Suvremeni pristup liječenju oralnog mukozitisa: pregledni rad

Oral mucositis (OM) is a serious inflammation of the mucosa and occurs in patients with head and neck cancer (HNC) who are being treated with radiotherapy (RT) and/or chemotherapy (CT), and in patients undergoing hematopoietic stem cell transplantation (HSCT). The inflammation accompanied with painful ulcerations inside the oral cavity impairs its function making the basic functions like eating and speech hard or even impossible. It usually occurs at the end of the first week of RT and lasts for several weeks after cessation. The intensity of OM can sometimes lead to discontinuation of RT. The degree of mucositis regarding chemotherapy depends on the type of antineoplastic drug, therapeutic procedure, duration of the therapy and dose, as well as previous exposure of the oral cavity to toxic agents. Prolonged or repeated administration of lower doses of chemotherapy is associated with a higher chance of developing oral mucositis comparing to a bolus, while chronomodulation of chemotherapy reduces the possibility of mucositis without affecting antineoplastic activity. The treatment of OM is symptomatic, as there is still no effective treatment. In this review paper, several contemporary options for alleviating the symptoms of oral mucositis are listed.Oralni mukozitis (OM) ozbiljna je upala sluznice i javlja se u bolesnika s karcinomom glave i vrata (HNC) koji se liječe radioterapijom (RT) i/ili kemoterapijom (CT) te u bolesnika koji su podvrgnuti transplantaciji hematopoetskih matičnih stanica (HSCT). Upala praćena bolnim ulceracijama unutar usne šupljine narušava njezinu funkciju, čineći osnovne funkcije poput prehrane i govora teškim ili čak nemogućim. Obično se javlja na kraju prvog tjedna radioterapije i traje nekoliko tjedana nakon prestanka. Intenzitet oralnog mukozitisa ponekad može dovesti do prekida radioterapije. Stupanj mukozitisa kod kemoterapije ovisi o vrsti antineoplastičnog lijeka, terapijskom postupku, trajanju terapije i dozi, kao i o prethodnoj izloženosti usne šupljine toksičnim agensima. Produljena ili ponovljena primjena nižih doza kemoterapije povezana je s većom šansom za razvoj oralnog mukozitisa u usporedbi s bolusom, dok kronomodulacija kemoterapije smanjuje mogućnost mukozitisa bez utjecaja na antineoplastično djelovanje. Liječenje oralnog mukozitisa je simptomatsko jer još uvijek nema učinkovitog lijeka. U ovom preglednom radu navodi se nekoliko suvremenih opcija za ublažavanje simptoma oralnog mukozitisa