Oncology Pharmacotherapy: Modulation of Chemotherapy-Induced Mucositis

Inflammation of the mucous membranes of the gastrointestinal tract, or mucositis, can impair the quality of life and treatment of patients with cancer. Mucositis is a particularly common problem in this population due to the use of chemotherapy and radiation with curative or palliative intent. Many patients who receive standard-dose chemotherapy experience some degree of mucositis, while most patients treated with high-dose chemotherapy with stem cell rescue experience severe complications. When the mucous membranes are exposed to ionizing radiation, inflammatory changes are expected. Combined modality therapy consisting of concurrent radiation and chemotherapy can produce highly symptomatic stomatitis (in patients with head and neck cancer) or esophagitis (in patients with small cell lung cancer). Mucositis can be a dose-limiting complication that can interfere with attempts to increase the dose intensity of cancer therapy. This article reviews the clinical aspects of mucositis and focuses on efforts to discover effective prophylactic interventions.