New Frontiers in the Pathobiology and Treatment of Cancer Regimen-Related Mucosal Injury.
New Frontiers in the Pathobiology and Treatment of Cancer Regimen-Related Mucosal Injury.
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DOI：
10.3389/fphar.2017.00354
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发表时间：
2017
影响因子：
5.6
通讯作者：
Sonis ST
中科院分区：
文献类型：
--
作者：
Cinausero M;Aprile G;Ermacora P;Basile D;Vitale MG;Fanotto V;Parisi G;Calvetti L;Sonis ST
粘膜炎是化疗、放疗和靶向药物的常见并发症。它经常影响抗癌治疗的依从性，因为它经常导致治疗计划延迟，中断或停止。此外，与粘膜炎的管理相关的经济影响是局部的，并且最近已经报告了由于这种临床状况而导致的额外医院成本的几个估计。确定粘膜炎风险因素、早期发现其发作、正确评估毒性程度和规划多学科管理的能力，都是保证患者生活质量和避免无效剂量减少或治疗中断的关键要素。粘膜炎的发病机制是多因素的，根据其解剖表现可分为口腔粘膜炎和胃肠道粘膜炎。治疗和患者相关因素可能有助于预测症状发生的频率和潜在程度。在这里，我们讨论了粘膜炎的临床表现和发病机制与不同类型的治疗。此外，我们专注于治疗和预防策略，根据国际指南描述过去和现在的管理，以及有关可能在未来进一步改善粘膜炎治疗的药物的最有希望的新数据。
Mucositis is a common complication of chemotherapy, radiotherapy and targeted agents. It often affects compliance to anticancer therapies as it frequently causes schedule delays, interruptions or discontinuations of treatment. Moreover, the economic impact related to the management of mucositis is topical and several estimations of additional hospital costs due to this clinical condition have been recently reported. The ability to determine risk factors for mucositis, to early detect its onset, to assess correctly the degree of this toxicity and to plan its multidisciplinary management are all key elements to guarantee the quality of life of patients and to avoid useless dose reduction or interruption of treatment. The pathogenesis of mucositis is multifactorial and it is classily subdivided into oral and gastrointestinal mucositis according to its anatomic presentation. Treatment and patients’ related factors might help in predicting the frequency and the potential degree of symptoms onset. Here we discuss about clinical presentation and pathogenesis of mucositis in relation to different kinds of treatments. Moreover, we focus on therapeutic and prevention strategies, describing past and present management according to international guidelines and the most promising new data about agents potentially able to further improve the treatment of mucositis in the next future.