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MeSH Review


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Disease relevance of Mucositis


High impact information on Mucositis


Chemical compound and disease context of Mucositis

  • Clinically significant mucositis occurred after only 8% of courses of high-dose epirubicin [11].
  • The incidence of mucositis requiring morphine sulfate (MSO4) was similar in both groups (42.9%), with the mean number of days with MSO4 being 7.8 (SD = 3.4) in the PTX group versus 8.2 (SD = 3.4) in the control group (NS) [12].
  • Amifostine did not reduce mucositis [13].
  • While individual patient tolerance varied, moderate to severe myelosuppression and/or mucositis occurred frequently in patients receiving the combination with methotrexate doses greater than or equal to 60 mg/m2 [14].
  • Randomized trial of a chlorhexidine mouthwash for alleviation of radiation-induced mucositis [15].

Biological context of Mucositis

  • Pharmacodynamic analyses at the MTD showed that older age, female sex, and higher 5-FU area under the time versus concentration curve (AUC) were associated with lower nadir counts and/or increased mucositis [16].
  • The maximally tolerated dose of 5-FU in this study was 800 mg/m2/d, with mucositis in previously irradiated sites being dose-limiting [17].
  • This strongly suggests that, in addition to its value in protecting these severely immunocompromised patients from oral infection, chlorhexidine also offers a therapeutic benefit in the resolution of existing oral infections and of mucositis [18].
  • The kinetics of COX-2 expression relative to mucositis progression suggests that COX-2 is not a primary driver of radiation injury, but instead plays an amplifying role [19].

Anatomical context of Mucositis


Gene context of Mucositis

  • Finally, mucositis was induced in mutant mice with specific defects of the EGF signaling axis [25].
  • Gastrointestinal toxicity was low, grade 3-4 mucositis occured less frequently than in similarly-treated historical controls receiving GM-CSF [26].
  • We investigated the effects of IGF-I pre-treatment on chemotherapy-induced mucositis in rats [27].
  • These data indicate that mucositis lesions are related to massive release of proteolytic enzymes and are improved by RG1503 treatment, this effect being ascribable in part to restoration of the MMP-TIMP balance [28].
  • It is clear that G-CSF is the therapy of choice for most neutropenias and that both agents have effects in diminishing the myelotoxicity and mucositis seen after aggressive chemoradiotherapy [29].

Analytical, diagnostic and therapeutic context of Mucositis


  1. Multidrug resistance protein 1 protects the oropharyngeal mucosal layer and the testicular tubules against drug-induced damage. Wijnholds, J., Scheffer, G.L., van der Valk, M., van der Valk, P., Beijnen, J.H., Scheper, R.J., Borst, P. J. Exp. Med. (1998) [Pubmed]
  2. Aclacinomycin A and etoposide (VP-16-213): an effective regimen in previously treated patients with refractory acute myelogenous leukemia. Rowe, J.M., Chang, A.Y., Bennett, J.M. Blood (1988) [Pubmed]
  3. Cisplatin, fluorouracil, and leucovorin induction chemotherapy followed by concurrent cisplatin chemoradiotherapy for organ preservation and cure in patients with advanced head and neck cancer: long-term follow-up. Psyrri, A., Kwong, M., DiStasio, S., Lekakis, L., Kassar, M., Sasaki, C., Wilson, L.D., Haffty, B.G., Son, Y.H., Ross, D.A., Weinberger, P.M., Chung, G.G., Zelterman, D., Burtness, B.A., Cooper, D.L. J. Clin. Oncol. (2004) [Pubmed]
  4. Pharmacodynamics of fluorouracil-based induction chemotherapy in advanced head and neck cancer. Vokes, E.E., Mick, R., Kies, M.S., Dolan, M.E., Malone, D., Athanasiadis, I., Haraf, D.J., Kozloff, M., Weichselbaum, R.R., Ratain, M.J. J. Clin. Oncol. (1996) [Pubmed]
  5. Effect of granulocyte-macrophage colony-stimulating factor on oral mucositis after hematopoietic stem-cell transplantation. Gordon, B., Spadinger, A., Hodges, E., Ruby, E., Stanley, R., Coccia, P. J. Clin. Oncol. (1994) [Pubmed]
  6. Oral sucralfate suspension for mucositis. Solomon, M.A. N. Engl. J. Med. (1986) [Pubmed]
  7. Overview of combined modality therapies for head and neck cancer. Dimery, I.W., Hong, W.K. J. Natl. Cancer Inst. (1993) [Pubmed]
  8. Soft-laser therapy for iatrogenic mucositis in cancer patients receiving high-dose fluorouracil: a preliminary report. Pourreau-Schneider, N., Soudry, M., Franquin, J.C., Zattara, H., Martin, P.M., Ciais, G., Namer, M., Schneider, M., Chauvel, P., Demard, F. J. Natl. Cancer Inst. (1992) [Pubmed]
  9. Chemotherapy- and radiotherapy-induced intestinal damage is regulated by intestinal trefoil factor. Beck, P.L., Wong, J.F., Li, Y., Swaminathan, S., Xavier, R.J., Devaney, K.L., Podolsky, D.K. Gastroenterology (2004) [Pubmed]
  10. Biological actions and therapeutic potential of the glucagon-like peptides. Drucker, D.J. Gastroenterology (2002) [Pubmed]
  11. Chemotherapy of intermediate- and high-grade non-Hodgkin's lymphomas with an intensive epirubicin-containing regimen. Zuckerman, K.S., Case, D.C., Gams, R.A., Prasthofer, E.F. Blood (1993) [Pubmed]
  12. Prevention of regimen-related toxicities after bone marrow transplantation by pentoxifylline: a prospective, randomized trial. Attal, M., Huguet, F., Rubie, H., Charlet, J.P., Schlaifer, D., Huynh, A., Laurent, G., Pris, J. Blood (1993) [Pubmed]
  13. Phase III randomized trial of amifostine as a radioprotector in head and neck cancer. Brizel, D.M., Wasserman, T.H., Henke, M., Strnad, V., Rudat, V., Monnier, A., Eschwege, F., Zhang, J., Russell, L., Oster, W., Sauer, R. J. Clin. Oncol. (2000) [Pubmed]
  14. Methotrexate and dipyridamole combination chemotherapy based upon inhibition of nucleoside salvage in humans. Willson, J.K., Fischer, P.H., Remick, S.C., Tutsch, K.D., Grem, J.L., Nieting, L., Alberti, D., Bruggink, J., Trump, D.L. Cancer Res. (1989) [Pubmed]
  15. Randomized trial of a chlorhexidine mouthwash for alleviation of radiation-induced mucositis. Foote, R.L., Loprinzi, C.L., Frank, A.R., O'Fallon, J.R., Gulavita, S., Tewfik, H.H., Ryan, M.A., Earle, J.M., Novotny, P. J. Clin. Oncol. (1994) [Pubmed]
  16. Cisplatin, fluorouracil, and leucovorin augmented by interferon alfa-2b in head and neck cancer: a clinical and pharmacologic analysis. Vokes, E.E., Ratain, M.J., Mick, R., McEvilly, J.M., Haraf, D., Kozloff, M., Hamasaki, V., Weichselbaum, R.R., Panje, W.R., Wenig, B. J. Clin. Oncol. (1993) [Pubmed]
  17. Cisplatin, fluorouracil, and high-dose leucovorin for recurrent or metastatic head and neck cancer. Vokes, E.E., Choi, K.E., Schilsky, R.L., Moran, W.J., Guarnieri, C.M., Weichselbaum, R.R., Panje, W.R. J. Clin. Oncol. (1988) [Pubmed]
  18. Therapeutic use of chlorhexidine in bone marrow transplant patients: case studies. Ferretti, G.A., Hansen, I.A., Whittenburg, K., Brown, A.T., Lillich, T.T., Ash, R.C. Oral Surg. Oral Med. Oral Pathol. (1987) [Pubmed]
  19. The relationship between mucosal cyclooxygenase-2 (COX-2) expression and experimental radiation-induced mucositis. Sonis, S.T., O'Donnell, K.E., Popat, R., Bragdon, C., Phelan, S., Cocks, D., Epstein, J.B. Oral Oncol. (2004) [Pubmed]
  20. Inhibition of fluorouracil-induced stomatitis by oral cryotherapy. Mahood, D.J., Dose, A.M., Loprinzi, C.L., Veeder, M.H., Athmann, L.M., Therneau, T.M., Sorensen, J.M., Gainey, D.K., Mailliard, J.A., Gusa, N.L. J. Clin. Oncol. (1991) [Pubmed]
  21. High dose methotrexate with leucovorin rescue. Rationale and spectrum of antitumor activity. Frei, E., Blum, R.H., Pitman, S.W., Kirkwood, J.M., Henderson, I.C., Skarin, A.T., Mayer, R.J., Bast, R.C., Garnick, M.B., Parker, L.M., Canellos, G.P. Am. J. Med. (1980) [Pubmed]
  22. Prevention of mucositis in bone marrow transplantation: a double blind randomised controlled trial of sucralfate. Castagna, L., Benhamou, E., Pedraza, E., Luboinski, M., Forni, M., Brandes, I., Pico, J.L., Dietrich, P.Y. Ann. Oncol. (2001) [Pubmed]
  23. Efficacy and safety of granulocyte macrophage-colony stimulating factor (GM-CSF) on the frequency and severity of radiation mucositis in patients with head and neck carcinoma. Kannan, V., Bapsy, P.P., Anantha, N., Doval, D.C., Vaithianathan, H., Banumathy, G., Reddy, K.B., Kumaraswamy, S.V., Shenoy, A.M. Int. J. Radiat. Oncol. Biol. Phys. (1997) [Pubmed]
  24. Comparison of granulocyte-macrophage colony-stimulating factor and sucralfate mouthwashes in the prevention of radiation-induced mucositis: a double-blind prospective randomized phase III study. Saarilahti, K., Kajanti, M., Joensuu, T., Kouri, M., Joensuu, H. Int. J. Radiat. Oncol. Biol. Phys. (2002) [Pubmed]
  25. Role of epidermal growth factor and its receptor in chemotherapy-induced intestinal injury. Huang, F.S., Kemp, C.J., Williams, J.L., Erwin, C.R., Warner, B.W. Am. J. Physiol. Gastrointest. Liver Physiol. (2002) [Pubmed]
  26. A phase I study of interleukin-6 after autologous bone marrow transplantation for patients with poor prognosis Hodgkin's disease. Imrie, K.R., Sheridan, B., Colwill, R., Crump, M., Stewart, A.K., McCrae, J., Danish, R., Sutton, D., Romeyer, F., Keating, A. Leuk. Lymphoma (1997) [Pubmed]
  27. Pre-treatment with insulin-like growth factor-I partially ameliorates 5-fluorouracil-induced intestinal mucositis in rats. Cool, J.C., Dyer, J.L., Xian, C.J., Butler, R.N., Geier, M.S., Howarth, G.S. Growth Horm. IGF Res. (2005) [Pubmed]
  28. An engineered biopolymer prevents mucositis induced by 5-fluorouracil in hamsters. Morvan, F.O., Baroukh, B., Ledoux, D., Caruelle, J.P., Barritault, D., Godeau, G., Saffar, J.L. Am. J. Pathol. (2004) [Pubmed]
  29. Hematopoietic growth factors. Williams, M.E., Quesenberry, P.J. Hematologic pathology. (1992) [Pubmed]
  30. Phase I/II randomized trial evaluating the safety and clinical effects of repifermin administered to reduce mucositis in patients undergoing autologous hematopoietic stem cell transplantation. Freytes, C.O., Ratanatharathorn, V., Taylor, C., Abboud, C., Chesser, N., Restrepo, A., Arango, J., Odenheimer, D. Clin. Cancer Res. (2004) [Pubmed]
  31. A pilot study of the effect of granulocyte-macrophage colony-stimulating factor on oral mucositis in head and neck cancer patients during X-radiation therapy: a preliminary report. Nicolatou, O., Sotiropoulou-Lontou, A., Skarlatos, J., Kyprianou, K., Kolitsi, G., Dardoufas, K. Int. J. Radiat. Oncol. Biol. Phys. (1998) [Pubmed]
  32. High-dose therapy with peripheral blood progenitor cell transplantation in multiple myeloma. Goldschmidt, H., Hegenbart, U., Wallmeier, M., Hohaus, S., Engenhart, R., Wannenmacher, M., Haas, R. Ann. Oncol. (1997) [Pubmed]
  33. Oral administration of short-chain fatty acids reduces the intestinal mucositis caused by treatment with Ara-C in mice fed commercial or elemental diets. Ramos, M.G., Bambirra, E.A., Cara, D.C., Vieira, E.C., Alvarez-Leite, J.I. Nutrition and cancer. (1997) [Pubmed]
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