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Head and neck radiation and mucositis

Garden, Adam S; Chambers, Mark S

Current Opinion in Supportive and Palliative Care: April 2007 - Volume 1 - Issue 1 - p 30–34
doi: 10.1097/SPC.0b013e32813aeb34
Gastrointestinal symptoms
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Purpose of review We will review the recent literature that has provided new insights into the pathogenesis, metrics and therapeutics of mucositis.

Recent findings Radiation techniques include conformal therapy and intensity modulated therapy that attempt to minimize dose to normal tissues while still delivering high doses to tumor targets. Drugs used to prevent or treat mucositis typically fall into three classes: antimicrobials, growth factors and radioprotectors. To date, drugs in all three categories have had little success in preventing radiation-induced mucositis, but palifermin, a keratinocyte growth factor, and RK-0202, a topical radioprotector, hold promise and are under investigation.

Summary Treatment of patients with head and neck cancers often requires multimodality therapy, and radiotherapy is often a critical component of this approach. Unfortunately, the dose intense regimens required to treat patients often results in mucositis. While this treatment sequela has long been recognized, only recently have researchers clearly identified its incidence and developed metrics to quantify mucositis and its resultant symptoms. Efforts to minimize mucositis have involved both advances in radiation physics, and the development of pharmacologic agents to prevent or treat mucositis. While no drug to date has shown significant efficacy in reducing the incidence of radiation-induced mucositis for head and neck cancer patients, several agents are currently being tested and hold promise.

Departments of Radiation Oncology and Head and Neck Surgery, University of Texas M. D. Anderson Cancer Center, Houston Texas, USA

Correspondence to Adam S. Garden, Department of Radiation Oncology #97, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA Tel: +1 713 563 2321; e-mail: agarden@mdanderson.org

© 2007 Lippincott Williams & Wilkins, Inc.