical morphine 0.2% in H&N cancer patients treated with RT-CT for the treatment of OM-associated pain.


Assuntos
Analgésicos/uso terapêutico , Anestésicos/uso terapêutico , Anti-Infecciosos/uso terapêutico , Mucosite/tratamento farmacológico , Estomatite/tratamento farmacológico , Adulto , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Guias como Assunto , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Humanos , Masculino
19.
Support Care Cancer ; 28(5): 2457-2472, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32056010

RESUMO

OBJECTIVE: To update the clinical practice guidelines for the management of oral mucositis (OM) that were developed by the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). This part focuses on honey, herbal compounds, saliva stimulants, probiotics, and miscellaneous agents. METHODS: A systematic review was conducted by the Mucositis Study Group of MASCC/ISOO. The body of evidence for each intervention, in each clinical setting, was assigned an evidence level. The findings were added to the database used to develop the 2014 MASCC/ISOO clinical practice guidelines. Based on the evidence level, one of the following guidelines were determined: Recommendation, Suggestion, No Guideline Possible. RESULTS: A total of 78 papers were identified within the scope of this section, of which 49 were included in this review and merged with nine publications that were reported in the previous guidelines update. A new Suggestion was made for honey (combined topical and systemic delivery) for the prevention of OM in head and neck cancer patients receiving radiotherapy with or without chemotherapy. A new Suggestion clarified that chewing gum is not effective for the prevention of OM in pediatric patients with hematological or solid cancer treated with chemotherapy. No guideline was possible for other interventions. CONCLUSIONS: Numerous natural products and herbal remedies were studied for the management of OM. Of the agents reviewed in this systematic review, a guideline in favor was made for honey (combined topical and systemic), while a guideline against was made for chewing gum. Additional research is warranted to clarify the potential of other interventions.


Assuntos
Mel , Mucosite/tratamento farmacológico , Plantas Medicinais , Probióticos/uso terapêutico , Saliva/metabolismo , Estomatite/tratamento farmacológico , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Estimulantes do Sistema Nervoso Central/uso terapêutico , Goma de Mascar , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Humanos , Saliva/efeitos dos fármacos
20.
Support Care Cancer ; 28(5): 2485-2498, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-32080767

RESUMO

PURPOSE: To update the clinical practice guidelines for the use of growth factors and cytokines for the prevention and/or treatment of oral mucositis (OM). METHODS: A systematic review was conducted by the Mucositis Study Group of the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO). The body of evidence for each intervention, in each cancer treatment setting, was assigned an evidence level. The findings were added to the database used to develop the 2014 MASCC/ISOO clinical practice guidelines. Based on the evidence level, the following guidelines were determined: recommendation, suggestion, and no guideline possible. RESULTS: A total of 15 new papers were identified within the scope of this section and were merged with 51 papers that were reviewed in the previous guidelines update. Of these, 14, 5, 13, 2, and 1 were randomized controlled trials about KGF-1, G-CSF, GM-CSF, EGF, and erythropoietin, respectively. For the remaining agents there were no new RCTs. The previous recommendation for intravenous KGF-1 in patients undergoing autologous hematopoietic stem cell transplantation (HSCT) conditioned with high-dose chemotherapy and TBI-based regimens is confirmed. The previous suggestion against the use of topical GM-CSF for the prevention of OM in the setting of high-dose chemotherapy followed by autologous or allogeneic stem cell transplantation remains unchanged. CONCLUSIONS: Of the growth factors and cytokines studied for the management of OM, the evidence supports a recommendation in favor of KGF-1 and a suggestion against GM-CSF in certain clinical settings.


Assuntos
Citocinas/uso terapêutico , Fator Estimulador de Colônias de Granulócitos e Macrófagos/uso terapêutico , Peptídeos e Proteínas de Sinalização Intercelular/uso terapêutico , Mucosite/tratamento farmacológico , Estomatite/tratamento farmacológico , Antineoplásicos/efeitos adversos , Antineoplásicos/uso terapêutico , Humanos , Masculino , Neoplasias/tratamento farmacológico , Guias de Prática Clínica como Assunto , Proteínas Recombinantes/uso terapêutico
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