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2 Initiation results from the production of free radicals caused by chemotherapy or radiotherapy, which damages cell DNA. Different cytokines are responsible for the various stages ( TABLE 1). The development of mucositis involves five stages: (1) initiation, (2) message generation, (3) signaling and amplification, (4) ulceration, and (5) healing. Mucositis also affects a wide range of patients receiving chemotherapy. Oral and gastrointestinal mucositis affects up to 100% of patients undergoing high-dose chemotherapy and hematopoietic stem-cell transplantation and 80% of patients with malignancies of the head and neck who are receiving radiotherapy.

1 It is a devastating consequence of cancer treatment for patients, who find it extremely difficult to perform simple, everyday mouth-related activities, including chewing, biting, talking, swallowing, drinking, and sipping. Oral mucositis is a widespread and potentially serious consequence of high-dose chemotherapy and radiotherapy treatments that appears to be particularly associated with fluorouracil, doxorubicin, and methotrexate. Mucositis, a painful inflammation and ulceration of the mucous membranes lining the digestive tract, can involve both the oral tract and the gastrointestinal tract. For compounded preparations such as mouthwashes, there are various formulations that pharmacists can use based on the experience and needs of the individual physician and patient, respectively. Treatment is mainly supportive, involving both nonpharmacologic and pharmacologic methods. Symptoms, which may include altered taste perception, sores, and varying degrees of pain, usually appear 4 to 5 days after treatment initiation. It seems to be particularly associated with fluorouracil, doxorubicin, and methotrexate. 2011 36(7)(Oncology suppl):12-15.ĪBSTRACT: Oral mucositis is a widespread and potentially serious consequence of high-dose chemotherapy and radiotherapy.

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