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The frequency
and severity of cancer regimen-induced oral mucositis remains
a large and significant unmet need in the management of thousands
of patients with malignancies. Not only does mucositis cause great
symptomatic hardship, it also predisposes to local and systemic
infection and has a marked influence on a number of healthcare
outcomes. As a result of this need, there has been a great deal
of interest in the development of an effective intervention for
the condition.
The biology
of mucositis is still being determined. Initially thought of as
a one-step process in which epithelial stem cells were directly
destroyed by drug or radiation cancer therapy, it has become clear
that the pathogenesis of mucositis involves all cell types of
the oral mucosa and results from a complex series of interactive
molecular events. Furthermore, it is quite possible that patient
risk for mucositis is related, at least in part, to underlying
genetic factors.
The most significant
impediment to mucositis research is the lack of a uniformly accepted
scale to describe and measure the condition. This has led to conflicting
estimates of disease prevalence, an inability to adequately describe
risk factors for mucositis, and conflicting data on the efficacy
of potential interventions. The future of mucositis research,
however, is promising. Opportunities exist to investigate the
epidemiology and biology of the condition, as well as to conduct
clinical trials of possible new therapies.
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