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Oral and Gastrointestinal Mucositis: Considerations in Palliative Care

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Textbook of Palliative Care

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Abstract

Mucositis is an inflammatory reaction of the mucosa of the alimentary tract (AT) caused by traditional cytotoxic agents (chemotherapy, radiotherapy) and novel anti-cancer therapies. It presents a significant burden not only to patient quality of life but also may result in diminished tumor control (through dose reductions) and increased treatment costs (due to extended hospital stays and supportive care). Mucositis symptoms may vary not only due to the treatment modality but also according to genetic, biological and social determinants. Currently the management of mucositis focuses on supportive care (i.e. symptom management), with treatments that reduce the incidence, severity, and duration mucosal injury limited. This chapter provides a clinically-focused overview of the current mechanistic understanding of mucositis as well as its presentation and assessment. We also provide an overview of current clinical practice guidelines for mucositis in both adult and paediatric settings, highlighting emerging areas of interest.

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Abbreviations

5-FU:

5-fluorouracil

AT:

alimentary tract

BF:

Bayes factor

CAM:

complementary and alternative medicine

CT:

chemotherapy

GI:

gastrointestinal

GLP:

glucagon-like peptide

H2BT:

hydrogen breath test

HSCT:

hematopoietic stem cell transplantation

IL:

interleukin

LIL:

low-intensity laser

LLLT:

low-level laser therapy

MASCC/ISOO:

Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology

mAb:

monoclonal antibody

MMPs:

matrix metalloproteases

mTOR:

mechanistic target of rapamycin

NCI-CTCAE:

National Cancer Institute Common Terminology Criteria for Adverse Events

NF-κB:

nuclear factor kappa B

OM:

oral mucositis

PRO:

patient-reported outcome

QOL:

quality of life

RCT:

randomized controlled trial

RT:

radiotherapy

SBS:

short bowel syndrome

SBT:

13C-sucrose breath test

TAT:

targeted anticancer therapy

TBI:

total body irradiation

TKI:

tyrosine kinase inhibitor

TLR:

toll-like receptor

TNF:

tumour necrosis factor

WHO:

World Health Organization

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Authors and Affiliations

  1. School of Biomedicine, University of Adelaide, Adelaide, Australia

    Hannah R Wardill, Emma H Bateman & Joanne M Bowen

  2. Supportive Oncology Research Group, The South Australian Health and Medical Research Institute (SAHMRI), Adelaide, Australia

    Hannah R Wardill

  3. School of Dentistry, University of Adelaide, Adelaide, Australia

    Richard M Logan

  4. School of Allied Health, University of Adelaide, Adelaide, Australia

    Rachel J Gibson

  5. Cancer Treatment Toxicities Group, School of Medicine, University of Adelaide, Adelaide, Australia

    Dorothy M Keefe

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  1. Hannah R Wardill
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  2. Emma H Bateman
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  3. Richard M Logan
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  4. Rachel J Gibson
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  5. Dorothy M Keefe
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  6. Joanne M Bowen
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Correspondence to Hannah R Wardill .

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Editors and Affiliations

  1. HammondCare Learning and Research Centre, Greenwich Hospital, Greenwich, NSW, Australia

    Roderick Duncan MacLeod

  2. Vrije Universiteit Brussel, VUB-UGent End-of-Life Care Research Grou Vrije Universiteit Brussel, Brussels, Belgium

    Lieve Van den Block

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Wardill, H.R., Bateman, E.H., Logan, R.M., Gibson, R.J., Keefe, D.M., Bowen, J.M. (2023). Oral and Gastrointestinal Mucositis: Considerations in Palliative Care. In: MacLeod, R.D., Van den Block, L. (eds) Textbook of Palliative Care. Springer, Cham. https://doi.org/10.1007/978-3-319-31738-0_17-3

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  • DOI: https://doi.org/10.1007/978-3-319-31738-0_17-3

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  1. Latest

    Oral and Gastrointestinal Mucositis: Considerations in Palliative Care
    Published:
    13 November 2023

    DOI: https://doi.org/10.1007/978-3-319-31738-0_17-3

  2. Mucositis
    Published:
    08 November 2018

    DOI: https://doi.org/10.1007/978-3-319-31738-0_17-2

  3. Original

    Mouth
    Published:
    13 January 2018

    DOI: https://doi.org/10.1007/978-3-319-31738-0_17-1

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