A gyermekkori malignus kórképek kemoterápiájának leggyakoribb mellékhatása, az oralis mucositis. Irodalmi áttekintés

2018 ◽  
Vol 159 (13) ◽  
pp. 495-502 ◽  
Author(s):  
Judit Nemes ◽  
Ágnes Jenei ◽  
Ildikó Márton
Keyword(s):  
Oral Mucosa ◽  
Oral Mucositis ◽  
Chemotherapeutic Agents ◽  
Assessment Tools ◽  
Prevention And Treatment ◽  
Dividing Cells ◽  
Oral Complication ◽  
Pharmacologic Agents ◽  
Scoring Tools

Abstract: Mucositis is the most common oral complication of cancer therapy. Oral mucositis in childhood is more frequent and severe compared to adults, especially in children with leukemia. Lesions develop as the chemotherapeutic agents attack the rapidly dividing cells of the oral mucous membrane. Patients may experience trouble in eating, drinking, swallowing or even speaking due to the significant pain caused by the ulceration of the oral mucosa. Oral mucositis has a direct impact on the quality of life and may affect survival. The regular assessment of the oral mucosa is crucial during chemotherapy to evaluate the effectiveness of the oral mucositis prevention and treatment. Several oral mucositis scoring tools have been developed for adults to qualify the symptoms, but there is no universally accepted assessment scale for children. The prevention and treatment of therapy-related mucositis is difficult, though several methods and pharmacologic agents have been tested. Here we discuss the pathogenesis of chemotherapy-induced oral mucositis, the available assessment tools and their applicability to pediatric patients and the available therapeutic and preventive strategies. Orv Hetil. 2018; 159(13): 495–502.

scholarly journals Prevention and Treatment of Oral Mucositis in Children with Cancer

2012 ◽  
Vol 17 (4) ◽  
pp. 340-350 ◽  
Author(s):  
Misty M. Miller ◽  
David V. Donald ◽  
Tracy M. Hagemann
Keyword(s):  
Oral Mucositis ◽  
Keratinocyte Growth Factor ◽  
Oral Intake ◽  
Chemotherapeutic Agents ◽  
Increased Risk ◽  
Significant Burden ◽  
Dividing Cells ◽  
Tissue Changes ◽  
New Research ◽  
Pharmacologic Agents

Oral mucositis affects more than three-fourths of patients undergoing chemotherapy and represents a significant burden to patients and caregivers. Lesions develop as a result of chemotherapeutic agents attacking the rapidly dividing cells of the gastrointestinal tract. Severity can range from mild, painless tissue changes to bleeding ulcerations that prevent oral intake and require narcotic pain relievers. Oral mucositis also leads to an increased risk of infection and can often delay further chemotherapy treatment. A number of assessment scales have been developed to better qualify the symptoms associated with this condition. Few pharmacologic agents have been approved to either prevent the development or alleviate the symptoms of oral mucositis. Current options include the use of antimicrobial mouthwashes, amino acid rinses, and topical healing agents. Palifermin, a keratinocyte growth factor, may be a future option after its use in children is explored. With achievements in other areas of supportive care in patients undergoing chemotherapy, oral mucositis should represent the forefront of new research. This review will provide a comprehensive examination of available options for children who have oral mucositis.

Evaluation of the effectiveness of a new medical device containing verbascoside, polyvinylpyrrolidone, and hyaluronic acid in prevention and treatment of mucositis in patients with cancer.

2018 ◽  
Vol 36 (34_suppl) ◽  
pp. 206-206
Author(s):  
Olga Nigro
Keyword(s):  
Complete Remission ◽  
Cancer Patients ◽  
Oral Mucositis ◽  
Mucosal Injury ◽  
Oral Solution ◽  
Patients With Cancer ◽  
Radiation Fields ◽  
Oral Environment ◽  
Prevention And Treatment

206 Background: Mucosal injury is the consequence of biologic events coupled with the influence of the oral environment and microbiome. Oral mucositis is one of the most common toxicities of chemoradiation therapies. Incidence and severity varies by chemoradiation regimens, radiation fıelds, and tumor site. The influence of mucositis on quality of life is greater among patients than the medical literature would suggest. Lack of experience in evaluating treatment toxicities is a daily problem in cancer patients. The aim of this study was to assess the efficacy of verbascoside’s (mucosyte) oral solution on mucositis in cancer patients. Methods: Fourty-five patients with different grade mucositis treated with mucosyte (ranging from 1-2 to 6-7 rinses/day, according to the guidelines) were evaluated from October 2017 to June 2018. Patients were monitored every week until complete remission. Results: Of 45 patients enrolled, 5 had G1 oral mucositis at baseline, 21 had G2, 13 had G3 and 3 had G4. Three patients had G0 oral mucositis at baseline. Median age was 66.8 years. Six patients were treated with carboplatin/paclitaxel, and six with cisplatin/pemetrexed for non-small cell lung cancer; nine patients were treated with paclitaxel, six with adriamycin/cyclophosphamide, and two with eribulin for breast cancer; four patients were treated with FOLFOX for intestinal adenocarcinoma; three patients were treated with nab-paclitaxel/gemcitabine for pancreatic cancer; five patients were treated with cisplatin/cetuximab, and four with cisplatin/cetuximab plus radiotherapy for squamous-cell head and neck cancer. All patients reached complete remission in a median time of 14.9 days (10-24 days). Conclusions: Mucosyte treatment was able to rapidly shorten G3/4 oral mucositis to G1/2, and to never happen mucositis in G0 at baseline. Thus, we suggest that mucosyte can be effective both in prevention and treatment of mucositis.

scholarly journals Application Potential of Plant-Derived Medicines in Prevention and Treatment of Platinum-Induced Peripheral Neurotoxicity

2022 ◽  
Vol 12 ◽  
Author(s):  
Xiaowei Xu ◽  
Liqun Jia ◽  
Xiaoran Ma ◽  
Huayao Li ◽  
Changgang Sun
Keyword(s):  
Clinical Trials ◽  
Plant Secondary Metabolites ◽  
Chemotherapeutic Agents ◽  
Common Adverse Event ◽  
Sufficient Evidence ◽  
Peripheral Neurotoxicity ◽  
Herbal Products ◽  
Prevention And Treatment ◽  
Platinum Agents

As observed with other chemotherapeutic agents, the clinical application of platinum agents is a double-edged sword. Platinum-induced peripheral neuropathy (PIPN) is a common adverse event that negatively affects clinical outcomes and patients’ quality of life. Considering the unavailability of effective established agents for preventing or treating PIPN and the increasing population of cancer survivors, the identification and development of novel, effective interventions are the need of the hour. Plant-derived medicines, recognized as ideal agents, can not only help improve PIPN without affecting chemotherapy efficacy, but may also produce synergy. In this review, we present a brief summary of the mechanisms of platinum agents and PIPN and then focus on exploring the preventive or curative effects and underlying mechanisms of plant-derived medicines, which have been evaluated under platinum-induced neurotoxicity conditions. We identified 11 plant extracts as well as 17 plant secondary metabolites, and four polyherbal preparations. Their effects against PIPN are focused on oxidative stress and mitochondrial dysfunction, glial activation and inflammation response, and ion channel dysfunction. Also, ten clinical trials have assessed the effect of herbal products in patients with PIPN. The understanding of the molecular mechanism is still limited, the quality of clinical trials need to be further improved, and in terms of their efficacy, safety, and cost effectiveness studies have not provided sufficient evidence to establish a standard practice. But plant-derived medicines have been found to be invaluable sources for the development of natural agents with beneficial effects in the prevention and treatment of PIPN.

scholarly journals Emerging Pharmacological and Non-Pharmacological Therapeutics for Prevention and Treatment of Chemotherapy-Induced Peripheral Neuropathy

Cancers ◽  
2021 ◽  
Vol 13 (4) ◽  
pp. 766
Author(s):  
Yang Li ◽  
Maryam B. Lustberg ◽  
Shuiying Hu
Keyword(s):  
Peripheral Neuropathy ◽  
Chemotherapeutic Agents ◽  
Common Adverse Event ◽  
Platinum Compounds ◽  
First Line ◽  
Effective Strategies ◽  
Effective Interventions ◽  
Prevention And Treatment ◽  
Mechanistic Understanding

Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse event of several first-line chemotherapeutic agents, including platinum compounds, taxanes, vinca alkaloids, thalidomide, and bortezomib, which negatively affects the quality of life and clinical outcome. Given the dearth of effective established agents for preventing or treating CIPN, and the increasing number of cancer survivors, there is an urgent need for the identification and development of new, effective intervention strategies that can prevent or mitigate this debilitating side effect. Prior failures in the development of effective interventions have been due, at least in part, to a lack of mechanistic understanding of CIPN and problems in translating this mechanistic understanding into testable hypotheses in rationally-designed clinical trials. Recent progress has been made, however, in the pathogenesis of CIPN and has provided new targets and pathways for the development of emerging therapeutics that can be explored clinically to improve the management of this debilitating toxicity. This review focuses on the emerging therapeutics for the prevention and treatment of CIPN, including pharmacological and non-pharmacological strategies, and calls for fostering collaboration between basic and clinical researchers to improve the development of effective strategies.

scholarly journals Effects of chemotherapy on oral mucosa

2020 ◽  
Vol 6 ◽  
pp. 11-15
Author(s):  
Sakshi Sharma
Keyword(s):  
Oral Mucosa ◽  
Direct Effect ◽  
Oral Mucositis ◽  
Treatment Modality ◽  
Chemotherapeutic Agents ◽  
Host Cells ◽  
Oral Complications ◽  
Lichenoid Reactions ◽  
Cancerous Cells ◽  
Malignant Condition

Cancer leads to several oral and dental complications arise during the course of a malignant condition, oral or non-oral. These are largely due to the direct effect of cancer but may also result from the complication of treatment modality undertaken to cure the malignancy. This article elaborates on complications of the chemotherapeutic agents, which when employed to combat cancerous cells, may target the host cells. The oral complications of such a therapy results in several conditions like oral mucositis, infections, hemorrhage, salivary alterations, dysgeusia, lichenoid reactions amongst others. Thus, an in-depth understanding of these complications is a must in order to provide better care for an already frail and ailing patient.

EVALUATION PATIENT'S QUALITY OF LIFE WHO HAVE PAINFUL AND PARESTETIC SYMPTOMS OF ORAL MUCOSA

2018 ◽  
Vol 20 (9) ◽  
pp. 57-61 ◽  
Author(s):  
E.G. Borisova ◽  
◽  
A.A. Komova ◽  
E.A. Nikitina ◽  
M.K. Pendyurina ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Oral Mucosa

Cytoprotective Agents to Avoid Chemotherapy Induced Sideeffects on Normal Cells: A Review

2019 ◽  
Vol 19 (10) ◽  
pp. 765-781
Author(s):  
Seema Rohilla ◽  
Harish Dureja ◽  
Vinay Chawla
Keyword(s):  
Adverse Effects ◽  
Anticancer Agents ◽  
Therapeutic Index ◽  
Chemotherapeutic Agents ◽  
Vital Role ◽  
Normal Cells ◽  
Normal Tissues ◽  
Organ Specific ◽  
Delay In Treatment

Anticancer agents play a vital role in the cure of patients suffering from malignancy. Though, the chemotherapeutic agents are associated with various adverse effects which produce significant toxic symptoms in the patients. But this therapy affects both the malignant and normal cells and leads to constricted therapeutic index of antimalignant drugs which adversely impacts the quality of patients’ life. Due to these adversities, sufficient dose of drug is not delivered to patients leading to delay in treatment or improper treatment. Chemoprotective agents have been developed either to minimize or to mitigate the toxicity allied with chemotherapeutic agents. Without any concession in the therapeutic efficacy of anticancer drugs, they provide organ specific guard to normal tissues.

Assessing Medical Evidence

2018 ◽  
Author(s):  
Jacob Stegenga
Keyword(s):  
Quality Assessment ◽  
Randomized Trials ◽  
Empirical Studies ◽  
Allocation Concealment ◽  
Assessment Tools ◽  
Medical Evidence ◽  
Empirical Methods ◽  
First Order ◽  
First Order Methods

Medical scientists employ ‘quality assessment tools’ to assess evidence from medical research, especially from randomized trials. These tools are designed to take into account methodological details of studies, including randomization, subject allocation concealment, and other features of studies deemed relevant to minimizing bias. There are dozens of such tools available. They differ widely from each other, and empirical studies show that they have low inter-rater reliability and low inter-tool reliability. This is an instance of a more general problem called here the underdetermination of evidential significance. Disagreements about the quality of evidence can be due to different—but in principle equally good—weightings of the methodological features that constitute quality assessment tools. Thus, the malleability of empirical research in medicine is deep: in addition to the malleability of first-order empirical methods, such as randomized trials, there is malleability in the tools used to evaluate first-order methods.

Evaluating Qualitative Research

2017 ◽  
Author(s):  
Jeasik Cho
Keyword(s):  
Qualitative Research ◽  
Large Scale ◽  
Academic Research ◽  
Research Community ◽  
Assessment Tools ◽  
Journal Articles ◽  
Journal Editors ◽  
The Past ◽  
Grant Proposals

This book provides the qualitative research community with some insight on how to evaluate the quality of qualitative research. This topic has gained little attention during the past few decades. We, qualitative researchers, read journal articles, serve on masters’ and doctoral committees, and also make decisions on whether conference proposals, manuscripts, or large-scale grant proposals should be accepted or rejected. It is assumed that various perspectives or criteria, depending on various paradigms, theories, or fields of discipline, have been used in assessing the quality of qualitative research. Nonetheless, until now, no textbook has been specifically devoted to exploring theories, practices, and reflections associated with the evaluation of qualitative research. This book constructs a typology of evaluating qualitative research, examines actual information from websites and qualitative journal editors, and reflects on some challenges that are currently encountered by the qualitative research community. Many different kinds of journals’ review guidelines and available assessment tools are collected and analyzed. Consequently, core criteria that stand out among these evaluation tools are presented. Readers are invited to join the author to confidently proclaim: “Fortunately, there are commonly agreed, bold standards for evaluating the goodness of qualitative research in the academic research community. These standards are a part of what is generally called ‘scientific research.’ ”

scholarly journals Evaluation of the efficacy of hearing aids in older adults: a multiparametric longitudinal study protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Domenico Cuda ◽  
Sara Ghiselli ◽  
Alessandra Murri
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Speech Perception ◽  
Hearing Aids ◽  
Assessment Tools ◽  
Elderly Subjects ◽  
Single Subject ◽  
Measurement Tools ◽  
First Time

Abstract Background Prevalence of hearing loss increases with age. Its estimated prevalence is 40–50 % in people over 75 years of age. Recent studies agree that declinein hearing threshold contribute to deterioration in sociality, sensitivity, cognition, and quality of life for elderly subjects. The aim of the study presented in this paper is to verify whether or not rehabilitation using first time applied Hearing Aids (HA) in a cohort of old people with hearing impairment improves both speech perception in a noisy environment over time and the overall health-related quality of life. Methods The monocentric, prospective, repeated measurements, single-subject, clinical observational study is to recruit 100 older adults, first-time HA recipients (≥ 65 years).The evaluation protocol is designed to analyze changes in specific measurement tools a year after the first HA usage in comparison with the evaluation before HA fitting. Evaluations will consist of multiparametric details collected through self-report questionnaires completed by the recipients and a series of commonly used audiometric measures and geriatric assessment tools. The primary indicator of changes in speech perception in noise to be used is the Italian version of Oldenburg Satz (OLSA) test whereas the indicator of changes in overall quality of life will be the Assessment of Quality of Life (AQoL) and Hearing Handicap Inventory for the Elderly (HHIE) questionnaires. The Montreal Cognitive Assessment (MoCA) will help in screening the cognitive state of the subjects. Discussion The protocol is designed to make use of measurement tools that have already been applied to the hearing-impaired population in order to compare the effects of HA rehabilitation in the older adults immediately before first HA usage (Pre) and after 1 year of experience (Post). This broad approach will lead to a greater understanding of how useful hearing influences the quality of life in older individuals, and therefore improves potentials for healthy aging. The data is to be analyzed by using an intrasubject endpoint comparison. Outcomes will be described and analyzed in detail. Trial registration This research was retrospectively registered underno. NCT04333043at ClinicalTrials.gov (http://www.clinicaltrials.gov/) on the 26 March 2020. This research has been registered with the Ethics Committee of the Area Vasta Emilia Nord under number 104, date of approval 17/07/2017.

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