Management of radiation therapy-induced mucositis in head and neck cancer patients. Part II: Supportive treatments

Oncology Reviews

Volumn 2, Issue 3, 2008, Pages 164-182

  Ngeow, Wei Cheong ^a   Chai, Wen Lin ^a   Zain, Rosnah Binti ^a  

^a UNIVERSITY OF MALAYA   (Malaysia)

Author keywords

Head and Neck Cancer; Management; Mucositis; Pharmaceutical Agents; Radiation Therapy

Indexed keywords

EID: 84859443892     PISSN: 19705557     EISSN: 19705565     Source Type: Journal    
DOI: 10.1007/s12156-008-0072-2     Document Type: Review

References (140)

1. Patni N, Patni S and Bapna A (2005) The optimal use of granulocyte macrophage colony stimulating factor in radiation induced mucositis in head and neck squamous cell carcinoma. J Cancer Res Ther 1:136-141
2. Sutherland SE and Browman GP (2001) Prophylaxis of oral mucositis in irradiated head-and-neck cancer patients: a proposed classification scheme of interventions and meta-analysis of randomized controlled trials. Int J Radiat Oncol Biol Phys 49:917-930 (Pubitemid 32184598)
3. Pfeiffer P, Hansen O, Madsen EL et al (1990) Aprospective pilot study on the effect of sucralfate mouth-swishing in reducing stomatitis during radiotherapy of the oral cavity. Acta Oncol 29:471-473 (Pubitemid 20262594)
4. Makkonen TA, Bostrom P, Vilja P et al (1994) Sucralfate mouth washing in the prevention of radiation-induced mucositis: a placebo-controlled double-blind randomized study. Int J Radiat Oncol Biol Phys 30:177-182 (Pubitemid 24291128)
5. Franzen L, Henriksson R, Littbrand B et al (1995) Effects of sucralfate on mucositis during and following radiotherapy of malignancies in the head and neck region. A double-blind placebo-controlled study. Acta Oncol 34:219-223
6. Cengiz M, Ozyar E, Ozturk D et al (1999) Sucralfate in the prevention of radiation-induced oral mucositis. J Clin Gastroenterol 28:40-43 (Pubitemid 29011592)
7. Etiz D, Erkal HS, Serin M et al (2000) Clinical and histopathological evaluation of sucralfate in prevention of oral mucositis induced by radiation therapy in patients with head and neck malignancies. Oral Oncol 36:116-120
8. Hancock PJ, Epstein JB and Sadler GR (2003) Oral and dental management related to radiation therapy for head and neck cancer. J Can Dent Assoc 69:585-590
9. Epstein JB and Wong FL (1994) The efficacy of sucralfate suspension in the prevention of oral mucositis due to radiation therapy. Int J Radiat Oncol Biol Phys 28:693-698 (Pubitemid 24072754)
10. Carter DL, Hebert ME, Smink K et al (1999) Double blind randomized trial of sucralfate vs placebo during radical radiotherapy for head and neck cancers. Head Neck 21:760-766
11. Lievens Y, Haustermans K, Van den Weyngaert D et al (1998) Does sucralfate reduce the acute side-effects in head and neck cancer treated with radiotherapy? A double-blind randomized trial. Radiother Oncol 47:149-513
12. Dodd MJ, Miaskowski C, Greenspan D et al (2003) Radiationinduced mucositis: a randomized clinical trial of micronized sucralfate versus salt & soda mouthwashes. Cancer Invest 21:21-33 (Pubitemid 36292504)
13. Keefe DM, Schubert MM, Elting LS et al (2007) Updated clinical practice guidelines for the prevention and treatment of mucositis. Cancer 109:820-831 (Pubitemid 46335677)
14. Stokman MA, Spijkervet FK, Boezen HM et al (2006) Preventive intervention possibilities in radiotherapy- and chemotherapyinduced oral mucositis: results of meta-analyses. J Dent Res 85:690-700 (Pubitemid 44297322)
15. Worthington HV, Clarkson JE and Eden OB (2007) Interventions for preventing oral mucositis for patients with cancer receiving treatment. Cochrane Database Syst Rev CD000978
16. Berndtson M (2001) A preliminary study of Orassist (Gelclair) in the management of oral mucositis. Swedish Hospital Dentistry 3:17-21
17. Flook C, Calman F, Mant M et al (2005) Gelclair vs Benzydamine in a randomised controlled study in patients with oral mucositis due to radical radiotherapy. Support Care Cancer 13:443-444
18. Barber C, Powell R, Ellis A et al (2007) Comparing pain control and ability to eat and drink with standard therapy vs Gelclair: a preliminary, double centre, randomised controlled trial on patients with radiotherapy-induced oral mucositis. Support Care Cancer 15:427-440 (Pubitemid 46697020)
19. Epstein JB, Silverman S, Paggiarino DA et al (2001) Benzydamine HCl for prophylaxis of radiation-induced oral mucositis: results from a multicenter, randomized, double-blind, placebo-controlled clinical trial. Cancer 92:875-885 (Pubitemid 32783076)
20. Leborgne JH, Leborgne F, Zubizarreta E et al (1998) Corticosteroids and radiation mucositis in head and neck cancer. A double-blind placebo-controlled randomized trial. Radiother Oncol 47:145-148 (Pubitemid 28275923)
21. Epstein JB, Stevenson-Moore P, Jackson S et al (1989) Prevention of oral mucositis in radiation therapy: a controlled study with benzydamine hydrochloride rinse. Int J Radiat Oncol Biol Phys 16:1571-1575 (Pubitemid 19154345)
22. Samaranayake LP, Robertson AG, MacFarlane TW et al (1988) The effect of chlorhexidine and benzydamine mouthwashes on mucositis induced by therapeutic irradiation. Clin Radiol 39:291-294
23. Prada A and Chiesa F (1987) Effects of benzydamine on the oral mucositis during antineoplastic radiotherapy and/or intra-arterial chemotherapy. Int J Tissue React 9:115-119 (Pubitemid 17097101)
24. Epstein JB and Stevenson-Moore P (1986) Benzydamine hydrochloride in prevention and management of pain in oral mucositis associated with radiation therapy. Oral Surg Oral Med Oral Pathol 62:145-148 (Pubitemid 17193614)
25. Rubenstein EB, Peterson DE, Schubert M et al (2004) Clinical practice guidelines for the prevention and treatment of cancer therapy-induced oral and gastrointestinal mucositis. Cancer 100:2026-2046 (Pubitemid 38525884)
26. Abdelaal AS, Barker DS and Fergusson MM (1989) Treatment for irradiation-induced mucositis. Lancet 1:97 (Pubitemid 19034009)
27. Pillsbury HC, Webster WP, Rosenman J (1986) Prostaglandin inhibitor and radiotherapy in advanced head and neck cancers. Arch Otolaryngol Head Neck Surg 112:552-553 (Pubitemid 16043964)
28. Momo K, Shiratsuchi T, Taguchi H et al (2005) Preparation and clinical application of indomethacin gel for medical treatment of stomatitis. Yakugaku Zasshi 125:433-440 (Pubitemid 40745682)
29. Stokman MA, Spijkervet FK, Burlage FR et al (2005) Clinical effects of flurbiprofen tooth patch on radiation-induced oral mucositis. A pilot study. Support Care Cancer 13:42-48 (Pubitemid 40193064)
30. Kaul R, Mishra BK, Sutradar P et al (1999) The role of Wobe-Mugos in reducing acute sequele of radiation in head and neck cancers-a clinical phase-III randomized trial. Indian J Cancer 36:141-148
31. Gujral MS, Patnaik PM, Kaul R et al (2001) Efficacy of hydrolytic enzymes in preventing radiation therapy-induced side effects in patients with head and neck cancers. Cancer Chemother Pharmacol 47[Suppl]:S23-S28
32. Dorr W and Herrmann T (2007) Efficacy of Wobe-Mugos E for reduction of oral mucositis after radiotherapy: results of a prospective, randomized, placebo-controlled, triple-blind phase III multicenter study. Strahlenther Onkol 183:121-127 (Pubitemid 46364899)
33. Rymes N, Glick L and Holmes JA (1996) Topical mesalazine in the treatment of chemotherapy and radiotherapy-induced oral mucositis. Bone Marrow Transplant 18:484 (Pubitemid 26283713)
34. Spijkervet FK, van Saene HK, van Saene JJ et al (1990) Mucositis prevention by selective elimination of oral flora in irradiated head and neck cancer patients. J Oral Pathol Med 19:486-489
35. Donnelly JP, Bellm LA, Epstein JB et al (2003) Antimicrobial therapy to prevent or treat oral mucositis. Lancet Infect Dis 3:405-412 (Pubitemid 36791117)
36. Raybould TP, Carpenter AD, Ferretti GA et al (1994) Emergence of gram-negative bacilli in the mouths of bone marrow transplant recipients using chlorhexidine mouthrinse. Oncol Nurs Forum 21:691-696
37. Ferretti GA, Raybould TP, Brown AT et al (1990) Chlorhexidine prophylaxis for chemotherapy- and radiotherapy-induced stomatitis: a randomized double-blind trial. Oral Surg Oral Med Oral Pathol 69:331-338 (Pubitemid 20091288)
38. Rutkauskas JS and Davis JW (1993) Effects of chlorhexidine during immunosuppressive chemotherapy. A preliminary report. Oral Surg Oral Med Oral Pathol 76:441-448
39. Ferretti GA, Ash RC, Brown AT et al (1988) Control of oral mucositis and candidiasis in marrow transplantation: a prospective, double-blind trial of chlorhexidine digluconate oral rinse. Bone Marrow Transplant 3:483-493
40. Foote RL, Loprinzi CL, Frank AR et al (1994) Randomized trial of a chlorhexidine mouthwash for alleviation of radiationinduced mucositis. J Clin Oncol 12:2630-2633 (Pubitemid 24379649)
41. Wahlin YB (1989) Effects of chlorhexidine mouthrinse on oral health in patients with acute leukemia. Oral Surg Oral Med Oral Pathol 68:279-287 (Pubitemid 19233628)
42. Dodd MJ, Dibble SL, Miaskowski C et al (2000) Randomized clinical trial of the effectiveness of 3 commonly used mouthwashes to treat chemotherapy-induced mucositis. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 90:39-47
43. Tombes MB and Gallucci B (1993) The effects of hydrogen peroxide rinses on the normal oral mucosa. Nurs Res 42:332-337
44. Feber T (1996) Management of mucositis in oral irradiation. Clin Oncol (R Coll Radiol) 8:106-111 (Pubitemid 26139009)
45. Adamietz IA, Rahn R, Bottcher HD et al (1998) Prophylaxis with povidone-iodine against induction of oral mucositis by radiochemotherapy. Support Care Cancer 6:373-377 (Pubitemid 28337128)
46. Rahn R, Adamietz IA, Boettcher HD et al (1997) Povidoneiodine to prevent mucositis in patients during antineoplastic radiochemotherapy. Dermatology 195[Suppl 2]:57-61 (Pubitemid 27487602)
47. Vokurka S, Bystricka E, Koza V et al (2005) The comparative effects of povidone-iodine and normal saline mouthwashes on oral mucositis in patients after high-dose chemotherapy and APBSCT-results of a randomized multicentre study. Support Care Cancer 13:554-558 (Pubitemid 40933614)
48. Spijkervet FK, Van Saene HK, Van Saene JJ et al (1991) Effect of selective elimination of the oral flora on mucositis in irradiated head and neck cancer patients. J Surg Oncol 46:167-173
49. Kaanders JHAM, Pop LAM, Muytjens HL et al (1995) Topical administration of antimicrobial agents to prevent irradiation mucositis of the oral cavity and oropharynx: A pilot study. Radiation Oncology Investigations 2:283-290
50. Symonds RP, McIlroy P, Khorrami J et al (1996) The reduction of radiation mucositis by selective decontamination antibiotic pastilles: a placebo-controlled double-blind trial. Br J Cancer 74:312-317 (Pubitemid 26254151)
51. Okuno SH, Foote RL, Loprinzi CL et al (1997) A randomized trial of a nonabsorbable antibiotic lozenge given to alleviate radiation-induced mucositis. Cancer 79:2193-2199 (Pubitemid 27227385)
52. Wijers OB, Levendag PC, Harms ER et al (2001) Mucositis reduction by selective elimination of oral flora in irradiated cancers of the head and neck: a placebo-controlled double-blind randomized study. Int J Radiat Oncol Biol Phys 50:343-352 (Pubitemid 32472262)
53. Stokman MA, Spijkervet FK, Burlage FR et al (2003) Oral mucositis and selective elimination of oral flora in head and neck cancer patients receiving radiotherapy: a double-blind randomised clinical trial. Br J Cancer 88:1012-1016 (Pubitemid 36560767)
54. El-Sayed S, Nabid A, Shelley Wet al (2002) Prophylaxis of radiation-associated mucositis in conventionally treated patients with head and neck cancer: a double-blind, phase III, randomized, controlled trial evaluating the clinical efficacy of an antimicrobial lozenge using a validated mucositis scoring system. J Clin Oncol 20:3956-3963
55. Giles FJ, Miller CB, Hurd DD et al (2003) A phase III, randomized, double-blind, placebo-controlled, multinational trial of iseganan for the prevention of oral mucositis in patients receiving stomatotoxic chemotherapy (PROMPT-CT trial). Leuk Lymphoma 44:1165-1172 (Pubitemid 36609110)
56. Giles FJ, Rodriguez R, Weisdorf D et al (2004) A phase III, randomized, double-blind, placebo-controlled, study of iseganan for the reduction of stomatitis in patients receiving stomatotoxic chemotherapy. Leuk Res 28:559-565 (Pubitemid 38543192)
57. Trotti A, Garden A, Warde P et al (2004) A multinational, randomized phase III trial of iseganan HCl oral solution for reducing the severity of oral mucositis in patients receiving radiotherapy for head-and-neck malignancy. Int J Radiat Oncol Biol Phys 58:674-681 (Pubitemid 38221120)
58. Nicolatou-Galitis O, Velegraki A, Sotiropoulou-Lontou A et al (2006) Effect of fluconazole antifungal prophylaxis on oral mucositis in head and neck cancer patients receiving radiotherapy. Support Care Cancer 14:44-51 (Pubitemid 43119596)
59. Plevova P and Blazek B (1997) Intravenous immunoglobulin as prophylaxis of chemotherapy-induced oral mucositis. J Natl Cancer Inst 89:326-327 (Pubitemid 27085897)
60. Mose S, Adamietz IA, Saran F et al (1995) Efficacy of prophylactic application of immunoglobulins in radiation induced mucositis. Strahlenther Onkol 171:415-416
61. Mose S, Adamietz IA, Saran F et al (1997) Can prophylactic application of immunoglobulin decrease radiotherapy-induced oral mucositis? Am J Clin Oncol 20:407-411 (Pubitemid 27329578)
62. Sprinzl GM, Galvan O, de Vries A et al (2001) Local application of granulocyte-macrophage colony stimulating factor (GM-CSF) for the treatment of oral mucositis. Eur J Cancer 37:2003-2009 (Pubitemid 32938102)
63. Chi KH, Chen CH, Chan WK et al (1995) Effect of granulocytemacrophage colony-stimulating factor on oral mucositis in head and neck cancer patients after cisplatin, fluorouracil, and leucovorin chemotherapy. J Clin Oncol 13:2620-2628
64. Nemunaitis J, Rosenfeld CS, Ash R et al (1995) Phase III randomized, double-blind placebo-controlled trial of rhGM-CSF following allogeneic bone marrow transplantation. Bone Marrow Transplant 15:949-954
65. Bez C, Demarosi F, Sardella A et al (1999) GM-CSF mouthrinses in the treatment of severe oral mucositis: a pilot study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 88:311-315
66. Kannan V, Bapsy PP, Anantha N et al (1997) Efficacy and safety of granulocyte macrophage-colony stimulating factor (GM-CSF) on the frequency and severity of radiation mucositis in patients with head and neck carcinoma. Int J Radiat Oncol Biol Phys 37:1005-1010 (Pubitemid 27230023)
67. McAleese JJ, Bishop KM, A'Hern R et al (2006) Randomized phase II study of GM-CSF to reduce mucositis caused by accelerated radiotherapy of laryngeal cancer. Br J Radiol 79:608-613 (Pubitemid 44083397)
68. Tejedor M, Valerdi JJ, Arias F et al (2000) Hyperfractionated radiotherapy concomitant with cisplatin and granulocyte colonystimulating factor (filgrastim) for laryngeal carcinoma. Cytokines Cell Mol Ther 6:35-39 (Pubitemid 30664322)
69. Masucci G, Broman P, Kelly C et al (2005) Therapeutic efficacy by recombinant human granulocyte/monocyte-colony stimulating factor on mucositis occurring in patients with oral and oropharynx tumors treated with curative radiotherapy: a multicenter open randomized phase III study. Med Oncol 22:247-256 (Pubitemid 41176321)
70. Schneider SB, Nishimura RD, Zimmerman RP et al (1999) Filgrastim (r-metHuG-CSF) and its potential use in the reduction of radiation-induced oropharyngeal mucositis: an interim look at a randomized, double-blind, placebo-controlled trial. Cytokines Cell Mol Ther 5:175-180 (Pubitemid 29481355)
71. Ausili-Cefaro G, Marmiroli L, Nardone L et al (1995) Comparison between RHGM-CSF and RHG-CSF administered during radiotherapy and after prolonged carboplatin infusion in preventing leukopenia and mucosytes produced by chemoradiotherapy in advanced head and neck cancer. Eur J Cancer 31:S56
72. Abitbol AA, Sridhar KS, Lewin AA et al (1997) Hyperfractionated radiation therapy and 5-fluorouracil, cisplatin, and mitomycin-C (+/- granulocyte-colony stimulating factor) in the treatment of patients with locally advanced head and neck carcinoma. Cancer 80:266-276 (Pubitemid 27282321)
73. Ryu JK, Swann S, LeVeque F et al (2007) The impact of concurrent granulocyte macrophage-colony stimulating factor on radiation-induced mucositis in head and neck cancer patients: a double-blind placebo-controlled prospective phase III study by Radiation Therapy Oncology Group 9901. Int J Radiat Oncol Biol Phys 67:643-650 (Pubitemid 46215878)
74. Makkonen TA, Minn H, Jekunen A et al (2000) Granulocyte macrophage-colony stimulating factor (GM-CSF) and sucralfate in prevention of radiation-induced mucositis: a prospective randomized study. Int J Radiat Oncol Biol Phys 46:525-534 (Pubitemid 30100628)
75. Mascarin M, Franchin G, Minatel E et al (1999) The effect of granulocyte colony-stimulating factor on oral mucositis in head and neck cancer patients treated with hyperfractionated radiotherapy. Oral Oncol 35:203-208 (Pubitemid 29113065)
76. Su YB, Vickers AJ, Zelefsky MJ et al (2006) Double-blind, placebo-controlled, randomized trial of granulocyte-colony stimulating factor during postoperative radiotherapy for squamous head and neck cancer. Cancer J 12:182-188 (Pubitemid 43894333)
77. Gutschalk CM, Herold-Mende CC, Fusenig NE et al (2006) Granulocyte colony-stimulating factor and granulocytemacrophage colony-stimulating factor promote malignant growth of cells from head and neck squamous cell carcinomas in vivo. Cancer Res 66:8026-8036 (Pubitemid 44299167)
78. Nicolatou O, Sotiropoulou-Lontou A, Skarlatos J et al (1998) A pilot study of the effect of granulocyte-macrophage colony-stimulating factor on oral mucositis in head and neck cancer patients during X-radiation therapy: a preliminary report. Int J Radiat Oncol Biol Phys 42:551-556 (Pubitemid 28501104)
79. Saarilahti K, Kajanti M, Joensuu T et al (2002) Comparison of granulocyte-macrophage colony-stimulating factor and sucralfate mouthwashes in the prevention of radiation-induced mucositis: a double-blind prospective randomized phase III study. Int J Radiat Oncol Biol Phys 54:479-485
80. Rovirosa A, Ferre J and Biete A (1998) Granulocyte macrophage-colony- stimulating factor mouthwashes heal oral ulcers during head and neck radiotherapy. Int J Radiat Oncol Biol Phys 41:747-754 (Pubitemid 28285950)
81. Mantovani G, Massa E, Astara G et al (2003) Phase II clinical trial of local use of GM-CSF for prevention and treatment of chemotherapy- and concomitant chemoradiotherapy-induced severe oral mucositis in advanced head and neck cancer patients: an evaluation of effectiveness, safety and costs. Oncol Rep 10:197-206
82. Fung SM and Ferrill MJ (2002) Granulocyte macrophagecolony stimulating factor and oral mucositis. Ann Pharmacother 36:517-520 (Pubitemid 34205328)
83. Elad S, Cohen G, Zylber-Katz E et al (1999) Systemic absorption of lidocaine after topical application for the treatment of oral mucositis in bone marrow transplantation patients. J Oral Pathol Med 28:170-172 (Pubitemid 29174804)
84. Epstein JB, Truelove EL, Oien H et al (2001) Oral topical doxepin rinse: analgesic effect in patients with oral mucosal pain due to cancer or cancer therapy. Oral Oncol 37:632-637 (Pubitemid 32925197)
85. Epstein JB, Epstein JD, Epstein MS et al (2006) Oral doxepin rinse: the analgesic effect and duration of pain reduction in patients with oral mucositis due to cancer therapy. Anesth Analg 103:465-470 (Pubitemid 44140654)
86. Alterio D, Jereczek-Fossa BA, Zuccotti GF et al (2006) Tetracaine oral gel in patients treated with radiotherapy for headand-neck cancer: final results of a phase II study. Int J Radiat Oncol Biol Phys 64:392-395 (Pubitemid 43083423)
87. Yamamura K, Yotsuyanagi T, Okamoto T et al (1999) Pain relief of oral ulcer by dibucaine-film. Pain 83:625-626
88. Carnel SB, Blakeslee DB, Oswald SG et al (1990) Treatment of radiation- and chemotherapy-induced stomatitis. Otolaryngol Head Neck Surg 102:326-330 (Pubitemid 20152725)
89. Yotsuyanagi T, Yamamura K and Akao Y (1985) Mucosa-adhesive film containing local analgesic. Lancet 2:613 (Pubitemid 15232303)
90. Yamamura K, Ohta S, Yano K et al (1998) Oral mucosal adhesive film containing local anesthetics: in vitro and clinical evaluation. J Biomed Mater Res 43:313-317 (Pubitemid 28390333)
91. LeVeque FG, Parzuchowski JB, Farinacci GC et al (1992) Clinical evaluation of MGI 209, an anesthetic, film-forming agent for relief from painful oral ulcers associated with chemotherapy. J Clin Oncol 10:1963-1968 (Pubitemid 23064210)
92. Slatkin NE and Rhiner M (2003) Topical ketamine in the treatment of mucositis pain. Pain Med 4:298-303
93. Berger A, Henderson M, Nadoolman W et al (1995) Oral capsaicin provides temporary relief for oral mucositis pain secondary to chemotherapy/radiation therapy. J Pain Symptom Manage 10:243-248
94. Sudoh Y, Cahoon EE, De Girolami U et al (2004) Local anesthetic properties of a novel derivative, N-methyl doxepin, versus doxepin and bupivacaine. Anesth Analg 98:672-676 (Pubitemid 38252656)
95. Epstein JB, Epstein JD, Epstein MS et al (2007) Management of pain in cancer patients with oral mucositis: follow-up of multiple doses of doxepin oral rinse. J Pain Symptom Manage 33:111-114 (Pubitemid 46186870)
96. McCaffery M (1992) Pain control. Barriers to the use of available information. World Health Organization Expert Committee on Cancer Pain Relief and Active Supportive Care. Cancer 70:1438-1449
97. Scully C, Sonis S and Diz PD (2006) Oral mucositis. Oral Dis 12:229-241 (Pubitemid 43736412)
98. Shaiova L, Mori M, Anderson K et al (2007) Administration of morphine sulfate extended-release capsules via gastrostomy: dissolution study and case reports. J Palliat Med 10:1063-1067 (Pubitemid 350073550)
99. Kim JG, Sohn SK, Kim DH et al (2005) Effectiveness of transdermal fentanyl patch for treatment of acute pain due to oral mucositis in patients receiving stem cell transplantation. Transplant Proc 37:4488-4491 (Pubitemid 43016062)
100. Shaiova L, Lapin J, Manco LS et al (2004) Tolerability and effects of two formulations of oral transmucosal fentanyl citrate (OTFC; ACTIQ) in patients with radiation-induced oral mucositis. Support Care Cancer 12:268-273 (Pubitemid 38660750)
101. Cerchietti LC, Navigante AH, Bonomi MR et al (2002) Effect of topical morphine for mucositis-associated pain following concomitant chemoradiotherapy for head and neck carcinoma. Cancer 95:2230-2236 (Pubitemid 35253386)
102. Meredith R, Salter M, Kim R et al (1997) Sucralfate for radiation mucositis: results of a double-blind randomized trial. Int J Radiat Oncol Biol Phys 37:275-279 (Pubitemid 27138709)
103. Oguchi M, Shikama N, Sasaki S et al (1998) Mucosa-adhesive water-soluble polymer film for treatment of acute radiationinduced oral mucositis. Int J Radiat Oncol Biol Phys 40:1033-1037 (Pubitemid 28152917)
104. Allison RR, Vongtama V, Vaughan J et al (1995) Symptomatic acute mucositis can be minimized or prophylaxed by the combination of sucralfate and fluconazole. Cancer Invest 13:16-22
105. Matthews RH and Ercal N (1996) Prevention of mucositis in irradiated head and neck cancer patients. J Exp Ther Oncol 1:135-138
106. Barker G, Loftus L, Cuddy P et al (1991) The effects of sucralfate suspension and diphenhydramine syrup plus kaolin-pectin on radiotherapy-induced mucositis. Oral Surg Oral Med Oral Pathol 71:288-293
107. Rothwell BR and Spektor WS (1990) Palliation of radiationrelated mucositis. Spec Care Dentist 10:21-25
108. Hasenau C, Clasen BP and Roettger D (1988) Use of standardized oral hygiene in the prevention and therapy of mucositis in patients treated with radiochemotherapy of head and neck neoplasms. Laryngol Rhinol Otol (Stuttg) 67:576-579 (Pubitemid 18264933)
109. Maciejewski B, Zajusz A, Pilecki B et al (1991) Acute mucositis in the stimulated oral mucosa of patients during radiotherapy for head and neck cancer. Radiother Oncol 22:7-11
110. Dorr W, Jacubek A, Kummermehr J et al (1995) Effects of stimulated repopulation on oral mucositis during conventional radiotherapy. Radiother Oncol 37:100-107
111. Schindl A, Schindl M, Pernerstorfer-Schon H et al (2000) Lowintensity laser therapy: a review. J Investig Med 48:312-326
112. Arora H, Pai KM, Maiya A et al (2008) Efficacy of He-Ne Laser in the prevention and treatment of radiotherapy-induced oral mucositis in oral cancer patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 105:180-186
113. Bensadoun RJ, Franquin JC, Ciais G et al (1999) Low-energy He/Ne laser in the prevention of radiation-induced mucositis. A multicenter phase III randomized study in patients with head and neck cancer. Support Care Cancer 7:244-252 (Pubitemid 29302632)
114. Genot MT and Klastersky J (2005) Low-level laser for prevention and therapy of oral mucositis induced by chemotherapy or radiotherapy. Curr Opin Oncol 17:236-240 (Pubitemid 40586163)
115. Grotz KA, Wustenberg P, Kohnen R et al (2001) Prophylaxis of radiogenic sialadenitis and mucositis by coumarin/troxerutine in patients with head and neck cancer-a prospective,randomized, placebo-controlled, double-blind study. Br J Oral Maxillofac Surg 39:34-39 (Pubitemid 32203758)
116. Chen J (2007) Effect of quadruple fluid aerosol inhalation on oral mucositis induced by radiotherapy in nasopharyngeal carcinoma and its mechanism. Zhong Nan Da Xue Xue Bao Yi Xue Ban 32:527-530
117. Kaushal V, Verma K, Manocha S et al (2001) Clinical evaluation of human placental extract (placentrex) in radiation-induced oral mucositis. Int J Tissue React 23:105-110 (Pubitemid 32755101)
118. Gravett P (2000) Aromatherapy treatment of severe oral mucositis. The International Journal of Aromatherapy 10:52-53
119. Fidler P, Loprinzi CL, O'Fallon JR et al (1996) Prospective evaluation of a chamomile mouthwash for prevention of 5-FUinduced oral mucositis. Cancer 77:522-525
120. Carl W and Emrich LS (1991) Management of oral mucositis during local radiation and systemic chemotherapy: a study of 98 patients. J Prosthet Dent 66:361-369
121. Mazokopakis EE, Vrentzos GE, Papadakis JA et al (2005) Wild chamomile (Matricaria recutita L.) mouthwashes in methotrexate-induced oral mucositis. Phytomedicine 12:25-27 (Pubitemid 40174325)
122. Su CK, Mehta V, Ravikumar L et al (2004) Phase II double-blind randomized study comparing oral aloe vera versus placebo to prevent radiation-related mucositis in patients with head-andneck neoplasms. Int J Radiat Oncol Biol Phys 60:171-177 (Pubitemid 39165482)
123. Huang GX, Zhao C, Han F et al (2003) Clinical study in prophylactic use of chinese medicine to prevent chemoradiotherapy induced mucositis in nasopharyngeal carcinoma. Ai Zheng 22:1084-1087
124. Song PR, Qiu BS and Wu YT (2007) Clinical observation on TCM treatment according to syndrome differentiation in relieving acute radio-reaction in nasopharyngeal carcinoma patients. Zhongguo Zhong Xi Yi Jie He Za Zhi 27:452-455
125. Wang B, Liu X and Wang T (2000) Study of prevention and treatment on acute radioactive injury with huoxue yiqi yangyin recipe. Zhongguo Zhong Xi Yi Jie He Za Zhi 20:180-182
126. Wu MH, Yuan B, Liu QF et al (2007) Study of qingre liyan decoction in treating and preventing acute radioactive oral mucositis. Chin J Integr Med 13:280-284
127. Rubel DM, Freeman S and Southwell IA (1998) Tea tree oil allergy: what is the offending agent? Report of three cases of tea tree oil allergy and review of the literature. Australas J Dermatol 39:244-247 (Pubitemid 28539059)
128. Biswal BM, Zakaria A and Ahmad NM (2003) Topical application of honey in the management of radiation mucositis: a preliminary study. Support Care Cancer 11:242-248 (Pubitemid 36733528)
129. Golder W (2004) Propolis. The bee glue as presented by the Graeco-Roman literature. Wurzbg Medizinhist Mitt 23:133-145
130. Motallebnejad M, Akram S, Moghadamnia A et al (2008) The effect of topical application of pure honey on radiation-induced mucositis: a randomized clinical trial. J Contemp Dent Pract 9:40-47
131. Hay KD and Greig DE (1990) Propolis allergy: a cause of oral mucositis with ulceration. Oral Surg Oral Med Oral Pathol 70:584-586
132. Matceyevsky D, Hahoshen NY, Vexler A et al (2007) Assessing the effectiveness of Dead Sea products as prophylactic agents for acute radiochemotherapy-induced skin and mucosal toxicity in patients with head and neck cancers: a phase 2 study. Isr Med Assoc J 9:439-442 (Pubitemid 46979145)
133. Naidu MU, Ramana GV, Ratnam SV et al (2005) A randomised, double-blind, parallel, placebo-controlled study to evaluate the efficacy of MF 5232 (Mucotrol), a concentrated oral gel wafer, in the treatment of oral mucositis. Drugs R D 6:291-298
134. Ladas EJ, Post-White J, Hawks R et al (2006) Evidence for symptom management in the child with cancer. J Pediatr Hematol Oncol 28:601-615 (Pubitemid 44496338)
135. Antin JH, Lee SJ, Neuberg D et al (2002) A phase I/II doubleblind, placebo-controlled study of recombinant human interleukin-11 for mucositis and acute GVHD prevention in allogeneic stem cell transplantation. Bone Marrow Transplant 29:373-377 (Pubitemid 34262638)
136. de Koning BA, Philipsen-Geerling B, Hoijer M et al (2007) Protection against chemotherapy induced mucositis by TGFbeta( 2) in childhood cancer patients: results from a randomized cross-over study. Pediatr Blood Cancer 48:532-539 (Pubitemid 46496348)
137. Foncuberta MC, Cagnoni PJ, Brandts CH et al (2001) Topical transforming growth factor-beta3 in the prevention or alleviation of chemotherapy-induced oral mucositis in patients with lymphomas or solid tumors. J Immunother 24:384-388 (Pubitemid 32825870)
138. Nasilowska-Adamska B, Rzepecki P, Manko J et al (2007) The influence of palifermin (Kepivance) on oral mucositis and acute graft versus host disease in patients with hematological diseases undergoing hematopoietic stem cell transplant. Bone Marrow Transplant 40:983-988 (Pubitemid 350048198)
139. Epperly MW, Carpenter M, Agarwal A et al (2004) Intraoral manganese superoxide dismutase-plasmid/liposome (MnSODPL) radioprotective gene therapy decreases ionizing irradiationinduced murine mucosal cell cycling and apoptosis. In vivo 18:401-410 (Pubitemid 39199983)
140. Guo H, Seixas-Silva JA Jr, Epperly MW et al (2003) Prevention of radiation-induced oral cavity mucositis by plasmid/liposome delivery of the human manganese superoxide dismutase (SOD2) transgene. Radiat Res 159:361-370 (Pubitemid 36314951)