Animal Models of Oral Mucositis Induced by Antineoplastic Drugs and Radiation

Abstract

Oral mucositis is a common, troubling, and often dose-limiting toxicity of cancer chemotherapy (1). In the case of patients receiving radiation to the head and neck, stomatotoxicity is a frequent cause of unplanned interruptions in treatment. In its most dramatic form, mucositis results in diffuse full-thickness ulceration of the oral mucosa, causing severe pain and loss of function. The lesions that develop are often a site of secondary infection. Importantly, in the myelosuppressed patient, the loss of mucosal integrity results in a systemic portal of entry for the mouth’s indigenous bacterial flora (2). Consequently, oral mucositis is a major risk factor for sepsis in this population. In addition to its physiologic cost, the results of a number of pharmacoeconomic studies have attached significant economic and outcome costs to the condition. The length of hospital stay, febrile days, days of total parenteral nutrition, antibiotic use, and analgesic use are all increased in-patients with mucositis (3). Among bone-marrow transplant recipients, the difference in charges between patients with mucositis compared to those without the condition is over $25,000 (4). The finding by Bellm et al. that mucositis was the most commonly cited negative outcome among bone-marrow transplant recipients is illustrative of its impact on patients’ quality of life (5).